Medical History Disregarded (MHD)
Medical history disregarded (MHD) is the underwriting basis for corporate group schemes in international health insurance under which the insurer waives any health assessment and covers employees' pre-existing conditions from day one; it is typically offered from a minimum group size of around 15 to 20 members and is the most expensive but most inclusive underwriting option.
Function
For corporate schemes of sufficient size, the insurer can price the risk on the group rather than the individual. Medical history disregarded means that neither a health questionnaire nor medical reports are obtained and that conditions existing before joining are not excluded – in contrast to full medical underwriting (permanent exclusion) and moratorium (time-limited exclusion). Pre-existing conditions and ongoing treatment are therefore covered from day one within the benefit schedule. The employer is also spared the sensitive collection of employees’ health data, and enrolling new joiners becomes a purely administrative act. The price is a premium well above that of FMU or moratorium groups, because the insurer cannot control anti-selection; UK market examples show roughly double the cost for the same group.
Requirements and Limits
MHD is available only for group contracts, not for individuals. The minimum size is typically around 15 to 20 insured employees; smaller companies are offered moratorium or FMU, sometimes with group-wide simplifications. The general exclusions of the wording, such as cosmetic procedures, continue to apply under MHD, and certain benefits such as maternity may carry waiting periods. Since MHD in international practice is often tied to compulsory membership of all eligible employees (“compulsory scheme”), the insurer protects itself against selection of only unhealthy members.
Practical Note
The main disadvantage becomes apparent on leaving: on transfer to an individual policy, MHD is not portable; the person is underwritten afresh unless the insurer offers a conversion right carrying over the existing terms or accepts continued personal medical exclusions. When changing the group insurer, it should likewise be clarified in advance whether the new insurer will continue MHD for the existing group.