Understanding common insurance terms
Get more detailed explanations of our products in VitalityHealth’s Terms and Conditions or VitalityLife’s Plan Provisions document. Otherwise, contact us if you still have any questions.
A violent and visible injury directly caused by something accidental, outside the body. It does not include sickness, disease or any naturally occurring or deteriorating condition.
A type of alternative medicine that must be carried out by a member of the British Acupuncture Council, or the Acupuncture Association of Chartered Physiotherapists, or by a medical practitioner who holds a Certificate of Basic Competence or a Diploma of Medical Acupuncture issued by the British Medical Acupuncture Society and who is recognised by us.
A disease, illness or injury that is likely to respond quickly to treatment, which aims to return you to the state of health you were in immediately before suffering the disease, illness or injury; or which leads to your full recovery.
Acute flare-up of a chronic condition
A sudden and unexpected deterioration of a chronic condition likely to respond quickly to treatment that aims to restore you to your state of health immediately before suffering the acute flare-up. For example, we would cover eligible surgery following a heart attack that resulted from chronic heart disease. This does not include deterioration of a chronic condition where this is part of the normal progress of the illness, or recurring relapses of a chronic condition.
Annual renewal date
The date 12 months after the plan start date and each anniversary after that date.
A malignant tumour, tissues or cells, characterised by the uncontrolled growth and spread of malignant cells and invasion of tissue.
A consultation with, or a visit to, any medical practitioner about any medical condition or any signs and symptoms of a medical condition.
Diagnosis and treatment of disorders, diseases and deformities of the feet by a chiropodist/podiatrist. Treatment must be given by a practitioner who is registered with the Health and Care Professions Council (HCPC) and recognised by us.
A type of complementary medicine that must be carried out by a member of the General Chiropractic Council and who is recognised by us.
A disease, illness or injury that has one or more of the following characteristics:
- it needs ongoing or long-term monitoring through consultations, examinations, check-ups and/or tests
- it needs ongoing or long-term control or relief of symptoms
- it requires your rehabilitation or for you to be specially trained to cope with it
- it continues indefinitely
- it has no known cure
- it comes back or is likely to come back.
A clinical psychologist is a mental health professional trained in the diagnosis and psychological treatment of mental illness, who uses psychological techniques rather than medication to treat mental illness. Psychologists must be registered with the Health and Care Professions Council (HCPC) and be recognised by us.
A medical or dental practitioner recognised by us:
- whose name appears on the General Medical Council or General Dental Council specialist register and has a licence to practise, and
- who currently holds, or has held within the past five years, a substantive, non-locum appointment of consultant or senior lecturer status in an NHS or a Defence Medical Services hospital. Alternatively, if they do not hold a substantive NHS consultant post but can provide evidence of status and clinical experience which, in the opinion of VitalityHealth, is equivalent to that required for appointment to such a post and who has full practising privileges in a private hospital.
Cover start date
The date on which each insured person’s cover starts, as shown on your certificate of insurance.
Any care given in an Intensive Care Unit, Intensive Therapy Unit, Coronary Care Unit, High Dependency Unit, Paediatric Intensive Care Unit, Neonatal Intensive Care Unit, Special Care Baby Unit or similar level of care, wherever provided.
A patient who is admitted to a hospital or day-patient unit because they need a period of medically supervised recovery but does not occupy a bed overnight.
Dental procedures undertaken by your dental practitioner which are clinically necessary for the maintenance and/or restoration of oral health and are provided in accordance with accepted standards of dental practice.
Investigations, such as x-rays or blood tests, to find or to help find the cause of your symptoms.
A registered dietician who uses the science of nutrition to help in the treatment of medical conditions and promote good health and is recognised by us.
The taking of any non-prescription drug, substance or solvent, or misuse of a drug prescribed by a GP or consultant.
Excess - per claim
The maximum amount you’ll have to pay each time you or your insured dependants make a new claim for treatment covered by a plan. If treatment for the same condition has gone on for more than a year, we’ll treat any further treatment as a new claim after the anniversary of the claim and a further excess will be applied.
