I am going to post 3 different, but closely related, topics on this issue.

I have found out this week, that most North American insurance companies have exclusions for people 60 or over who have pre-existing illnesses, and exclusions for those under 60, if their pre-existing illnesses have not been stable (depending upon the policy) for 3-12 months. The insurance company will not say as to whether someone's medical ("new" potential) condition) will be excluded or not, up front. One has to submit the claim, and only then the insurance company will decide if the claim will be honoured, or not.

Most policies state that if a new condition is a direct, or indirect, complication of a pre-existing condition, if will not be included. The word "indirect" gives an insurance company wide latitude to reject almost any non-accident related problem. For example, if someone has hypertension, then heart attacks and strokes could be excluded.

Question - has does anyone know of people who have successfully submitted a claim, after being treated (esp in USA)?

Question - is a group policy more liberal than an individual policy, in terms of accepting claims?

[This message has been edited by FlyerGoldII (edited 08-25-2001).]