I understand that the persons covered by this application will be subject to a two-year rolling moratorium clause, the details of which are:
Initially, there is no cover at all for treatment of any medical condition which was in existence at any time during the five years immediately preceding the date on which the persons included on this application joined Atlas Healthcare Insurance Agency. This exclusion relates not only to those conditions for which a diagnosis has been received but also to any medical condition for which they actually had symptoms, even though no diagnosis had been attached to those symptoms. All that matters is that the person knows, or ought reasonably to have known, that something was wrong even if they had not consulted a doctor. If a claim is made, therefore, the person’s doctor may be asked for confirmation that they would have had no reason to know or believe, when they joined, that they might have the condition for which they are claiming treatment. In addition, the persons covered by this application will not be covered for treatment of specified related conditions where they have been diagnosed with diabetes, are currently undergoing treatment for blood pressure (hypertension), are currently under investigation, having treatment or undergoing monitoring for bowel polyps, are under investigation, having treatment or undergoing monitoring as a result of a Prostate Specific Antigen (PSA) test.
Treatment of all such conditions is completely excluded from cover for two years from the date of joining.
At the end of those two years the persons included in this application will be able to claim for treatment of those conditions or symptoms described in (a) above, but only if they have not had any medical treatment or any medical advice, or taken any drugs or medicines, or followed any special diets in respect of those conditions for the period of two consecutive years. If such treatment is received within the period of two consecutive years then they won’t be able to claim for treatment of those conditions until such time as they have gone for a period of two consecutive years without any treatment or advice or help or drugs. It follows that there are some medical conditions and related conditions – those which continue or keep recurring – for which it will never be possible to make a claim for treatment. This is because the person will always need to have medical advice or take medication and therefore will not be able to go for a period of two consecutive years without advice or medication. Treatment of those conditions and their related conditions is therefore completely excluded from cover for all time.