Excess - per plan year
The first amount which you must pay before we make any payment under a plan for treatment covered by the plan. You only need to pay one excess each plan year for each insured person. This excess resets at the beginning of each new plan year.
GP (General Practitioner)
A medical practitioner registered and licensed with the General Medical Council, whose name appears on the GP register.
Skilled nursing care provided by a qualified nurse. Home nursing must be supervised by an insured person’s consultant.
A type of alternative medicine that must be carried out by a member of The Faculty of Homeopathy, Society of Homeopaths or Alliance of Registered Homeopaths and is recognised by us.
Any hospital that is eligible under your plan.
A person who is admitted to hospital and who occupies a bed overnight or longer, for medical reasons.
- Your insured husband, wife or partner, who was aged between 16 and 79 at the plan start date or their cover start date (whichever applies to them) and who lives at the same address as you
- Your insured children (including adopted children), who must be aged 25 or under at their cover start date, unless you both joined us on a continued personal medical exclusion (switch) underwriting basis, in which case there was no upper joining age. Once accepted for cover, insured children will only be removed if requested by you (the planholder). Children aged 21 or over will be charged the adult rate. If they are aged 21 or over when they first join, the adult rate will apply immediately. Otherwise it will apply from the renewal date following their 21st birthday.
Medically underwritten/medical underwriting
The basis on which you’ve applied for cover and the process we use to decide the terms on which we’ll accept you and your insured dependants, based on the medical information we receive when you make your application.
A qualified nurse on the register of the Nursing and Midwifery Council (NMC) and holds a valid NMC personal identification number. Any treatment they provide must be under the supervision of a consultant recognised by us.
A type of alternative medicine that must be carried out by a member of the General Osteopathic Council (GOsC) who is recognised by us.
A person who attends a hospital, consulting room or out-patient clinic and is not admitted as a day-patient or an in-patient.
Treatment carried out by a person who is registered with the Health and Care Professions Council (HCPC) as a physiotherapist and who is recognised by us.
Plan start date
The date on which the plan began, as shown on your certificate of insurance.
A period of 12 months from the plan start date or from any annual renewal date.
The person who has a contract with us, as shown on the certificate of insurance.
Any sporting activity in which the planholder or insured dependant participates as their main paid occupation, as opposed to being an amateur or semi-professional.
A road vehicle built solely for use as an ambulance and run by a registered private ambulance service.
Medical services aimed at restoring a person’s function and independence, following eligible in-patient treatment of a disease, illness or injury.
Any symptom, disease, illness or injury which reasonable medical opinion considers to be associated with another symptom, disease, illness or injury. It may also be known as an ‘underlying cause’ and / or a ‘condition arising therefrom’.
Any sporting activity for which the planholder or insured dependant receives payment (beyond expenses) for participation, irrespective of results, but which is not their main occupation.
Surgical or medical services (including diagnostic tests) that are needed to diagnose, relieve or cure a disease, illness or injury.
Great Britain and Northern Ireland, including the Channel Islands and the Isle of Man.
A medical practitioner who you contact using our dedicated advice line or Vitality GP app.
Money we pay to you if you make a successful claim under the plan.
Date of expiry
The date a cover ends. The date of expiry of each of your covers is shown on the plan schedule.
A plan account that decreases in value over the life of the plan. It decreases in the same way as a repayment mortgage that has a 10% annual equivalent interest rate. If the plan is fixed term, you can choose to have a decreasing account. If you have Disability Cover, you can also choose for it to decrease in this way.
The period during which an insured person must be ill or disabled before we will pay any benefit.
Disability Cover pays one or more lump sums if you become disabled because of an accident or illness. You can be covered for several different categories of disability, from temporary disability that stops you working in the short term, to severe disability that affects you for the rest of your life.
Education Cover provides a range of benefits to cover the expenses associated with your child’s education.
