Underwriting options: Examples
The answers to the following questions are designed specifically to deal with the differences in underwriting terms and all answers are subject to you having the necessary benefits in your policy.
Q.I had an operation on my right knee recently. Will I be covered for any further treatment to it after my policy starts?
A. Moratorium
This will be excluded from cover. We will only pay benefits after you have been a member for two continuous years, provided that during this time you have not experienced any further symptoms, or received advice, treatment or medication for the condition.
A. Full Medical Declaration
No. We ask for this information on the application form, and we will place an exclusion on your policy, although we will need to know the actual diagnosis to be able to make the exclusion more specific.
Q. Some time after my cover begins, I go to the doctor for a routine visit. A heart condition is diagnosed and it must have started to develop before my policy began. What is the position?
A. Moratorium
We will pay benefits providing:
- you were not aware of any symptoms of the condition prior to joining
- your GP confirms that this is a new condition and is not related to any other condition diagnosed or treated during the five years prior to joining.
A. Full Medical Declaration
We will pay benefits providing:
- your GP confirms that you were not aware of any symptoms (e.g. chest pain) when applying for cover
- the condition is not directly related to any other exclusion that we may have placed on your policy.
Q. What if I suspect I am suffering from a condition (for example, I have a lump) but have not seen a doctor about it, nor received any firm diagnosis before my cover starts? Will I be covered if I need to have any investigations or treatment for the condition once my policy has started?
A. Moratorium
As you were aware of a specific symptom, this will be excluded from cover for two years from the start of your policy. If you receive treatment, medication or advice during this time, you will not be covered until you have been free of symptoms, treatment, medication or advice for two continuous years after joining the policy.
A. Full Medical Declaration
You should tell us about this on your application form and we will place an exclusion on your policy. However, we will then need the diagnosis and details of the treatment you are going to have, so that we can make the exclusion more specific.
Q. For Moratorium Option only: How do regular check-ups affect the moratorium?
A. (i) If you have a specific condition before your policy starts, and your GP recommends that you continue to have check-ups for that condition, we will not cover the cost of these check-ups, or any investigations or treatment you receive for that condition. You will only be covered, subject to you having the necessary benefits in your policy, once you have been discharged from care and have had no further symptoms, treatment, medication or advice for a continuous period of two years.
(ii) If you have general health checks, simply in the interest of maintaining good health, and not for any particular condition, we ignore them when applying the moratorium.
Further information can be found in the relevant Policy Document for each plan or visit our Documents section to view and print a copy.
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