Pre-Existing Conditions

Health insurance policies are designed to cover health conditions arising after the commencement of the policy, rather than health conditions existing before the commencement of the policy. Pre-existing conditions are generally excluded from cover.

What is a pre-existing condition?

Each policy will contain its own definition for “pre-existing condition”. It is important to note that, while you may not consider that the health condition requiring treatment is a pre-existing condition, the policy will define what the insurer regards as a pre-existing condition. Read your policy carefully to determine what is a pre-existing condition and how the policy treats pre-existing conditions.Generally, a pre-existing condition is any health condition or symptoms, of which you were aware, or for which you had sought medical treatment or advice. This includes any health condition/s, which had not necessarily been diagnosed, but of which you had symptoms.

Disclosure of pre-existing conditions

When you apply for health insurance, the insurer relies on you to tell it about all pre-existing conditions, so it can decide what terms and conditions to offer. If you disclose a pre-existing condition, the insurance company may treat it in one of the following ways:

  1. offer cover for the condition, subject to an additional premium;
  2. permanently exclude cover for the condition; or
  3. exclude the condition from cover for a set period of time, i.e. 3 years.

Claims for undisclosed pre-existing conditions

If you do not tell the insurer about a pre-existing health condition, or symptoms, and you make a claim for it, or anything related to it, the insurer will probably decline the claim. This is because the policy excludes cover for pre-existing conditions which the insurer has not been told about and which it has not agreed to cover. This means that a condition, which develops after the policy commencement, will be excluded if it relates to a pre-existing condition.

Therefore, it is very important to accurately disclose all health conditions and symptoms when applying for health insurance; otherwise, if you make a claim for a pre-existing condition, it will probably be declined.

Be Aware!

If you currently have a health insurance policy and you are considering changing to another insurer, then you need to think very carefully about whether the other company will cover your pre-existing conditions. Often, you may have developed conditions, or symptoms of a condition, which would be covered if you remained with your current health insurer. But if you change policies, you might later discover your new policy does not cover the relevant condition.

Your Lloyd's Insurance Adviser will assess your situation and help you select the right insurance based on a range of factors including the size of debts, size of your family, your budget and your lifestyle.

Included in your personal assessment is a fast and accurate comparison of suitable products from the huge range available from major insurance companies.

Match your Situation with the correct Insurance for your family's needs

For a personal Insurance assessment that will match your situation to the Insurance products which are in your best interest, talk to your local Lloyd's Insurance Adviser, or call us at any time on 07 572 1599 (+64 7 572 1599).