Not Fit to Fly Certificate - Unable to Fly Medical Letter
An unable to fly due to medical reasons letter is an official document from a GMC-registered doctor confirming you cannot travel by air due to illness, injury, or a medical condition.
Airlines, travel insurers, and holiday providers require a not fit to fly certificate when processing cancellation claims or issuing refunds, a standard GP letter is rarely sufficient.
✔ Accepted by airlines, travel insurers and holiday providers.
✔ Covers illness, injury, post-surgery and pregnancy complications.
✔ Most Same day or by 9AM next morning. From £39
✔ Full refund if the GP cannot issue.
Get my certificate 
Dr Maria Knobel Medical Director 
Receive a full refund if we can’t provide a certificate
How It Works
Complete a short online questionnaire
No appointment required. Complete a short medical questionnaire and upload any supporting evidence.
Doctor reviews your evidence
A GMC-registered doctor reviews your submission individually. No automated approvals.
✔ Full refund if the GP cannot issue.
Receive your certificate
Certificates arrive most same day, all by 9AM next morning, delivered as a signed PDF direct to your inbox.
Very happy, I ordered my Medical Certificate in the early morning hours and before noon time of same day I had it on my inbox. Speedy service and they present the health condition precisely, get to the point.
They meet the incredibly fast turnaround stated (certificate/letter sent before 9am the following morning if the doctor feels that a letter/certificate is appropriate) which is incredibly quick and I am really grateful for the help provided!
Very easy and quick to get my certificate. And the certificate was approved from the specific company to travel with my dog. I will use them again. Well done.
Second time using this company and they are fabulous! Always great, fast, friendly service. Highly recommend!
This was my second time using Medical Cert, and once again the service was exceptionally quick and professional. Everything was handled efficiently, with clear communication throughout.
I found the service very straight forward and quick. Exactly what I needed to get my Padi medical form signed before our holiday. Thank you very much.
Process was easy and responses were quick. I would recommend their service.
Fast efficient service for medical certificates. I used the not fit to fly service and was provided with a certificate the next day, the price is very reasonable and enabled a flight credit refund with my airline. Would recommend and would use again if needed.
A fast and efficient service. It wasn't complicated and the Fit-to-fly note was accepted by the Airport without any further questions. Thank you.
Ideal for me, I am looking to get a certificate for some medical issues I have. So this is the perfect solution for me, uploading docs was easy and the forms very straightforward to fill in. Will definitely use them again. Many thanks.
Excellent service. Easy to use and certificate issued in less than 24 hours. £39 as opposed to the £150 my GP charges. Highly recommended.
Quick and reasonably pain-free. Received their standard certificate as well as my requested bespoke certificate, by email, by 9am the following morning. Both completed properly, signed and stamped as required. More expensive than my GP, but infinitely quicker and easier.
One of the best experiences. It's easy to get a GP note.
Excellent. My GP refuses to issue DWP MED 3 Fit Notes to students. MedicalCert were excellent and extremely helpful in providing a necessary certificate. Highly recommended.
You were amazing, you kept me updated and replied promptly to any queries I had. I thank you from the bottom of my heart.
They helped me, they were very professional and nice.
Very pleased. Quick service with very professional letter provided.
Great service, pretty straight forward and easy to use the website.
I was recommended Medical Cert by a friend and was so impressed with the service received. I would recommend using a laptop rather than a phone. Overall a fantastic and fast service.
Unable to Fly Due to Medical Reasons Letter
Yes, you can get a not fit to fly certificate online in the UK. An unable to fly due to medical reasons letter, also called a not fit to fly certificate or unfit to travel certificate, is a doctor-signed document confirming that a patient was medically unable to travel by air at the time of assessment. Airlines, travel insurers, and holiday providers require this letter to process refund, rebooking, or cancellation claims on medical grounds.
MedicalCert issues not fit to fly letters signed by GMC-registered UK doctors, delivered same day as a signed PDF with QR verification code. Every case is individually reviewed. No automated approvals. If the doctor cannot issue the letter on clinical grounds, you receive a full refund.
Fit to Fly vs Not Fit to Fly, Which Do You Need?
These two documents serve opposite purposes. Choosing the wrong one will delay your claim.
✈ Fit to Fly Certificate
- → Confirms you ARE medically safe to travel
- → Presented at check-in to allow boarding
- → Used for pregnancy, post-surgery, stable conditions
🚫 Not Fit to Fly Letter
- → Confirms you were UNABLE to travel for medical reasons
- → Submitted to airline or insurer after missing a flight
- → Used to support refund, rebooking, or insurance claim
If you have already missed your flight or holiday due to illness, this is the document you need. If you need clearance to board a flight despite a medical condition, see our fit to fly certificate.
Can You Get a Not Fit to Fly Certificate from the NHS?
No. The NHS does not routinely issue not fit to fly certificates. Most NHS GP practices classify these as private medical services and either decline to issue them or charge a private fee with a waiting time of one to three weeks. The British Medical Association (BMA) confirms that GPs are not contractually obligated to provide travel-related medical letters under their NHS contract.
❌ NHS GP route
- → Most practices decline or classify as private
- → Typical wait: 1 to 3 weeks for an appointment
- → Private fee if they agree: £25 to £80+
- → No standardised format for insurers
- → Not covered by NHS contract
✔ MedicalCert (private, online)
- → Available same day, no appointment needed
- → GMC-registered doctors, same clinical standard
- → £39, fixed price, no hidden fees
- → QR-verified format accepted by insurers
- → Full refund if the doctor cannot issue
Both NHS GPs and private online doctors hold the same GMC registration and follow the same General Medical Council professional standards. The clinical validity of the letter is identical. The difference is speed, availability, and format.
