An unknown pre-existing condition is one that existed before the policy has been in force, but the insured person was reasonably unaware of it which has no clear and distinct signs or symptoms and it has not been diagnosed or sought for medical advice.
Under the terms of Bowtie VHIS, the insurer will pay for claims arising from unknown pre-existing conditions during the waiting period as follows.
Reimbursement Ratio for Unknown Pre-Existing Conditions
Bowtie VHIS Standard |
Bowtie VHIS Flexi Regular |
Bowtie VHIS Flexi Plus |
Bowtie Pink VHIS |
|
1st Policy year |
0% (no reimbursement will be made to the insured) |
0% (no reimbursement will be made to the insured) |
0% (no reimbursement will be made to the insured) |
0% (no reimbursement will be made to the insured) |
2nd Policy year |
25% of the eligible medical expenses within benefit limit |
100% of the eligible medical expenses within benefit limit |
100% of the eligible medical expenses within benefit limit | 100% of the eligible medical expenses within benefit limit |
3rd Policy year |
50% of the eligible medical expenses within benefit limit |
100% of the eligible medical expenses within benefit limit | 100% of the eligible medical expenses within benefit limit | 100% of the eligible medical expenses within benefit limit |
4th Policy year onwards |
100% of the eligible medical expenses within benefit limit | 100% of the eligible medical expenses within benefit limit | 100% of the eligible medical expenses within benefit limit | 100% of the eligible medical expenses within benefit limit |