Page 308 - Ebook health insurance IC27
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The Insurance Times
Eligible Medical Condition
Means any disease, illness or injury not otherwise excluded by the policy terms and
conditions.
Illness
Means any kind of sickness or disease, not otherwise excluded by the policy, which is
sustained during the period of insurance and makes it necessary for a member to receive
treatment from a physician or consultant.
Maintenance Treatment
Is treatment provided for a medical condition of a long duration that will only give relief
or control symptoms rather than effect a cure.
Pre-existing Condition
Is any medical condition or its related condition that is medically existing prior to a
member's enrolment, whether it is known or not known to the member and necessitate
for the member to receive treatment from a physician or consultant.
Some insurers limit the existence of the condition to a period of 12 to 48 months prior to
the member's enrolment. Related conditions, means any medical condition considered
to be either an underlying cause of or directly attributable to a pre-existing condition.
Treatment
Is a surgical or medical procedure, the sole purpose of which is to cure a medical
condition and not to provide relief only for a chronic illness.
312 Guide for Health Insurance
