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GlobalFusion Flexible Underwriting

Your Choice of Underwriting

Cover for Pre-Existing Medical Conditions

 

GlobalFusion provides a range of underwriting methods to extend cover to you. You may choose to have your application underwritten and to apply on either a Full Medical Underwriting or a Moratorium Underwriting basis, or in some cases we may offer you our Flexible Underwriting Option. Your choice of either a Full Medical Underwriting Policy or a Moratorium Underwriting Policy will affect the basis upon which, and the coverage (if any), that will available for pre-existing medical conditions.

*Note: For Bronze Sub-Plans there is no cover for Pre-Existing Medical Conditions irrespective of your choice of Medical Underwriting.

 

Full Medical Underwriting Policy* - With Full Medical Underwriting you must complete a full medical questionnaire and health declaration. Upon review of your responses and any additional information we may require from you or your physician, we decide whether we can accept you for cover and any limitations on your cover. We then confirm any medical conditions that are excluded. Where we specifically have excluded cover for a disclosed pre-existing condition and after 24 months your condition has improved, you may request review of that exclusion. Non-disclosed Pre-Existing conditions will never be covered and failure to declare a condition could result in a claim being declined or your policy being void from inception.

Note: If you apply for a Full Medical Underwriting Policy and are declined on medical grounds, you may re-apply for a Moratorium Underwriting Policy (acceptance is not guaranteed).

 

The Silver, Gold and Gold Plus sub-plans provide a $50,000/£27,500/€33,500 lifetime benefit for eligible pre-existing conditions that existed at or prior to the effective date, subject to a maximum of $5000/£2750/€3350 per Period of Insurance. This benefit is payable whether or not you have received consultation or treatment for the condition(s) during the 24-month period of continuous cover.

 

On the Platinum sub-plan, conditions that are fully disclosed on the application and have not been excluded or restricted by a Personal Medical Exclusion will be covered the same as any illness without a requirement for a 24 months continuous cover wait period, and covered up to the policy maximum and not subject to the usual pre-existing medical conditions annual and lifetime sublimits. Conditions, including any complications therefrom, that are not fully disclosed on the application will not be covered.

 

Moratorium Underwriting Policy* - Moratorium Underwriting enables you to apply for your plan without completing a full health questionnaire. Instead, we apply blanket exclusions for any preexisting medical conditions you have had. The 'moratorium' refers to the fact that if, after 24 months of continuous cover under your plan, you demonstrate two consecutive years without symptoms or treatment or consultation, advice(excluding routine check-ups), medication (including injections) or special diet for a pre-existing condition (or any related conditions), then should you need subsequent treatment for that condition, you will have cover for it subject to the plan’s terms and conditions (refer to Schedule of Cover, Section 18.b for Sum Insured). Under the Moratorium Underwriting option, many pre-existing medical conditions, where you need regular or periodic treatment, medication, or check-ups, which existed prior to your purchase of your plan, may never be covered. This is because each symptom or treatment, consultation, advice (excluding routine check-ups), medication(including injections), or special diet for a preexisting condition (or any related conditions) starts the moratorium again.

See Policy Wording for definition of 'Pre-Existing Conditions' and a complete list of exclusion and other terms and conditions (available upon request).

 

Flexible Underwriting Option* - Where you may have otherwise been declined for cover, the Flexible Underwriting Option allows us to extend cover to you. After 24 months of continuous cover, a preexisting condition which has not been specially excluded by a Personal Medical Exclusion, will be covered the same as any other pre-existing condition, so long as in that 24 month period no treatment has been received for that condition. If treatment has been sought, then the 24 month period starts over from the treatment date. Treatment includes: 1) Consulted any physician for Medical Treatment or Advice (other than routine check-ups); or 2) Taken medication (including prescription drugs, special diets or injections).

*Note: That for Bronze Sub-Plans there is no cover for Pre-Existing Medical Conditions irrespective of your choice of Medical Underwriting.

 


The following illnesses which exist, manifest themselves, or are treated or have treatment recommended prior to or during the first 180 days of cover from the initial effective date are considered pre-existing conditions and are subject to the waiting period and other limitations of cover described above: allergies, asthma, any condition of the breast or the prostate, tonsillectomy, adenoidectomy, haemorrhoids or haemorrhoidectomy, any disorder of the reproductive system, hysterectomy, hernia, intervertebral disc disease, gall stones or kidney stones.

 

Other Exclusions & Limitations*

  • Adult routine physical examinations (health checks / well-being checks) are excluded under the Bronze & Silver sub-plans, and for the first 12 months for the Gold and Gold Plus sub-plans, and for the first 6 months for the Platinum sub-plan
  • Out-patient mental and nervous is excluded on the Bronze sub-plan and for the first 12 months on all other sub-plans
  • In-patient mental and nervous is excluded under the Bronze and Silver sub-plans and for the first 12 months for the Gold, Gold Plus and Platinum sub-plan
  • Maternity, newborn and congenital disorders (unless the maternity optional add-on coverage or Platinum sub-plan is purchased - see the Summary Schedule of Cover and Excesses)
  • Maternity expenses (including prenatal, delivery, postnatal, newborn and congenital disorders) when the pregnancy is a result of fertility treatment
  • Devices to correct sight are excluded under the Bronze, Silver, Gold and Gold Plus sub-plans (unless the Dental Treatment and Vision Care Benefits optional add-on coverage or Platinum sub-plan is purchased - see the Summary Schedule of Cover and Excesses)

·         Devices to correct hearing

·         Treatment or supplies not medically necessary

·         Treatment not ordered or received by a physician

·         Treatment by a relative or family member

·         Treatment as a result of war or riot

·         Treatment resulting from illegal activities

·         Organised amateur or professional sports

·         Services and treatment eligible for payment by any government or other insurance

·         Investigational, experimental or research procedures

·         Routine foot care

·         Elective cosmetic or plastic surgery

·         Drug and alcohol abuse treatment

·         Speech therapy

·         Custodial care

·         Weight modification

·         Treatment of impotency

·         Contraceptive medication or treatment

·         Persons HIV+ at effective date

*This Web page contains only a consolidated and summary description of some of the current benefits, conditions, limitations and exclusions. A Policy Wording containing the full terms, conditions and exclusions will be included in the fulfillment kit. IMG Europe reserves the right to issue the most current Policy Wording for this insurance program in the event this Web page, application and/or booklet has expired, is modified, or is replaced with a newer version. Current Policy Wordings are available upon request

 

 

 

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