A second opinion on the international insurance cover you already hold
Bring the policy. We read what you already hold, clause by clause, against the life you are living now — and put the answer in writing. Often the answer is: keep everything.
What a second opinion is here
The written answer is often keep everything.
A second opinion is a review of policies you already hold, done by an adviser who was not involved in selling them. We read the wording rather than the brochure, against your current life rather than the one the policy was underwritten for, and every finding is sourced to the clause it came from — so you can check the checking.
That is the whole proposition, and the least commercial sentence in it is the one that matters. A meaningful share of these reviews end with keep everything, change nothing. An older policy, bought young and held without a break, is often unbeatable — not because it was brilliantly chosen, but because it was underwritten against a younger version of you, and that person is no longer available for a new insurer to meet.
Switching costs in insurance are not fees. They are fresh questions about health that has aged since you last answered them. The strongest position in the whole market is frequently the one you are already standing in, and the only adviser who will tell you so is one whose review does not have to end in a sale.
It is the same discipline as a medical second opinion: not a new prescription by default, but a careful check on the existing one.
Who brings us a policy
Bought in a hurry, on someone else's advice.
The person this page is written for already has cover. It was usually arranged quickly — in the weeks around a move, an offer letter, a visa deadline — and usually on the recommendation of someone with a stake in which product was chosen: an employer's appointed intermediary, a relocation agent, an insurer's own sales desk, a colleague who bought the same thing two years earlier and has not read it either.
None of that makes the policy bad. It makes it unread. Nobody has looked at it since the day it was signed, and the life around it has moved. A child arrived and was assumed onto the policy rather than added to it. A job changed. A country changed. An employer plan appeared and quietly duplicated half of what you pay for privately. The premium that was priced for a thirty-four-year-old started climbing a curve nobody showed you at purchase.
None of this is scandal. It is entropy. Policies do not maintain themselves, and the person who sold you one has no particular reason to revisit it. An insurance policy is a photograph of your life on the day you bought it, and it goes on behaving as though the photograph were still true.
So if there is a document in a drawer somewhere that was written in another country, in another year, for another version of your life — that is the one to bring.
What we actually read
Four things decide whether a policy pays or fights.
We read the wording, not the brochure — and these four in this order, because each answer changes what the next question means.
The underwriting basis
What the insurer was told about you on the day the policy was written, and what it concluded. Personal endorsements — a named condition, a named body part, a loading — are built from your own application form, which is why they are the section people are most surprised to find. Anything time-limited should carry its expiry. Anything permanent should say so plainly.
How renewal is priced
What the premium has done since you bought it, and what it will do at fifty-five. Whether renewal is guaranteed at standard terms, or whether the insurer keeps the right to re-underwrite you or leave the market. A policy is a decades-long relationship and the renewal clause is its character — it reads as administrative at thirty-five and turns out to be the whole policy at sixty.
The exclusions, as written
Not as remembered. What was accepted at purchase, what attached itself at an upgrade, which waiting periods started again when you changed plan, and what a condition that has developed since would mean under these terms — set against what it would mean to a new insurer's questionnaire. The gap between those two answers is usually the reason to stay put.
What the schedule says about claim day
The area of cover against where you actually live and travel. Who is genuinely named on the policy, with dates, rather than assumed onto it. The annual ceiling, read against the most expensive place you could plausibly be treated. The cap on your own share. And who decides, and who pays, if you have to be moved. These are the lines a claims assessor reads, and almost nobody else does.
Most problems live in the gap between the life the policy was written for and the life being lived now. None of the four questions above can be answered from a benefits table, which is the document almost everyone reads and the one that decides almost nothing.
What arrives
The answer is a document.
Forty-five minutes, by video, in English, with your documents open on the table. Nothing is placed, signed or quoted on the call.
One working day later the Private Client Report arrives — around twelve pages: what you hold, restated in one register; where the exposure actually sits; what we would change and why, with what we considered and rejected; and, where the cover is right, the recommendation to change nothing.
It is yours either way. Whether you act on it, take it to another adviser, or hand it to your company's finance team, the document belongs to you and nothing in it is written to be unusable without us.
What a written opinion is worth
Elsewhere, the document has a price.
The Cleveland Clinic charges $1,690 for a written second opinion. Ours comes with the review, and there is no fee for it.
We keep quoting that figure because it is the closest like-for-like the market offers. Medicine worked out long ago that a second reading of an existing case, by someone with no stake in the first one, is a product in its own right — with a name, a stated turnaround and a price on it. Specialist second-opinion services price a report-only opinion in the four figures and publish the window it arrives in.
Insurance never did. In this category the equivalent is a sales call, and the written artefact does not exist at all. That is the only reason this page needs to be written: not because a document is unusual, but because here, apparently, it is.
How this is paid for
Free, and the reason is structural.
The review is free and the report is free. That is not generosity. It is how we earn the right to arrange what the report recommends, on the days it recommends arranging anything.
International cover is placed on a courtage basis: when a policy is placed, the insurer pays a percentage of the premium. A review that ends in keep everything places nothing, so nothing is owed by anyone. We publish that asymmetry deliberately — a written finding that costs us the work and pays us nothing is the loudest available proof that the advice is not a sales channel.
