Key Exclusions to Discuss with Clients
Overview
When advising clients on ALI Group's My Protection Plan, it's crucial to inform them about specific exclusions that may affect their coverage.
Pre-Existing Medical Conditions:
Claims arising directly or indirectly from pre-existing medical conditions will not be paid. A pre-existing condition is defined as any illness, injury, or condition that:
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Was the subject of a medical consultation in the 5 years immediately before the policy start date or a benefit increase date.
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The life insured was aware of, or a reasonable person in the circumstances could be expected to be aware of.
Qualifying Periods for Trauma Benefits:
Certain trauma conditions have a 90-day qualifying period. This means that if a condition first occurs, becomes reasonably apparent, or is first diagnosed within 90 days after:
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The policy start date.
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The policy reinstatement date.
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The date of any benefit increase.
No benefit will be paid for trauma conditions that are directly or indirectly related to a condition not covered due to this 90-day qualifying period.
Type A and Type B Exclusions:
There are two types of exclusions that can apply to the Death Benefit, Terminal Illness Benefit, Trauma Benefit, and Accidental Injury Benefit:
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Type A Exclusions: Relate to specific medical conditions and their history.
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Type B Exclusions: Relate to family medical history and genetic conditions.
For full details on these exclusions, please refer to the Exclusions for Pre-Existing Conditions page and consult the Product Disclosure Statement (PDS).