January 2026

In recent months, a number of private physiotherapy clinics across the UK have experienced changes in how AXA-PPP authorises and funds physiotherapy treatment under private medical insurance policies. Many patients understandably assume that having “unlimited” physiotherapy cover means they can attend sessions until they feel fully recovered. However, the reality is more complex and depends on policy terms, authorisation rules and how insurers interpret ongoing care.

AXA-PPP policies and provider agreements typically include defined treatment limits or outpatient financial caps for therapies such as physiotherapy. Depending on the individual plan, this may be expressed as a maximum number of sessions per condition, or as a total annual cost limit for outpatient therapies. Additional sessions may sometimes be requested, but these must be authorised in advance and are subject to underwriting criteria and benefit rules.

More recently, concerns have arisen around how AXA-PPP applies “ongoing or chronic condition” definitions to treatment episodes that extend beyond an expected average number of sessions. Where treatment numbers rise above insurer expectations, this may be interpreted as management of a long-term or recurrent condition rather than an acute, short-term issue. Under AXA’s policy definitions, chronic conditions are commonly excluded from cover unless specific medical evidence demonstrates otherwise.

The key issue is often not whether treatment is described as “limited” or “unlimited”, but how insurers interpret terms such as acute, chronic, ongoing treatment and clinical necessity. Insurers and dispute bodies may review patterns of care when determining eligibility for continued funding, and this can directly influence the number of sessions approved.

For physiotherapy clinics, this creates practical challenges. Where treatment averages exceed insurer expectations (currently around 5.5 sessions per patient under AXA’s benchmarking), clinics may risk investigation, suspension of recognition or deregistration if data suggests over-utilisation compared to underwriting assumptions. For patients, this can understandably feel confusing, particularly where they believed their policy provided unrestricted access to treatment.

What Patients Can Do

• Review the exact wording of your AXA-PPP policy, particularly sections relating to outpatient therapy limits, chronic condition exclusions and pre-authorisation requirements.
• Before booking additional sessions, always check directly with AXA whether further treatment is covered and obtain written authorisation where required.
• If you wish to continue treatment beyond 10 sessions, you may request written confirmation from AXA that your clinic will not be penalised for providing additional sessions under your policy.
• If you disagree with a decision to stop funding treatment, you have the right to raise a formal complaint with AXA and, if unresolved, escalate the matter to the Financial Ombudsman Service for independent review.

What Patients Need to Be Aware Of

• Surrey Physio Group clinics must comply with insurer recognition rules and benchmarking requirements. We are required to work within an average session threshold set by AXA.
• To protect our recognition status, we are unable to provide treatment beyond 10 sessions under AXA-funded care.

Why We Are Sorry

This situation is not determined by our clinical teams, but we must comply with the contractual rules set by insurance providers. We understand this may place patients in a difficult position if they feel further treatment is required. It also places our therapists in challenging circumstances when clinical judgement and insurance limits do not align.

Private medical insurance can be a valuable way to access timely care, but it operates within a contractual framework between insurer and policyholder. We appreciate your understanding and continued support.

Reference: Physio First Bulletin, 9 January 2026