private health insurance pre-existing condition

[hgllgh]

What happens if you take out PHI then go for a checkup and something significant is diagnosed?
As I understand it PHI companies may have 'pre-existing conditions' clauses (which are no doubt hidden away in the small print) which would invalidate a claim?

[SueEllen]

If you take out PHI and have a know condition it is either excluded completely, or excluded for a number of years.

Each PHI clearly states when they will exclude conditions and how long for.

[ladymuck]

Was the medical part of the PHI sign up process? Then they will either charge extra to cover you, or exclude it as mentioned above. Depends on what the condition is.

If you just happened to get a medical, after the PHI policy had been accepted, and honestly didn't know about the condition beforehand then you'll be covered but you may find the policy won't pay out in the first few months - most only allow limited claims in the first 6 months (the period may vary).

[northernladuk]

Last time I looked at one of these the pre-existing conditions were not hidden away. Depends if what has been diagnosed has been there since before you took the policy. If you didn't know then it's excluded. If there is evidence in your records you will have made a false declaration and could have your policy cancelled. I believe they ask for a medical history anyway so if you do have something then they will find out.

Why not get yourself a good work up so you know and you've also got evidence in case you find yourself in this situation.

Or is there something going on here you aren't telling us??

[hgllgh]

Last time I looked at one of these the pre-existing conditions were not hidden away. Depends if what has been diagnosed has been there since before you took the policy. If you didn't know then it's excluded. If there is evidence in your records you will have made a false declaration and could have your policy cancelled.

But say its something like a serious lung condition, or Cancer ... no evidence for this in the medical history and unknown to the patient... on that first diagnosis say 6 months after taking out the policy, could the insurance company still claim it was a pre-existing condition and therefore not covered?

[northernladuk]

But say its something like a serious lung condition, or Cancer ... no evidence for this in the medical history and unknown to the patient... on that first diagnosis say 6 months after taking out the policy, could the insurance company still claim it was a pre-existing condition and therefore not covered?

If that was the case I'd be reading the pre-existing T&C's carefully. If they require you to have a health check before starting the policy and it's not on there but it's diagnosed whilst you are in the term you'd think you'd be OK (well you know what I mean).. but.. a good read of the T&C's and ask the providers would be my advice. It might differ from provider to provider.

Are you speaking to that guy that works with contractors? I forget the company.

[Lance]

But say its something like a serious lung condition, or Cancer ... no evidence for this in the medical history and unknown to the patient... on that first diagnosis say 6 months after taking out the policy, could the insurance company still claim it was a pre-existing condition and therefore not covered?

Generally not. Pre-existing almost always means 'pre-existing and known about'. If in doubt ask when you buy.
Bear in mind that 'life' is a critical illness for which death is the only certainty. I cannot imagine an insurance company trying that on.

[pr1]

But say its something like a serious lung condition, or Cancer ... no evidence for this in the medical history and unknown to the patient... on that first diagnosis say 6 months after taking out the policy, could the insurance company still claim it was a pre-existing condition and therefore not covered?

AIUI when you take out the policy you sign to say you are telling the truth that you have declared all known existing medical conditions - so if it's not on your medical history then it doesn't count as a pre-existing condition

however if they can prove you lied when you said you'd declared all known medical conditions, they will, they'll read your doctors notes and checking the dates in your google history searching about cancer (probably)

[SueEllen]

AIUI when you take out the policy you sign to say you are telling the truth that you have declared all known existing medical conditions - so if it's not on your medical history then it doesn't count as a pre-existing condition

however if they can prove you lied when you said you'd declared all known medical conditions, they will, they'll read your doctors notes and checking the dates in your google history searching about cancer (probably)

They don't go into your search history in the UK it's not like the US where they try and say everything was linked as we have the NHS plus we have ombudsman covering insurance and the courts. Insurers have tried it on in the past in the UK saying an unrelated condition was linked but the ombudsman and courts have stood up to them so they don't try now.

[VectraMan]

BTW my previous employer's insurance didn't exclude pre-existing conditions "Medical history disregarded", which I guess was an option they paid extra for and I think was only available to large (>50 employees) companies.

Which was handy as my health cover started just as the NHS finally diagnosed me with something and I had the resulting surgery done privately.