Being unwell or having a previous medical condition can often be a concern for people taking out life insurance, but pre-existing conditions are not always excluded by life and health insurance providers. Usually, we can still offer you health insurance cover.
Each insurer has differing approaches when it comes to exclusions
Your medical history, or any pre-existing medical conditions, may affect what you can get health insurance cover for – not all health insurance providers offer cover for pre-existing conditions – which is why it’s important to get impartial, qualified advice from one of our insurance brokers.
What are considered pre-existing conditions?
When it comes to health insurance, a pre-existing condition is considered to be a sign or symptom that…
• you knew about before applying for health cover
• you’ve previously sought diagnosis for or asked for medical advice about
• a reasonable person would seek diagnosis or medical advice about
• was identified in diagnosis, even if you did not know about it – that means a pre-existing condition can exist even if you are unaware that you have it
• was treated before your cover started.
Pre-existing conditions are not usually covered unless the insurer says they are, so in order to avoid issues later if you need to make a claim, full and accurate disclosure is key.
Conditions for pre-existing conditions
If you’ve got an existing condition, we can usually still organise health cover for you, but most providers who offer cover for pre-existing conditions will add one these conditions to your policy:
• exclusion of your specific condition from what you’re covered for. These exclusions could be permanent or might have a set time frame
• addition of a ‘stand-down’ period for your condition; you may be offered cover for your condition after a set time or waiting period
• an increase in your premiums.
Excluding the condition from your cover
If you’ve had a heart attack in the past year, for example, your insurer will want the full details of your condition, but it’s unlikely any heart issues will be covered in the future. As an example, one major New Zealand health provider’s Premium or Standard Hospital cover does not provide cover for pre-existing conditions that relate to cardiovascular, cancer, hip or knee, back, transplant surgery, reconstructive or reparative surgery.
However, some health insurers may cover specified pre-existing conditions following a specified period of time from your join date. This brings us ‘stand-down’ periods.
What is a waiting period?
A waiting or stand-down period is the period of time an insured individual will need to wait before they’re able to make a claim on a pre-existing condition.
This wait period will vary from provider to provider and can range anywhere from one to four years. It can also be dependent upon the level of cover you have or the type of claim.
Higher premiums
Insurance products that provide cover for pre-existing conditions may be more expensive.
Making health insurance easier
If you you’re worried about pre-existing conditions affecting your health insurance, talk to one of our advisers and get independent advice about what your options might be.
At Global Finance, we can make your life easier by providing all the information you need for dealing with health insurance providers. We will go through your application with you to figure out which coverage you can get. We will also be able to give you an indication of what your insurance cover might cost and any potential exclusions that may apply.
If in doubt, leave it in
If you aren’t sure whether an aspect of your medical history is important or not, the best thing to do is tell us about it. The condition may not affect your application, but not disclosing it could have consequences when it comes to claim time. Even if you don’t think they are important, or you’ve had the all-clear from a doctor, you need to tell our insurance brokers the full details of your medical history.
Leaving out medical details is a problem
Effective health cover is about trusting that you will have access to the best medical care when you need it and that means understanding your pre-existing conditions and telling your insurer your whole health history.
Life and health insurance contracts are founded on the legal doctrine of uberrimae fidei which requires both parties to exercise the utmost good faith in their dealings with each other. From the client’s perspective, the obligation is to provide full disclosure when applying. The insurer’s obligation is to treat the client fairly in all its dealings, especially at claim time. Leaving out medical details on your application is definitely a problem.
Get personalised assistance from one of our qualified insurance advisers
Schedule a call with one of our insurance advisers to learn more about how we can make health insurance work for you. We can come up with a personalised solution, and you will get assistance at the time of any claims, lifelong support, and reassurance that your policies will regularly be reviewed as your circumstances change. Call us on 09 255 5500 or email us at info@www.globalfinance.co.nz.
**Underwriting criteria and insurer terms T’s and C’s apply