Health insurance waiting periods query

Escapees

An interesting scenario...

Joe Bloggs has health insurance with VHI for 10 years. His workplace then offers free membership of an equivalent plan with Laya and he switches to this. After say 1 year, he gets diagnosed with a condition that requires treatment. However, it becomes clear that Joe actually had some symptoms of this condition going back several years, but he had just dismissed or not recognised them himself at the time.

My question is... Will treatment of the condition be covered immediately by Joe's current health insurance or will a 2/5 year waiting period apply?

(I'm curious because it would seem from the small print that a 'pre-existing condition' can be regarded as any related symptom/s which dates back to before the cover commenced.)

L1011

Waiting periods include previous Irish insurers if a gap, if any, was less than 13 weeks. So even if that was judged to be pre-existing - which is a separate argument - they already had VHI for many years by that stage.

Fishdoodle

Is a confusing area. I remember talking to Insurers and here’s what I recall:

If Joe were already fully covered for his condition in his previous policy it shouldn’t make a difference and no waiting period applies.

The x year waiting period as I understand it applies if you haven’t had an existing policy.

Also, if Joe changes from a policy (A) say with 20% shortfall for certain procedures to another with a higher level of cover and no shortfall (B) -let’s say for a hip condition. Joe gets a hip replacement under his new policy, but as his condition was deemed pre-existing he will be covered to the level of his previous policy and (unless waived) is likely to have to pay the 20% shortfall. His waiting period for full hip cover with no shortfall on policy B is x amount of years.

Escapees

Thanks for the responses. This makes sense alright. It was just some wording in the one of the insurer's fine print that started me wondering.