CMFAS HI Common Policy Provisions question: moratorium-underwritten Medical Expense Insurance policy

CMFAS HICommon Policy Provisions

Under a moratorium-underwritten Medical Expense Insurance policy, Mr Goh has a history of a prior stroke — a long-term condition likely to need continuing treatment, medication or advice. After the moratorium period has passed he seeks cover for stroke-related treatment. What is the likely outcome?

A It is covered automatically once the moratorium period elapses, like any other pre-existing condition
B It stays excluded: a condition needing continuing treatment or advice is unlikely to satisfy the moratorium
C It would have been covered had he chosen full medical underwriting, which never excludes conditions he declared
D It is covered because moratorium underwriting cannot exclude any condition once the initial waiting period ends

Show the answer and explanation

Answer: B. It stays excluded: a condition needing continuing treatment or advice is unlikely to satisfy the moratorium

Long-term conditions such as stroke, kidney failure and dementia need ongoing treatment or advice, so they almost never go symptom- and treatment-free through the moratorium and are effectively never covered. Such declared conditions would also be permanently excluded under full medical underwriting.

Common mistake

Passing the calendar time is not enough — a condition that keeps requiring treatment can never meet the moratorium's symptom-free requirement.

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