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health insurance pre-existing condition and lapse in cover

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  • 29-03-2008 2:40am
    #1
    katnip
    Closed Accounts Posts: 28 ✭


    Am I right in thinking that insurance companies define pre-existing condition as one that was already there, whether you knew about it or NOT?

    I've had insurance for over 20 years and had a lapse in cover before I renewed it in the summer. Just my luck that during this non-insured time I ended up in hospital while living abroad. Foreign docs have diagnosed something that they say probably started 5 years ago but didn't show itself until now. Renewed my Irish insurance the day I went into hospital, and it was 5 months before foreign docs made a diagnosis.

    Afraid to broach the question with insurance company in case the start asking questions.

    Has anyone had experience dealing with the following:
    -VHI insurance while dividing residence between Ireland and another country
    -becoming ill during a lapse in cover and the implication of this illness being that you may have to make future claims.
    -lapse in cover with same insurance company requiring you to abide by new waiting period.

    I'm just kicking myself that after forking out high premiums to VHI for over 20 years I may now have to wait 5 years before I can make a claim, despite renewing my insurance with the same company.


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    #2
    Angus MacGyver
    Registered Users Posts: 329 ✭✭Angus MacGyver


    Your Health Insurer will look for an exact date from the doctor you visit as to the start date of the condition. This is not the date that you started to show symptoms.

    Ive seen claims that the doctor has written "a few months" on the claim form
    and the insurer has taken that as 6 months.

    Does your Health Insurer know that you have visited a doctor abroad and had the condition diagnosed. The insurer will always look for the report from the first doctor you have seen.

    As far as cover abroad goes. The Vhi will tell you that they have a global policy available to its members that ensure that the have cover while away and that they will have no waiting periods when transferring back to a domestic policy.

    If you have a lapse in cover for more than 13 weeks full waiting periods are applied again. However its not unusual for policies which have lapsed for up to 6 months may be reinstated for members. Health Insurers will demand a full payment to cover the lapse usually by credit card. They may become wary of a claim on the way in though.

    Claims are based on the date the doctor gives as the start date. So as long as the start date of the condition falls after the start date of the policy its not considered a pre existing condition. However if the full waiting periods have been applied to your policy there is also the 26 week initial waiting period. So no inpatient claims can be made in the first 26 weeks.

    How long was the lapse in cover?


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