Explanations

SME moratorium

Small corporate – rolling 5:2:1 moratorium

    • group around table

      A moratorium is the period of time when we can’t cover any condition you had before you joined us.

      This means that in the first two years of your membership we won’t cover pre-existing conditions including:

      • symptoms of conditions that have not yet been diagnosed and
      • the recurrence of past conditions or symptoms.

      What happens after two years

      If you’ve been trouble free for at least one year, starting from the date you joined us, we’ll then be able to consider any claims for pre-existing conditions, in line with the benefits of your plan.

      How it works

      Sue's knee

      Sue had a knee operation. Shortly after the operation, she joined us.

      During her first two years as a member, Sue isn’t covered for any treatment related to her knee operation or the medical condition(s) that led to the operation. After two years continuous cover, if Sue hasn’t received any treatment or any other medical advice for her knee problem (including check-ups) for at least one of those years, we’d cover her for treatment relating to the knee (in line with the benefits of the plan).

      Sue explaination
    • Definitions

      Pre-existing conditions

      A pre-existing condition is any disease, illness or injury that:

      • you have received medication, advice or treatment for in the five years before the start of your cover, or
      • you have experienced symptoms of in the five years before the start of your cover: whether or not the condition was diagnosed

      Trouble free

      Trouble-free means that you have not done any of the following for the medical condition you need treatment for:

      • had a medical opinion from a medical practitioner, including a GP or specialist
      • taken medication (including over-the-counter drugs)
      • followed a special diet
      • had medical treatment
      • visited a practitioner, physiotherapist, osteopath, chiropractor, homeopath, acupuncturist, optician or dentist