Private Health Insurance Act 2007

CHAPTER 3 - COMPLYING HEALTH INSURANCE PRODUCTS  

PART 3-3 - REQUIREMENTS FOR COMPLYING HEALTH INSURANCE PRODUCTS  

Division 75 - Waiting period requirements  

SECTION 75-15   MEANING OF PRE-EXISTING CONDITION  

75-15(1)    
A person insured under an insurance policy has a pre-existing condition if:

(a)    the person has an ailment, illness or condition; and

(b)    in the opinion of a ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

medical practitioner appointed by the insurer that issued the policy, the signs or symptoms of that ailment, illness or condition existed at any time in the period of 6 months ending on the day on which the person became insured under the policy.

75-15(2)    
In forming an opinion for the purposes of paragraph (1)(b) , the ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

medical practitioner must have regard to any information in relation to the ailment, illness or condition that the medical practitioner who treated the ailment, illness or condition gives him or her.

75-15(3)    
If:

(a)    a private health insurer replaces a ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

complying health insurance product with another complying health insurance product; and

(b)    a person who was insured under a policy that was in the replaced ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

product is ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

transferred by the insurer to a policy that is in the replacement product;

the reference in paragraph (1)(b) to the day on which the person became insured under the policy is taken to be a reference to the day on which the person became insured under the replaced policy.