Pre-existing Conditions

Pre-Existing conditions are defined as any injury or illness which is known to the individual or has manifested symptoms prior to the beginning of a policy. Insurance companies will inquire into your medical history at the time of application. In particular, they will attempt to identify any previous ailments which may fall under a ‘pre-existing condition;' at which point they will determine the level of coverage afforded to that particular condition.

Group policies are often the best means for gaining coverage for a pre-existing condition. It is possible for a large group to acquire coverage for all members for all pre-existing conditions.

Insurance plans will not normally cover a serious pre-existing condition. Insurance, by its nature, is meant to cover the consequences of unforeseen events, not to pay expenses for events that are certain to happen. For this reason it is not advisable to switch between medical insurance providers since any pre-existing conditions are not likely to be covered.

Insurance companies normally deal with pre-existing conditions in one of three ways: exclusion, moratorium, and loading.

Exclusion

In the event that a policyholder has a pre-existing condition, the insurance can still offer coverage, but exclude coverage for the pre-existing condition and any related symptoms. For more serious pre-existing conditions, such as diabetes or cancer, it may be difficult to buy new insurance; therefore, it is important to get insurance before you become ill.

Moratorium

Another way in which insurance companies handle pre-existing conditions is to offer a waiting period, or moratorium. These waiting periods are typically 24 months in duration. If during the moratorium the condition does not require any treatment in the form of a check-up, prescribed medication, or displays any symptoms, then the insurer may reconsider coverage for the condition.

Loading

Insurance companies may choose to cover the pre-existing condition by offering a higher premium, or 'Loading' the premium. Since not all pre-existing conditions can be covered through loading the premium, you should speak with one of our advisors to identify what options are available to you.