If a National Friendly letter has put your My PMI premium up, start with how the policy is built, because the letter is not a renewal notice in the usual sense. National Friendly offers terms in five-year blocks, and what arrives each year is the outcome of a premium review inside that block. Its policy conditions list what that review takes into account, and that list is the thing to hold your letter against. The decision in front of you is whether to accept the new figure, change the excess, or see what other insurers would charge for similar cover; a broker can price that last option for you, and a few details in this page's form are enough for one to phone you, without charge. You can also go straight to National Friendly with the questions near the end of this page.
A premium review inside a five-year term
National Friendly's My PMI policy conditions set out the structure the rest depends on, on page 2:
"If you decide to take out a policy, we will offer you terms for 5 years at a time. Your premiums will be reviewed each year but will not be affected by your own claims history during the 5 year term."
— National Friendly, My PMI Policy Conditions, page 2. Neither this document nor the policy summary quoted below prints an issue date; both were read on 21 October 2026, and the documents that came with your own policy are the ones that bind you.
The policy summary says the same thing from the reader's side, and draws the consequence: it "means you do not need to renew each year and that we won’t add any special terms based on your claims experience during that period" (My PMI Policy Summary, page 3). So the rise on your letter is not the policy ending and being offered again. It is the price for the next policy year being reset inside terms you already hold.
Your own claims history is kept out; claims across similar policies are not
It is natural to assume that a rise follows a claim you made. On the page 2 wording it should not: premiums "will not be affected by your own claims history during the 5 year term". Within the term, that is a different arrangement from a no-claims discount scale, where a claim moves you down a level and your own record sets part of the price. For how claims and discount scales work more generally, see Claiming on private health insurance.
The review itself is described as covering a group of policies rather than yours alone:
"4.9 Each year we will review the premiums payable on all policies like yours to determine the new premium rates for these policies."
— My PMI Policy Conditions, page 18.
So the rates are set across "all policies like yours", and one of the inputs, listed below, is the expected claims on National Friendly's similar policies. Your own premium then takes account of things particular to you, such as your age, postcode area and excess. What the clause does not do is define which policies count as "like yours" or how many there are, and that is a fair question to put to National Friendly. The practical point holds either way: a rise can arrive in a year in which you made no claim at all.
What National Friendly says goes into the new premium
This is the clause to read against your letter. It is on page 18 of the conditions, set out as a list. Your premium for each policy year "will take into account":
- "The standard premium for your age and postcode area at the policy renewal date";
- "Any excess you choose";
- "The hospital/provider choice you make";
- "The expected future frequency and value of all claims paid on our similar private medical insurance policies"; and
- "Changes in other factors such as taxation, regulation, National Friendly’s costs or any other factor that we have reasonable grounds to believe will change the expected future profitability of these policies, as relevant to your policy, from the level anticipated when the premium rates were originally set."
— My PMI Policy Conditions, page 18, quoted item by item with the lead-in above.
Taking them in the order that is likeliest to explain a change:
Your age and postcode area on the policy renewal date
The first item is a standard premium for your age and your postcode area, taken at the policy renewal date. The clause gives no scale: it does not say how the standard premium varies with age or with area, or how much a year older adds. So it names two inputs you can check on your own letter, your age as National Friendly records it and your postcode, without telling you how much either contributes. That is the question to ask.
Other insurers put age in other words, and what they say belongs to them. AXA Health's renewal infographic (April 2025, page 1) says: "Healthcare costs increase as you get older and need more care – we factor this into your price." That is AXA Health's statement about its own pricing; the National Friendly wording quoted here deals with age only through the standard premium above.
The choices you made: excess and hospital list
The second and third items are things you chose, the excess and the hospital or provider choice. If either differs from last year's, for example because you asked for a change, part of the movement is yours. If neither changed, your own choices are not what moved; whether the price attached to them has moved is something National Friendly can tell you.
Expected claims across similar policies
The fourth item looks forward: the "expected future frequency and value" of claims paid on National Friendly's similar policies. It is an expectation, not last year's total, and it covers both how often claims are paid and what they cost. If you have heard rises put down to medical inflation, this is the closest item on the list, though the clause uses neither that phrase nor a figure.
