If a customer has had symptoms or has been treated for a medical condition within a specified period of time before their Insurance Coverage began, no insurance benefits will be paid if their death, critical illness or total disability occurs within a specified period of time after your Insurance Coverage began. These specified periods of time are shown together on the customer's Insurance Enrolment as the Pre-Existing Condition exclusion period.
Example: Pre-Existing Condition Exclusion Period shown on the Insurance Enrolment is “6/6”. The customer had symptoms and as a result, they were treated for a heart condition five months before their coverage began. If they died, were diagnosed with a critical illness, or first became totally disabled, because of their heart condition, and their coverage had been in effect for less than six full months, we would not pay insurance benefits.
However, as long as they met all eligibility requirements for enrolment on the effective date of insurance shown on their Insurance Enrolment, we would pay insurance benefits if they died, were initially diagnosed with a critical illness, or first became entirely disabled from their heart condition, any time after their coverage has been in effect for six full months.