Family income cover
Family Income Cover pays a regular monthly benefit for a fixed period of time if you die or are diagnosed with a terminal illness. If you have selected Family Income Cover that provides a benefit on diagnosis of a serious illness, a benefit will also be paid if you are diagnosed with a serious illness that we cover and that meets our definition of that condition.
The term of a cover is how long the cover lasts. A fixed term has a defined date of expiry.
Guaranteed Insurability options: Guaranteed Insurability options allow you to increase certain covers when particular events happen in your life, without giving us any more information about your health.
Income protection cover
Income Protection Cover pays you a regular income if you become incapacitated and cannot work, and your incapacity meets our definitions.
A plan account that is designed to increase in value on each plan anniversary. The increase is a percentage of the current plan account. This percentage will be equal to the Retail Prices Index that applies exactly five months before the plan anniversary, subject to a maximum of 10% and a minimum of 0%.
If you have Disability Cover or Income Protection Cover or Family Income Cover, you can also choose for any of these covers to increase in this way.
Joint life plan
A plan that provides cover for two people. We call these two people the first person covered and the second person covered.
Joint life first death
Life Cover where we pay the benefit when the first of the persons covered dies or is diagnosed with a terminal illness.
Joint life second death
Life Cover where we pay the benefit when the last of the persons covered dies or is diagnosed with a terminal illness.
A plan account that stays the same unless you make a successful claim or change a cover. If you have Disability Cover or Income Protection Cover, you can also choose one or both of these covers to stay level in this way.
A single identifiable event or condition that causes you to make a claim.
Life Cover pays a lump sum if the person covered dies, or is diagnosed with a terminal illness.
Minimum protected account option
If you make a successful claim under Serious Illness Cover or Optional Serious Illness Cover for Children, the Minimum Protected Account option tops up your plan account to a minimum level.
A trade, profession or type of work undertaken for profit or pay. It is not a specific job with any particular employer and is independent of location and availability.
Optional Serious Illness Cover for Children
Optional Serious Illness Cover for Children pays a lump sum if your child suffers from a serious illness that we cover.
The full-time occupation you had immediately before the start of the illness or injury (or incapacity for the purposes of Income Protection Cover).
The VitalityLife Plan, VitalityLife Essentials Plan or Mortgage Plus Plan.
The owner of the plan.
An amount that determines how much we can pay out if you make a claim under Life Cover, Serious Illness Cover or Optional Serious Illness Cover for Children. There are special rules for simultaneous claims under Serious Illness Cover.
The anniversary of the start date of the plan.
This is the total premium payable in respect of the covers in your plan. This does not include any fee which you may be charged for Vitality Plus or Vitality Optimiser.
A document that shows:
- The cover or covers in the plan
- The amount of each cover
- The premium for each cover
- The date of expiry of each cover, unless the cover is whole of life
- Any special conditions
A medical condition (whether or not a diagnosis was made or any symptoms were evident) which existed before any of these dates, as appropriate:
- The start date of the plan
- The start date of the relevant cover
- The relevant child reaching the age of one month (only for Optional Serious Illness Cover for Children, Core Serious Illness Cover for Children, Family Income Cover (Serious Illness Cover for Children) and Education Cover (Serious Illness Cover for Children)
- The legal adoption of the relevant child (only for Optional Serious Illness Cover for Children, Core Serious Illness Cover for Children, Family Income Cover (Serious Illness Cover for Children) and Education Cover (Serious Illness Cover for Children)
- The date that the plan is reinstated following non-payment of plan premiums
If you have Serious Illness Cover as well as Life Cover, you have the option to include Protected Life Cover in your plan. This means that your Life Cover will not reduce if you claim under Serious Illness Cover or Optional Serious Illness Cover for Children.
The Prudential Assurance Company Limited
Resident of the United Kingdom
A person who legally lives in the United Kingdom for at least 40 weeks in any 52 week period.
Retail prices index
The measure of UK inflation known as the Retail Prices Index (all items), as published by the Office for National Statistics. If the UK Government replaces that index with another index of UK retail price increases, we shall use that replacement index.
