Pre-Existing Condition Exclusions
This policy will not pay any expenses or benefits relating to:
- A pre-existing condition which has not remained stable in the three (3) months before the effective date.
- Any pre-existing condition of a covered dependant and/or spouse that was not stable in the three (3) months before the date the dependant/spouse became covered under this policy.
- For covered dependants under two (2) years of age, any medical condition related to a birth defect whether genetic, acquired, or congenital.
Pre-Existing Condition means an injury, illness or symptom that exists before the effective date of insurance.
Stable medical condition means that all of the following apply:
- there have not been any new symptom(s); and
- existing symptom(s) have not become more frequent or severe; and
- a physician has not determined that the medical condition has become worse; and
- no test findings have shown that the medical condition may be getting worse; and
- a physician has not provided, prescribed, or recommended any new medication or any change in medication; and
- you have not received, been prescribed or a physician has not provided, prescribed or recommended any investigative testing, new treatment or any change in treatment and;
- there has been no admission to a hospital or referral to a specialty clinic or specialist; and
- a physician has not advised referral to a specialist or further testing, and there has been no testing for which the results have not yet been received.
Other conditions, limitations and exclusions apply. Please see the policy for details.