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Visitors to
Canada
Medical Insurance
Pre-Existing Condition Coverage
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TIC Travel Insurance Coordinators Ltd
Benefits are not payable for costs incurred due to:
a) If you are 69 years of age or under on the effective
date:
Any pre-existing medical condition unless it was stable
in the 180 days immediately before the effective date.
b) If you are 70 to 79 years of age on the effective
date:
i. Any cardiovascular, cerebrovascular and respiratory
condition that required any or all of: medical
consultation, prescription medication, medical treatment
or hospitalization, within 180 days immediately before
the effective date unless you have completed a Medical
Questionnaire, have been approved in writing by TIC and
have paid the required premium; or
ii. Any other pre-existing medical condition not listed
under “b) i.” unless it was stable in the 180 days
immediately before the effective date;
c) If you are 80 years of age or over on the effective
date:
Any pre-existing medical condition unless you have
completed a Medical Questionnaire, have been approved in
writing by TIC and have paid the required premium.
Stable
applies to a pre-existing medical condition that:
a) did not demonstrate any new, more frequent, or more
severe signs or symptoms;
b) did not require, or was not referred for any medical
consultation; and
c) did not require a change in type, brand, frequency or
dosage of medication.
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21st Century Travel Insurance
(underwritten by Manulife
Financial)
The
company will not reimburse “you” for “insured services”
or pay an Accidental Death and Dismemberment claim
and/or any other expenses arising after any applicable
"waiting period", from:
1.
any sickness, disease or “injury” for which medication
has been taken, received or prescribed, and/or treatment
has been received in the 180 days preceding the
"effective date".
Important Note regarding Exclusion #1: A
“stable chronic
condition” is covered (Exclusion # 1 will not
apply) if "you":
i)
are under 60 years of “age” on the “effective date” of
"your" coverage; or
ii) are 60
to 85 years of “age” on the "effective date" of "your"
coverage, completed the
Medical
Declaration and paid the required premium to
purchase the “stable chronic condition” option.
2.
any sickness, "injury", or symptom:
•
when "you" knew, prior to "your" "effective date", that
"you" would need or be required to seek treatment for
that medical condition during "your" trip; and/or
• for
which, prior to "your" "effective date", it was
reasonable to expect that "you" would need treatment
during "your" trip; and/or
• for
which future investigation or treatment was planned
prior to "your" "effective date"; and/or
•
which produced symptoms that would have caused an
ordinarily prudent person to seek treatment in the 180
days prior to the "effective date"; and/or
•
that had caused "your" "physician" to advise you not to
travel.
NOTE:
Under Exclusion #1 and #2, each time “you” purchase
another policy from “us” because “you” are staying in
Canada longer, each new policy will have a new
“effective date” and “you” will not be covered under the
new policy for any sickness, disease, symptom or
“injury” which had manifested itself in the 180-day
period immediately preceding that new “effective date”.
"You" will not be covered for any sickness, symptom or
disease suffered during any "waiting period".
“Stable
Chronic Condition” means:
a) a
condition which is under treatment and which has been
controlled by consistent use of medication prescribed by
a “physician”; and
•
there have been no new symptoms or change in symptoms;
and /or
•
there has been no “hospitalization” or change in
treatment, medication or dosage
in
the 180 days prior to the “effective date” of this
policy.
If
“your” “physician” has determined that “your” health
condition has improved and changes “your” treatment,
medication or dosage due to “your” improved health
condition, this does not
constitute a change.
►
Manulife Financial
The company
will not pay any expenses or benefits relating to:
1. Any claim within the waiting period.
2. A pre-existing condition
Plan A – the company will not pay any expenses relating
to:
a) a pre-existing condition for which medication has
been taken, received or prescribed and/or treatment has
been received in the 180 days before the effective date
of insurance;
b) any heart condition if, in the 180 days before the
effective date, you required any form of nitroglycerine
for the relief of angina pain; and/or
c) any lung condition, if in the 180 days before
the effective date, you required treatment with oxygen or
prednisone for a lung condition.
