1. How UK Private Medical Insurance (PMI) Works
Before diving in, it’s important to understand one key rule:
👉 You must always get pre-authorisation (pre-approval) before seeing a specialist or receiving treatment.
The typical process is:
Visit your GP and get a referral
Contact your insurer
The insurer:
Confirms your cover
Approves the claim
Provides a claim authorisation number
Depending on cover, help find who to see for further treatment
You attend your appointment
The specialist bills the insurer directly using this number
If applicable, you pay any excess directly to the provider
⚠️ If you skip pre-authorisation, your claim may not be covered.
2. If You Haven’t Started a Claim Yet
If you haven’t contacted your current insurer yet:
You have two options:
Option A: Start the claim before the switch
Contact your current insurer
Get pre-authorisation
Begin your treatment
Option B: Wait until the new insurer is live
Contact your new insurer
Start the process fresh under the new policy
3. If You Have an Ongoing Claim
If you are currently receiving treatment or have an approved claim:
You must act before your next appointment
Step-by-step:
Contact your new insurer as soon as possible
Do this before your next appointment or treatment
Tell them clearly:
This is an ongoing claim
What condition you are being treated for
Details of your specialist/hospital
Any previous authorisation details
The new insurer will:
Review your case
Confirm whether it’s covered under the new policy
Issue a new claim authorisation number
At your next appointment, provide:
New insurer name
Policy number
New claim number
4. What Happens Behind the Scenes (Helpful to Know)
Most UK policies are set up to continue ongoing treatment, provided:
The condition is covered
The treatment was already in progress
This is often referred to as “continuation of care”
👉 However, approval is not automatic, you must inform the new insurer.
5. What If You Forget to Contact the New Insurer?
If you attend treatment without updating your insurer:
The specialist may:
Not get paid
Contact you directly for payment
In some cases, escalate or threaten recovery action
If this happens:
Stay calm
Contact your new insurer immediately
Provide your new claim details to the provider
👉 This situation is usually fixable, but acting quickly is important.
6. Common Mistakes to Avoid
❌ Not getting pre-authorisation
❌ Assuming your old claim automatically transfers
❌ Attending appointments without updated insurer details
❌ Ignoring invoices or provider messages
7. Quick Checklist
Before your next appointment, make sure you have:
✅ Contacted your new insurer
✅ Confirmed cover
✅ Received a new claim number
✅ Shared updated details with your provider
8. Need Help?
If you’re unsure at any point or run into issues: