Insurance policies are designed for coverage of treatment or sickness to assure ease in the case of an emergency. The policy contracts legally bind the insurer and the policyholder.
Terms and conditions are the fundamental modules in expatriate insurance contracts in which include, sets of an agreement such as, the policyholder agrees to pay premiums and in return, the company agrees to compensate your medical necessity in case of any unforeseen events.
Pre-existing condition – what is it?
A pre-existing condition is any illness, diseases, or injuries that you have before you join any particular insurance scheme. This can also include signs or symptoms that you may have experienced before, even if the symptoms have not been diagnosed the insurer may not be able to cover it for a set period of time.
Example:
You have a heart medical condition before your policy begins, the insurer can exclude the coverage for any treatment that is relating to this medical condition.
How can the insurer know that I have a pre-existing condition?
It is very important for applicants to answer the medical questionnaire truthfully. When submitting a medical claim, your expatriate insurer may check with your doctors to ensure that you do not have that certain condition before. This is called “PMH – Past Medical History.”
If you chose to ignore your previous condition on the application, it can affect your future claims. If the insurer is aware that your pre-existing condition wasn’t declared, in the worst case the company can legally withdraw to the coverage and terminate your health expatriate policy.
In some cases, the insurer may exclude or cover the existing medical conditions from your policy. This will depend on the length of time you have the symptoms, treatment, and when you have been set trouble-free from the condition for a set period of time. The insurer will base its coverage on real facts and documents. It will result in a confidential agreement between the policyholder and the insurer.
For any chronic conditions, that require long term monitoring or rehabilitation, such as a cardiac problem will most likely not be covered by your insurance scheme.
Is there coverage for a pre-existing condition?
If a health condition appears after the subscription and was not linked to a pre-existing condition, the health insurer cannot deny coverage during the time of enrollment unless that specifically written in the wordings agreement.
Some insurer will be able to cover your pre-existing condition, however, your premiums will be significantly increased to be covered as they can add subprime to your premium.
If you are considering purchasing an insurance scheme with ongoing or chronic medical conditions, it will affect the type of plans you choose.
If you have a pre-existing condition, there are 3 possibilites of answers from the insurer:
1: Full coverage of your health including the pre-existing condition
2: Coverage of your health with exclusions of all or some of your pre-existing condition
3: Deny of coverage at all
The best way to protect your health from any unforeseen event is to purchase coverage while you are still healthy. Make sure that you ask your insurance company or AEXPAT Insurance questions to clarify on the contract that you wish to enroll in.