Plan B – the company will not pay any expenses relating
to:
a) a pre-existing condition that is not stable in the
180 days before the effective date of insurance;
b) any heart condition if, in the 180 days before the
effective date, you required any form of nitroglycerine
for the relief of angina pain; and/or
c) any lung condition if, in the 180 days before the
effective date, you required treatment with oxygen or
prednisone for a lung condition.
3. Expenses for a pre-existing condition for which you
were hospitalized either more than once, or for at least
2 consecutive days, in the 12-month period before your
effective date of insurance.
Pre-existing condition means a medical condition that
existed before your effective date.
Stable
means a medical condition for which:
a) there have been no new symptoms, and existing
symptoms have not become more frequent or severe; and/or
b) a physician has not determined that the condition has
become worse; and/or
c) a physician (or other medical professional) has not
prescribed or recommended a change in medication or
medical care received for that condition; and/or
d) a physician (or other medical professional) has not
prescribed or recommended a change in how often the
medication is taken or medical care is received for that
condition; and/or
e) admission to a hospital has not been required.
►
Manulife Financial
- Student Travel Plan
Pre-existing condition exclusions
This policy will not pay any expenses or benefits
relating to:
1. A pre-existing condition which has not remained
stable in the three (3) months before the effective
date.
2. Any pre-existing condition of a covered
dependant and/or spouse that was not stable in the three
(3) months before the date the dependant/spouse became
covered under this policy.
3. For covered dependants under two (2) years of age,
any medical condition related to a birth defect whether
genetic, acquired, or congenital.
Pre-Existing Condition means an injury, illness
or symptom that exists before the effective date of
insurance.
Stable means a medical condition for
which:
•
there have been no new symptoms, and existing symptoms
have not become more frequent or more severe or there
has been no test results showing deterioration;
•
a
physician has not determined that the condition has
become worse;
•
a physician (or other medical professional) has not
prescribed or recommended a change in medication taken
for that condition meaning that the medication dosage or
frequency has been reduced, increased, stopped and/or
new medication(s) has (have) been prescribed.
Exceptions: the routine adjustment of Coumadin, Warfarin,
(as long as they are not newly prescribed or stopped)
and
•
a
change from a brand name medication to a generic brand
medication (providing the dosage and frequency of usage
remain unchanged);
•
a
physician (or other medical professional) has not
prescribed or recommended a change in treatment;
•
there
has been no admission to a hospital and the insured is
not awaiting results of further investigations for any
medical condition.
►
Group Medical Services
The
following expenses are not covered by the policy and no
payment for these claims will be made:
1. Expenses incurred where you act against medical advice or
the advice of GMS.
2. Expenses resulting from the regular care of a chronic
condition.
3. Expenses incurred as a result of non-adherence with
medical treatment prior to departure.
4. Coverage for medical condition(s) that existed prior to
your effective date is subject to the following:
This policy does not provide coverage for any expenses
related directly or indirectly as a result of:
a) Your medical condition and/or related condition and/or
symptoms (whether or not the diagnosis has been determined)
if
at any time in the one hundred eighty (180) days preceding
your effective date your medical conditions or related
conditions and/or symptoms have not been stable;
b) if at any time in the one hundred eighty (180) days prior
to your effective date:
i) any heart condition has not been stable;
ii) any lung condition has not been stable.
Stable: Any medical condition or related medical
condition for which:
a) there have been no new symptoms, more frequent or more
severe symptoms;
b) there has been no change in treatment or change in
medications;
c) there has been no deterioration of your medical
condition;
d) there has been no hospitalization or referrals to a
specialist including initial follow-up visits, tests or
investigations booked in conjunction with a medical
condition/symptom;
e) there is no further testing, treatment or investigation
booked or results pending;
f ) you have not experienced a symptom that remains
undiagnosed;
g) no further medical treatment after departure would be
anticipated.
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