Guide · Insurer reports

Requesting further sessions from a health insurer: what to prepare

Last reviewed 12 October 2026 · 7 min read

An extension request asks a client's private health insurer to fund therapy sessions beyond the ones already pre-authorised. Bupa's published terms for recognised therapists (February 2020 version) ask for your assessment of the client's condition and a clear treatment plan before any extra sessions are delivered. Other insurers publish less, so your own recognition terms decide the format.

• Who decidesThe insurer, under the client's policy
• What Bupa asks forYour assessment and a clear treatment plan
• WhenBefore the additional sessions take place
• ConsentExplicit client consent for each report you share

How insurer authorisation works

In our experience and in Bupa's published terms, UK private medical insurers fund talking therapy in blocks. The client gets a pre-authorisation for a number of sessions, you deliver them and you invoice against the authorisation number. When the block is nearly used and further sessions seem clinically sensible, you ask for more. The insurer decides what the policy funds. Your report or call gives the case manager the clinical picture behind the request.

Plan the request before the last authorised session. A gap between the end of one block and the next authorisation means either a pause in therapy or sessions the client may have to pay for personally.

What Bupa's published terms say

Bupa's terms and conditions for recognised mental health therapists set out the process. If you want to deliver more sessions than Bupa has pre-authorised, you agree to contact Bupa's Mental Wellbeing Support Team before delivering them, to "provide them with your assessment of the Member's condition together with a clear treatment plan", and to obtain confirmation of how many additional sessions Bupa will fund. To go beyond that number, you repeat the process.

The same terms ask that each course of therapy has a plan that is "focussed and has short term expected outcomes and, if applicable, includes goals and objectives", and that you can store client records securely for more than seven years.

AXA Health, Aviva, Vitality and others

Unverified We could not find current public documents from AXA Health, Aviva, Vitality, WPA or Cigna that describe their extension process for therapists. Therapists commonly describe a short progress report or a portal form after a block of sessions, often with outcome scores such as PHQ-9, GAD-7 or CORE-10. Treat this as a starting point and follow the instructions in your own recognition agreement or in the request you receive.

A structure that answers the usual questions

Whatever the format, in our experience requests tend to cover the same seven things. The same order works as speaking notes for a phone call.

1. Client and authorisation details. Client reference or name as the insurer requires, membership and authorisation numbers, sessions authorised, sessions used, dates.
2. Presenting difficulties. What brought the client to therapy, in plain words, as recorded at assessment.
3. Your assessment of the current condition. Your own clinical view today. This part is yours to write.
4. Treatment plan and goals. The approach, each goal, and how you and the client will know it has been met.
5. Progress to date. What has changed and what has not, with concrete examples from dated session notes.
6. Outcome measures. Instrument, raw score and date, at the start and now. Report the numbers; the interpretation is yours.
7. Sessions requested and rationale. How many further sessions, at what frequency, and why that number fits the goals that remain open.

Write progress so that it can be checked

Specific sentences are quicker for a case manager to read and easier for you to stand behind if the report is looked at again later. Include what has not changed. Record open goals accurately; they bear on the number of sessions you request.

Consent before you share

A progress report to an insurer contains health information, which is special category data under UK GDPR. The safe practice is to ask for the client's explicit consent for each report and to record it: date, insurer, what was shared. A general consent given when the policy was taken out does not settle your own duty of confidentiality. Share what the insurer needs for the funding decision and nothing more. Our guide on letters to a client's GP applies the same principles to GP updates.

Points worth checking to avoid delays

• The request is made after the authorised sessions are used up.
• The authorisation or membership number is missing or wrong.
• Scores are given without dates, or a measure used at the start is not repeated.
• Goals do not match the difficulties described earlier in the report.
• The number of sessions requested has no visible link to what remains to be done.

Before you send, run through the free insurer extension report checklist. It prints on one or two pages.