Glossary of insurance terms

Accidental injury
An injury directly caused by something accidental, outside the body, violent and visible. It does not include sickness, disease or any naturally occurring or deteriorating condition. 

Acupuncture
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. 

Acute condition
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. 

Alcohol abuse
Alcohol dependence or hazardous drinking that results directly in harm to physical or mental health.

Annual renewal date
The date 12 months after the plan start date and each anniversary after that date. 

Cancer
A malignant tumour, tissues or cells, characterised by the uncontrolled growth and spread of malignant cells and invasion of tissue.

Check-up
A consultation with, or a visit to, any medical practitioner about any medical condition or any signs and symptoms of a medical condition. 

Chiropody/podiatry
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.

Chiropractic
A type of complementary medicine that must be carried out by a member of the General Chiropractic Council and who is recognised by us.

Chronic condition
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.

Clinical/Counselling psychologist
A clinical or counselling 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.

Consultant
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 membership certificate. 

Critical care
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, is considered critical care. 

Day-patient
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 treatment
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. 

Dental accident
A dental accident is a sudden unforeseen external blow to the face, teeth and jaws which occurs at an identifiable place and time and results in an injury to your teeth and gums.

Dental hygienist
A qualified dental hygienist registered with the General Dental Council.

Dentist
A dental practitioner who is registered with the General Dental Council in general practice.

Diagnostic tests
Investigations, such as x-rays or blood tests, to find or to help find the cause of your symptoms. 

Dietician
A registered dietician who uses the science of nutrition to help in the treatment of medical conditions and to promote good health and who is recognised by us. 

Drug abuse
The taking of any non-prescription drug, substance or solvent, or misuse of a drug prescribed by a GP or consultant.

Excess
The maximum amount you will have to pay towards your treatment. The excess can apply in one of two ways. Please refer to your membership certificate to see which one applies to you.

Excess per claim – you will pay the excess amount each time you claim for a new condition and have treatment covered by this plan. If treatment for that condition continues for more than 12 months, the excess will apply again to any further treatment after the anniversary of the claim.

Excess per plan year – you pay the excess on the first treatment (or treatments) that you have in the plan year. Only one excess is payable for each insured person in each plan year, regardless of how many conditions you claim for.

GP (General Practitioner) 
A medical practitioner registered and licensed with the General Medical Council, whose name appears on the GP register.

Home nursing
Skilled nursing care provided by a qualified nurse. Home nursing must be supervised by an insured person’s consultant. 

Homeopathy
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 who is recognised by us. 

Hospital
Any private hospital, or private wing of an NHS hospital, that is included on your hospital list or which we have agreed in advance you can attend. 

In-patient
A person who is admitted to hospital and who occupies a bed overnight or longer, for medical reasons. 

Insured dependant

• Your insured husband, wife or partner, who was aged between 18 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.

Nurse
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.

Osteopathy
A type of alternative medicine that must be carried out by a member of the General Osteopathic Council (GOsC) who is recognised by us.

Out-patient
A person who attends a hospital, consulting room or out-patient clinic and is not admitted as a day-patient or an in-patient. 

Physiotherapy
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 membership certificate.

Plan year
A period of 12 months from the plan start date or from any annual renewal date. 

Planholder
The person who has a contract with us, as shown on the membership certificate. 

Professional sports
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.

Private ambulance
A road vehicle built solely for use as an ambulance and run by a registered private ambulance service.

Rehabilitation
Medical services aimed at restoring a person’s function and independence, following eligible in-patient treatment of a disease, illness or injury. 

Related condition
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’. 

Semi-professional sports
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.

Treatment
Surgical or medical services (including diagnostic tests) that are needed to diagnose, relieve or cure a disease, illness or injury.

UK
Great Britain and Northern Ireland, including the Channel Islands and the Isle of Man.

Vitality GP
A medical practitioner who you contact using our dedicated advice line or Vitality GP app.

Benefit
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.

Decreasing account
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 specified equivalent interest rate. If the plan is fixed term, you can choose to have a decreasing account.

Deferred period
The period during which an insured person must be ill or disabled before we will pay any benefit.

Fixed term
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 insurance
Income Protection Cover pays you a regular income if you become incapacitated and cannot work, and your incapacity meets our definitions. Any annual increase in your cover will result in an increase in your Income Protection Cover premium.

Indexed account
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 Income Protection Cover or Family Income Cover, you can also choose for any of these covers to increase in this way.

Joint life insurance 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 insurance 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.

Level account
A plan account that stays the same unless you make a successful claim or change a cover. If you have Income Protection Cover, you can also choose one or both of these covers to stay level in this way.

Life-changing event
A single identifiable event or condition that causes you to make a claim.

Life cover
Life cover is another name for life insurance. It pays a lump sum if the person covered dies, or is diagnosed with a terminal illness.

Protected Cover
If you make a successful claim under Serious Illness Cover, the Protected Cover option tops up your plan account to it's original level. You can choose to protect just the Life Cover benefit or both the Life and Serious Illness Cover benefits.

Occupation
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.

Child Serious Illness Cover
Child Serious Illness Cover pays a lump sum if your child suffers from a serious illness that we cover.

Own occupation
The full-time occupation you had immediately before the start of the illness or injury (or incapacity for the purposes of Income Protection Cover).


Planholder
The owner of the plan.

Plan account
When you take out Life Cover, or Serious Illness Cover, or both, we set up a plan account for you.
For a single life plan, the amount of your plan account will be the same as your amount of Life Cover, if you have it. If you do not have Life Cover, the amount
of your plan account will be the same as your amount of Serious Illness Cover.
For a joint life plan, the amount of your plan account will be the same as the amount of Life Cover held by the first person covered. If they do not have
Life Cover, it will be the same as their amount of Serious Illness Cover.

The anniversary of the start date of the plan.

Plan premium
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 Optimiser.

Plan schedule
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

Pre-existing medical condition
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 Child Serious Illness Cover)
• The legal adoption of the relevant child only for Child Serious Illness Cover 
• The date that the plan is reinstated following non-payment of plan premiums

Protected life cover
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.

Resident of the United Kingdom
A person who legally lives in the United Kingdom for at least 183 days in any 365 day 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.

Start date
The date when cover under the whole plan begins or, where relevant, when a particular cover begins.

Survival period
The period after an insured event that the insured person has to survive before a claim becomes valid.

Term life insurance
Term life insurance gives you cover for a fixed term and pays out on death or terminal illness.

Terminal illness
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

Underwrite/underwriting
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
Vitality Optimiser can be added to your VitalityLife plan for an additional premium each month. This gives you access to our reward partners, like discounted gym membership and 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.

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.

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
Active Rewards are what you get from Vitality for being active. To earn an Active Reward, you need to complete your Health Profile during the current plan year, and then earn Vitality points for getting active each week. 

Health Profile
The home of your health. Answer a few questions about your health and unlock access to your rewards, too. Follow your personalised tips on how to get healthier and boost your wellbeing.

Vitality Age
Calculated using the results of your Health Profile on the Vitality Member app.

Vitality Healthcheck
An annual Vitality Healthcheck, through our partner Bluecrest, is available either as a face-to-face appointment or a virtual appointment. It helps you understand your key health numbers in more detail, as well as offer expert advice on how to become healthier.

Vitality partners
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.

Vitality Plus
For an additional monthly fee, Vitality Plus is an upgrade option you can add to your VitalityLife plan which gives you access to additional rewards, like cinema tickets. Vitality Plus can also be added to VitalityHealth Corporate Healthcare plans for an additional monthly fee.

Vitality points
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.

Vitality status
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.