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 that was not stable in the three (3) months before the date the dependant 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 means a medical condition for which:
- 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, any change in medication; and
- 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.