It is also the thing a comparison site or an insurer's own free review structurally cannot offer, because their economics need the funnel to end in a switch. Ours does not need it to end in anything at all.
And when it is not
Sometimes the reading finds the other thing.
The gap each policy assumed the other one was covering. The exclusion that did not matter at thirty-two and matters now. The premium about to climb a cliff. Cover attached to a job, a residence permit or a mortgage, which ends the month that thing ends — worth exactly the remaining length of the contract it hangs from, and a surprising share of a mobile household's protection turns out to be borrowed in that way rather than owned.
When that happens the second opinion becomes an ordinary review with a recommendation attached: what we would change, what it costs, what it replaces, and what we weighed it against. If a recommendation cannot survive its reasoning being shown, it does not go in the report.
Then you decide, or you don't. Nothing has to change afterwards. Either way you end up holding something you did not have before — a current photograph of what you are actually covered for, in writing, with the clauses attached.
Before you book
Read the method first.
Everything this review does is written down somewhere on this site, and none of it is behind a form. The long version of the argument on this page — what a second opinion checks, in what order, and why so many end in keep everything — is in the journal piece it grew from.
If you would rather do the first pass yourself, start with the nine lines of a policy schedule — fifteen minutes, and it is the same reading order we use. Then what "worldwide" actually means, because the geography line is where cover fails outright rather than merely narrowly.
And the counter-case, in our own words: when not to buy international health insurance at all. It is the same discipline pointed at a purchase instead of a policy, and it is the piece we would want read by anyone deciding whether this practice is worth their afternoon.
Common questions
Questions people ask before bringing a policy.
What is a second opinion on insurance cover?
A review of the policies you already hold, carried out by an adviser who had no part in selling them. We read the wording clause by clause against your current life, and you receive a written account of what the cover does, what it does not, and whether anything should change. It is the same discipline as a medical second opinion — a check on the existing prescription rather than a new one by default.
Will you try to replace the cover I already have?
Often not, and the reason is structural rather than polite. New cover means new underwriting, which means answering health questions as whoever you are today rather than whoever you were when you first applied. A well-built older policy held without a break is frequently the strongest position available, and the report says keep what you have regularly. We are paid only when a policy is placed, which is exactly why that recommendation is the one worth listening to.
What do you read first in a policy I already hold?
Four things, in this order: the underwriting basis — what the insurer was told and what it concluded, including any exclusion or loading endorsed onto you personally; how renewal is priced, and whether it is guaranteed at standard terms; the exclusions and waiting periods as written rather than as remembered; and what the schedule says happens on the day a claim is filed — area of cover, who is genuinely named, the annual ceiling, and the cap on your own share.
Is there a fee for the second opinion?
No. The review is free, the Private Client Report is free, and the report is yours either way. International cover is placed on a courtage basis: the insurer pays a percentage of the premium when a policy is placed. If the reading ends in keep everything, nothing is placed and nothing is owed.
How long does it take, and what do you need from me?
Forty-five minutes by video, in English, and the documents themselves. Right after you book we email a short intake form — where you are, where you are going, who is with you, what you already hold. The two documents worth digging out are the policy schedule and the policy wording; the brochure is the one that answers least. The report follows within one working day of the consultation.
Why you can trust us
Independent by structure, not by adjective.
Comparison sites are paid by the insurers they list. Captive agents represent one carrier. Neither of those is independent, however the homepage words it.
Here is our structure, plainly. International cover is placed through SIP Medical Family Office — independent consultants in health management and international medical insurance, established in Switzerland since 1997, whose group companies are licensed as medical insurance intermediaries for the EU/EEA and the United Kingdom. We hold no insurance licences of our own, and that arrangement covers Switzerland, European Union, United Kingdom.
Working under a principal's licences is ordinary in this industry and rarely admitted. We say it in the first paragraph because the alternative — letting you assume we hold our own paper — is the kind of small omission this page exists to argue against. We hold no exclusive arrangement with any insurer, and no insurer owns any part of this business.
Here's the mechanism, because "independent" is easy to write and hard to check. International cover is placed on a courtage basis: the insurer pays a percentage of the premium when a policy is placed. It is a percentage of the premium, which means we have no reason to sell you more cover than you need and no reason to steer you towards the most expensive plan. What we do have a reason to do is place you well — because we review your cover with you every year, for as long as you're our client, and a policy that turns out to be wrong is our problem too.
Check it rather than take our word for it. The entries are SIP's, not ours — we hold no licence of our own to look up: FINMA intermediary register — Switzerland · FMA register — Liechtenstein, SIP Europe AG licence 10116 · FCA register — United Kingdom. The full arrangement is set out on our about page.
Ready for a calm conversation about cover?
A first review is free — 45 minutes, in English, wherever in the world you happen to be. We'll listen first. Then you'll hear exactly what we would arrange if the situation were ours. What you do with that is yours to decide.
Book a reviewOr write to hello@expatsavvy.com — we reply within the working day.