Tax, regulation, costs and "any other factor"
The fifth item is the broad one. It allows for changes in taxation, regulation, National Friendly’s own costs, or anything else the society has "reasonable grounds to believe" will change the expected future profitability of the policies, measured against what was anticipated when the rates were first set. That wording gives National Friendly room, and it does not say how much of any rise belongs to which factor. The clause does not promise you a breakdown, but nothing stops you asking for one.
Insurance premium tax: a change that need not wait for the review
The factors above work on the annual cycle. Clause 4.1 does not wait for it:
"4.1 Premiums include insurance premium tax which is levied by the government and we may change your premium at any time to reflect any changes to the rate of insurance premium tax applicable to the policy. We will let you know in writing of any such change."
— My PMI Policy Conditions, page 17.
So a change tied to the tax rate could arrive on a different date from the review letter, and the clause promises written notice of it. It also says the premium already includes the tax, so the figure on your letter is not a pre-tax price. Our page on private health insurance and tax sets out the general position as we understand it, which is not tax advice. If your letter mentions a tax change, clause 4.1 is the one to hold it against.
When the letter comes, and what the review can do
The wording on timing is short. National Friendly "will write to you in good time before the first, second, third, and fourth anniversaries of your policy to tell you your new premium(s) for the following policy year" (conditions, page 18). The summary adds that the letter also serves "to remind you of the cover you hold" (summary, page 3). "In good time" is not a number of days, and the clause names four anniversaries, not five. What happens at the end of the five-year term, and when terms for the next block are offered, are questions for National Friendly, and a broker can also explain how a five-year block ends on a call-back that costs you nothing.
The review can also go the other way. Clause 4.11 says that "The annual premium review could result in your premium rising, falling or staying the same." That is not a forecast, but it does mean a higher figure is one of three outcomes the conditions describe, not a promised increase every year.
The option you get before the new premium starts
The same section gives you a choice about the excess:
"4.12 Before your new premium takes effect on the next policy anniversary, you have the option to choose whether to keep your excess at the same amount or to increase it, in order to help offset any rise in your new premium for the upcoming policy year. You will not be able to decrease your excess to a lower amount."
— My PMI Policy Conditions, page 18.
Two things stand out. The option is timed: it runs before the new premium takes effect on the anniversary, so a letter is a prompt to act, not a bill to file. And it only runs upward. National Friendly presents a higher excess as a way "to help offset any rise", but the clause gives no figure, so ask it for the new premium at each excess level before you choose. Because the excess cannot be brought down at this point, set it by what you could comfortably pay if you did claim. What is a private health insurance excess? explains how it works in a claim, and How much excess should you choose? takes the choice itself.
If the increase is large enough to make you weigh moving as well as adjusting, moving normally means being underwritten again, so read Your health insurance renewal price: what to do before you cancel anything.
Questions about a National Friendly premium rise
Did my premium go up because I made a claim?
On National Friendly's wording, not directly: the conditions keep your own claims history out of the premium during the five-year term. Expected claims across its similar policies do feed the review, which is why a rise can still come in a year when you did not claim.
Does moving house change what I pay?
The standard premium in the review is for your age and postcode area at the policy renewal date. A move part-way through a policy year is for National Friendly to price, so tell it the new address and ask whether and when the price changes.
Is National Friendly's yearly letter a renewal I have to accept?
The policy summary says that with terms offered for five years at a time you "do not need to renew each year". The letter tells you the premium for the following year. Whether it needs anything else from you beyond the excess option is something your letter should say, so check it for any date it gives.
Will National Friendly explain why the premium rose?
The clauses promise a letter with "your new premium(s) for the following policy year" and, where the tax rate changes, a written notice. Neither promises a breakdown by factor, so asking for one is reasonable.
What to put to National Friendly, and to a broker
- Is any of this rise because of my age or my postcode area, and what were last year's and this year's standard premiums for me?
- Has anything about my excess or my hospital choice changed from last year?
- What is the new premium at each excess I could choose before the anniversary, and by what date must I decide?
- Which policies are treated as like mine in the review, and how is the expected change in claims reflected in my figure?
- Does any part of the rise reflect a change in insurance premium tax, and have you written to me about that separately?
- What happens at the end of my five-year term?
National Friendly holds the answers about your own policy, so those six go to it, ideally in writing. Comparing that figure with other insurers' charges for similar cover begins with the form here; a broker authorised by the FCA phones back and you pay nothing.