Serious Illness Cover
Serious Illness Cover pays a lump sum if you are diagnosed with an illness or condition that we cover and that meets our definition of that condition.
Single Life Plan
A plan that provides cover for one person only, referred to in this plan as the person covered. This does not include any cover provided for children.
The date when cover under the whole plan begins or, where relevant, when a particular cover begins.
The period after an insured event that the insured person has to survive before a claim becomes valid.
A definite diagnosis by the attending Consultant of an illness that satisfies both of the following:
- The illness either has no known cure or has progressed to the point where it cannot be cured
- In the opinion of the attending Consultant, the illness is expected to lead to death within 12 months
The process we use to assess your application to include or change a cover. Underwriting may lead us to:
- Accept your application
- Reject your application
- Amend one or more terms
Vitality Optimiser can be added to your VitalityLife plan for an additional premium each month. This gives you access to our exclusive reward partners, like discounted gym memberships and weekly cinema tickets. It also gives you an upfront discount on your protection premium (from 5-47%) and allows you to manage your premium in future years by looking after your health.
Vitality Plus is an upgrade option you can add to your VitalityLife plan which gives you access to annual cashback and additional rewards, like cinema tickets and monthly gym discount. Vitality Plus has an additional monthly fee.
A measure of your achievement toward getting healthy. There are four status levels: Bronze, Silver, Gold and Platinum. Your Vitality status depends on the recorded efforts that you make toward getting healthy between each plan anniversary.
Waiver of premium on death
This cover is only available if you have a joint life plan. Waiver of Premium on Death means that if one person covered dies or is diagnosed with a terminal illness, we stop charging plan premiums for the other person covered by your plan.
Waiver of premium on incapacity
Waiver of Premium on Incapacity means that if you become incapacitated, we stop charging the plan premium for your plan.
Waiver of premium on serious illness
Waiver of Premium on Serious illness means that if you get a serious illness that we class as severity A, we stop charging the plan premium for your plan.
Whole of life
The term of a cover that lasts from the covers start date to the death of the insured person for joint life first death or the death of both persons covered for joint life second death.
Active Rewards are what you get from Vitality for being active. To earn an Active Reward, you need to complete your online Health Review during the current plan year, and then earn Vitality points for getting active. Reach Gold or Platinum status and you’ll automatically get these rewards once you’ve completed your Health Review.
Our online calculator that assesses your lifestyle and risk factors to reveal your Vitality Age. We use what you tell us to set goals and suggest which of our partners can help you reach them.
Our scientific calculation that assesses the impact of your lifestyle on your health. Your Vitality Age may be higher or lower than your actual age.
A Vitality Healthcheck is a 30-minute check-up at a local pharmacy. It helps you understand your key health numbers in more detail, as well as offer expert advice on how to become healthier.
You can add this to your VitalityLife plan for an additional premium each month. It gives you access to exclusive rewards, like discounted gym membership and weekly cinema tickets. It also gives you an upfront discount on your protection premium (between 5 and 40%) and allows you to manage your premium in future years by looking after your health.
Third party providers we work with to give you discounts, cashback and rewards for getting healthier. These discounts, cashback and rewards can change over time as new opportunities and technologies arise. They’re also dependent on our relationship with third party providers and the range of services they offer.
For an additional monthly fee, Vitality Plus is an upgrade option you can add to your VitalityLife plan which gives you access to annual cashback and additional rewards, like cinema tickets. Vitality Plus can also be added to VitalityHealth Business and Corporate Healthcare plans for an additional monthly fee.
These are what you earn for healthy behaviour, like tracking your activity or taking a health check. They count towards your Vitality status. The more points you earn the higher your status and the bigger the rewards.
A measure of your achievement toward getting healthy. Everyone starts at Bronze and can move up to Silver, Gold and finally Platinum. Your Vitality status depends on the recorded efforts that you make toward getting healthy between each renewal.