When Is an Unable to Fly Letter Used?
Airline refund or rebooking
Airlines distinguish voluntary cancellations from medically necessary ones. A doctor's letter may support a request to waive change fees or obtain a partial refund, subject to each airline's medical cancellation policy.
Travel insurance claim
Most travel insurance policies require medical evidence before processing a cancellation claim. The insurer requires a letter dated close to the flight date, confirming the condition and that travel was clinically inadvisable.
Package holiday provider
Holiday providers and travel agents typically require the same documentation as insurers to release a rebooking or credit. A letter issued promptly is more effective than one obtained retrospectively.
Cruise cancellation
Cruise operators follow similar requirements to airlines. A certificate that covers sea travel as well as air travel is useful where the booking involves a cruise. See also our travel cancellation certificate.
Visa or travel obligation
If a medical condition prevented attendance at a scheduled visa appointment or mandatory international commitment, a doctor's letter confirms the legitimate reason for non-attendance.
Work or academic travel
Employers or educational institutions may require documentation if illness disrupted a required business trip, conference, or international study placement.
Airline Medical Cancellation Policies
Each airline handles medical cancellations differently. The table below summarises the general approach of major UK carriers. Policies change, so always check the airline's current terms before submitting your letter.
| Airline | Medical cancellation approach | Notes |
|---|---|---|
| British Airways | May waive rebooking fees or offer a travel voucher with medical evidence. Requires a letter from a registered doctor. | Submit via ba.com "Manage My Booking" or email medicaldocs@ba.com |
| TUI | Package holiday cancellation assessed on a case-by-case basis. Medical documentation required for any refund or rebooking outside standard cancellation terms. | Contact TUI customer service with medical letter and booking reference |
| easyJet | No automatic refund for medical cancellation on standard fares. Travel insurance is the primary route. Medical declaration form available for some situations. | easyJet medical declaration form may be required alongside your letter |
| Jet2 | Compassionate policy available for serious illness. May offer rebooking or credit depending on circumstances and fare type. | Submit medical letter via Jet2 customer care with booking details |
| Ryanair | No-refund policy on most fares regardless of reason. Travel insurance is the recommended route. Medical letters support insurance claims rather than direct airline refunds. | Ryanair does not process medical cancellations directly in most cases |
| Emirates | Medical cancellation waiver may apply on higher fare classes. Requires a doctor's letter confirming unfitness to fly on the specific date. | Submit via Emirates contact centre or airport office |
Regardless of the airline's policy, a not fit to fly letter supports your travel insurance claim. Even where the airline cannot offer a direct refund, your insurer may reimburse the unrecovered cost if your policy includes cancellation cover for illness.
What Medical Conditions Make You Unfit to Fly?
A wide range of conditions can make air travel medically inadvisable. The Civil Aviation Authority (CAA) and individual airlines set their own guidance, but the decision to issue a not fit to fly letter rests with the assessing doctor based on the clinical picture at the time. Common examples include:
Each case is assessed on its clinical merits. The letter will not contain exaggerated claims. It reflects an honest assessment of the information and evidence provided. The CAA publishes guidance on medical fitness to fly, and airlines may have additional restrictions for specific conditions.
Important: Refunds Are Not Guaranteed
Understand what this letter does and does not do
A not fit to fly letter supports your submission to an airline or insurer but does not guarantee a refund or claim outcome. Airlines are not legally required to refund non-refundable fares because a passenger was ill, though many have goodwill policies. Travel insurance claims are assessed against the specific policy wording and exclusions set by the insurer. Obtaining medical documentation promptly, as close to the original travel date as possible, significantly strengthens your submission.
What the Letter Includes
Letter contents
- ✔ Your name, date of birth, and contact details
- ✔ The medical condition or symptoms that prevented travel
- ✔ Confirmation that travel was clinically inadvisable at the time
- ✔ Dates of the period of medical unfitness to travel
- ✔ GMC registration number of the signing doctor
- ✔ Unique QR code for verification by airline or insurer
If your insurer or airline has a specific form requiring completion by a doctor, upload it alongside your medical evidence when applying. Our doctors will complete it where the information provided supports doing so.
How to Get Your Unable to Fly Letter
Complete the online consultation form
Describe your illness or injury, the dates you were unable to travel, and your booking details. Upload supporting evidence: photos of symptoms, discharge letters, prescriptions, or test results.
GMC-registered doctor reviews your case
Your submission is reviewed the same day. If additional information is needed, the doctor may contact you before issuing.
Letter delivered to your inbox
If clinically appropriate, your signed PDF letter arrives same day (submit before 9pm) or by 9am next morning. If the doctor cannot issue, you receive a full refund.
Submit to your airline or insurer
Submit the letter alongside your booking confirmation and any insurer claim form. Keep a copy for your records.
✔ Full refund if the GP cannot issue on clinical grounds
Not Fit to Fly Letter for Cruise Cancellations
If your cancelled trip involved a cruise, a standard not fit to fly letter may not be sufficient on its own. Cruise operators and cruise-specific travel insurers typically require documentation confirming you were unfit to travel by any mode, not just air.
MedicalCert can issue a letter confirming you were medically unfit to travel that covers both air and sea travel. When applying, mention that your booking included a cruise so the reviewing doctor can ensure the wording is appropriate for your cruise line or insurer. For a general travel cancellation certificate that covers all modes of transport, see our travel and holiday cancellation certificate.