In this blog our Account Executive, Gil Okai, explains the function of Private Medical Insurance. It’s a great way for organisations to build resilience as well as supporting, caring for and protecting their people.

Private Medical Insurance (PMI) provides early diagnosis and then immediate medical care for acute conditions: the right treatment, exactly when it is needed most.

PMI is not suited to the management of existing or chronic conditions although there are circumstances where assistance can be provided.

The primary function is to facilitate rapid recovery from illness and reduce the impact of NHS waiting lists.

The core features of a PMI policy usually include:

  • Immediate triage
  • Early diagnosis consultation
  • Fast-Track for medical care and elective surgery
  • Cancer care priority cover with end to end treatment programme
  • Mental health priority – Employee Assistance programme
  • Dental care
  • Foreign business travel
  • Medical appointments and routine screenings
  • Comfortable private recovery and therapy
  • Lifestyle benefits & Bonuses

The main benefits of a PMI policy are therefore:

  • Appropriate recovery and fast return to work – increased staff attendance levels
  • Reduced trauma and stress waiting for treatment – waiting for care can be stressful and painful for a patient nursing an untreated condition
  • Reduced absence costs
  • Reduced “presenteeism” – working while sick or unfit for task
  • Morale benefits – Long term staff retention
  • Positive attraction to new recruits

PMI gives access to immediate triage for acute conditions, immediate specialist consultations when care is needed and a fast track approach to elective surgical procedures.  Because efficiency is at the heart of PMI there are provisions to ensure that the most appropriate treatment is available. Options therefore exist to ensure that all suitable medicines are available to the patient thereby avoiding postcode lotteries associated with the high cost of certain effective solutions. In the same way there is degree of choice over medical practitioner and also hospital used for treatment. This facilitates convenience of access as well as selection of the best people to provide the best care.

There are, however, some limitations that can apply to PMI policies:

  • Any condition that has presented symptoms or received treatment in the last five years is usually excluded for two years before being covered by a new plan.
  • Existing issues can continue to be covered by NHS provision.

Reasons to consider a PMI policy:

  • Sole trader – you are your business.  Anything that can accelerate recovery from ill-health and get you back to work generating earnings can be valuable. As well as personal cover, options are available to extend the same service to cover a spouse and dependent children.
  • Organisations – key personnel. These are the drivers of the organisation or those whose contribution is most difficult to replace. This can include:
    • Business leaders and managers
    • Licence holders, certified and professionally qualified persons
    • Specialist technicians
    • Highly skilled persons or those with knowledge capital or key accounts

Cover for the key persons in the business aims to return those individuals who are have the most impact on the business.

As well as reducing direct cost to the business through lost production, there are the added benefits from reduced absenteeism.

The availability of private medical health care is seen as highly attractive especially to professionals and therefore can be a key draw when looking to recruit key personnel.

Protecting your bottom line – whether your organisation is commercial enterprise or a third sector organisation, cost is a major consideration. Arranging PMI insurance can work effectively as part of a wider risk management strategy to manage costs relating to absenteeism.

Aside from all the pragmatic, financial and business-focused arguments for considering PMI cover for your organisation, it is also a really practical and impactful way to show care, support and concern for your team and their loved ones when they really need it.


Talbot Jones Ltd is a community-focused commercial insurance brokerage based in Gateshead but working nationally. If you would like more information about PMI do get in touch with Gil at or on 0191 917 0330.