Medical Gap Cover | Do I need a medical examination?

If you join a medical scheme there is an outside chance you might be required to have a medical test (on the odd occasion I’ve actually seen this). Most life insurers will require their applicants to have at least a pin prick in the arm (blood test). Because short term insurance deals with insuring your assets and not your life, you are off the hook on that one. But what about medical aid gap cover? Any medicals required?

Some medical gap cover underwriters might exclude pre-existing conditions and impose a waiting period before you can claim. But I’m yet to find an underwriter who has asked for medical tests.

I can’t speak for all gap cover underwriters, but the guys at Zestlife allow you cover without any medical examinations and your pre-existing conditions aren’t excluded.

“Hold on. They will take me on with my health conditions and no medicals”. I’m not a risk analyst but surely that’s a little risky for them?”

It’s a good point. But it’s also good for business.

Think about needing medical gap cover, then at application stage finding out that you have a 3 month general waiting period before you can claim and your knee has been excluded because of an old rugby injury you sustained in 1996.

My guess is that you aren’t going to be very impressed and will probably say

“Too he’ll with this insurance.”

Zestlife understand that and so they allow you to come on cover immediately.

But to protect themselves these waiting periods apply.

1. Childbirth claims have an effective 10th month waiting period.

2. For the benefits below, a six month waiting period is in place and 50% of the normal benefit for the second six months after joining.

  • Joint replacements, arthroscopic procedures, spinal surgery (including spinal fusion)
  • Nasal Surgery (including sinus related), cataract surgery, hysterectomy (except for cancer diagnosed after joining), dentistry related claims, all hernia repairs and all cardiac related surgery.

So, no medicals, no general waiting periods, no exclusions for pre- existing health conditions.

What are you waiting for?

Kind regards,

The InsuranceFundi Team

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