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 Conditions irrespective of your choice of Medical Underwriting.
Full Medical Underwriting Policy* - With Full Medical Underwriting, youmust complete a fullmedical questionnaire. Upon reviewof your responses and any additional information we
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 cover is in
effect for 24 continuous months under the Plan, you are provided with Pre-Existing Condition cover up to the annual and lifetime limits of the Plan for eligible fully disclosed and accepted
Pre-Existing Conditions as defined by the Plan and subject to the terms and conditions of the PolicyWording. This benefit is payable even if you have received consultation or treatment for
the condition(s) during the 24 month period.Where we specifically have excluded cover for a disclosed Pre-Existing Condition and after 24 months of cover your condition has improved, you may
request review of that exclusion. Pre-Existing Conditions which have not been disclosed will never be covered.
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.
The Silver 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.
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 Pre-Existing Condition, as defined by the plan, you have. 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, consultation, advice (excluding routine check-ups), medication (including prescription
drugs, special diets or injections), 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, any Pre-Existing Conditions will only be covered on this basis if they have been disclosed and accepted under your Plan. There is never any cover under the Plan for any
Pre-Existing Condition which has not been disclosed. Under the Moratorium Underwriting option, many Pre-Existing Conditions, where you need regular or periodic treatment, medication,
or checkups, 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 prescription drugs, special diets or injections), for a Pre-Existing 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 Conditions irrespective of your choice of Medical Underwriting.
The following exclusion applies to all sub-plans: Treatment of any condition of: allergies; asthma; any condition of the breast or the prostate; tonsillectomy; adenoidectomy;
haemorrhoids or haemorrhoidectomy; any disorder of the reproductive system; hysterectomy; intervertebral disc disease, hernia, gall stones or kidney stones; which:
- exist, or
- manifest themselves, or
- involve procedures which take place or are recommended, during the first 180 days of cover under Your Plan, beginning on the Effective Date.
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 Plus
- 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 Plus sub-plan
- Maternity, newborn and congenital disorders (unless the maternity optional add-on coverage 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 and Gold Plus sub-plans (unless the Dental Treatment and Vision Care Benefits optional add-on coverage 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.