Understanding the Terms of Your Policy: Waiting Period, Pre-Existing Conditions and More

Waiting period is a span of time in which you cannot claim some or all the policy benefits from the insurer.

The duration of the waiting period and its terms and conditions vary according to the policy and benefit type. Thus, it is essential to understand the duration and terms of the waiting period stated in your policy contract.

Do note that for any claims not offered under the Hospital Alliance Services (HAS) facility, the customer is advised to pay first and submit the claims for reimbursement with all supporting documents upon completion of treatment(s). Reimbursement claim is subjected to policy terms and condition.

What are the types of waiting period?

 The eligibility for the benefits under the policy will only start after the waiting periods below from the effective date of the policy/certificate or the date of revival, whichever is later.

Please note that if you switch your current plan with another or from one provider to another, you may be subject to new underwriting requirements and waiting periods for the new plan.

If the medical condition(s) is pre-existing or was not disclosed prior to the policy being issued, Guarantee Letters will not be issued. The policyholder is required to pay on his/her own and make a claim where the reimbursement will be subjected to review.

Pre-existing means a physical and/or mental condition that existed before submission of the proposal form. If the condition was not declared upon submission of the proposal form or when a policy is reinstated (due to lapsation), it will not be covered. In addition, the benefits and/or terms of the policy may be subjected to change due to the non-disclosure.

All policyholders have a duty to provide all relevant information and details required without any misrepresentation to Prudential when completing the proposal form.

Policy holders also have to disclose to Prudential any matter which may not be covered in the proposal form, that they know could be relevant to Prudential’s decision on the policy rates and term.

There are two types of exclusions:

1. General exclusion refers to risks that are not covered by the insurer and it applies to all customers.

    The example of general exclusions are plastic/cosmetic treatment, dental condition, congenital condition and General Practitioner treatments/Specialist Outpatient Treatments that are not part of pre-hospitalisation treatments

2. Specific exclusion refers to risks that are not covered by the insurer that are specific to you based on your previous medical history.

    Please ensure that you go through and understand the General exclusions or Specific exclusions (if there is) that will be clearly stated in the policy contract.