What is an "unknown pre-existing condition"? How does this clause affect my claim?

  • Updated

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