Acute Onset of Pre-existing Conditions – Covered up to Policy Maximum for Ages Below 80 Years

The Atlas America plan provides coverage in very specific circumstances for the acute onset of pre-existing conditions to people below the age of 80. Understanding what a pre-existing condition is will help you understand what the acute onset coverage provides.

Pre-Existing Condition

Pre-existing Condition means any injury, illness, sickness, disease, or other physical, medical, mental, or nervous disorder, condition, or ailment that, with reasonable medical certainty, existed at the time of application or at any time during the 2 years prior to the effective date of this insurance, whether or not previously manifested, symptomatic or known, diagnosed, treated, or disclosed to us prior to the effective date, and including any and all subsequent, chronic or recurring complications or consequences related thereto or resulting or arising therefrom.

Chronic means any condition that usually persists three months or longer.

For the purposes of the Complications of Pregnancy coverage offered hereunder, pregnancy will not be included within the definition of a pre-existing condition.

Acute Onset of a Pre-Existing Condition

Acute Onset of Pre-existing Condition means a sudden and unexpected outbreak or recurrence that is of short duration, is rapidly progressive, and requires urgent care. A pre-existing condition that is a chronic or congenital, or that gradually becomes worse over time is not acute onset of a pre-existing condition. An Acute Onset of Pre-existing Condition does not include any condition for which, as of the Effective date, the Insured Person (i) knew or reasonably foresaw he/she would receive, (ii) knew he/she should receive, (iii) had scheduled, or (iv) was told that he/she must or should receive, any medical care, drugs or treatment.

• If you are under age 80, you may be covered for an acute onset of a pre-existing condition up to the overall policy maximum.

This benefit is available under Atlas America for non-US citizens traveling anywhere outside their home country including the U.S. If emergency medical evacuation for a covered acute onset of a pre-existing condition is necessary, then the maximum limit is $25,000.

Conditions and Restrictions

The benefit will apply only if all of the following conditions are met:

• The Acute onset of a Pre-Existing Condition does not directly or indirectly relate to a chronic condition or congenital condition;
• Treatment must be obtained within twenty-four (24) hours of the sudden and unexpected outbreak or reoccurrence;
• You must be under eighty (80) years of age;
• You must not be traveling against or in disregard of the recommendations, established treatment programs, or medical advice of a physician or other healthcare provider;
• You must not be traveling with the intent or purpose to seek or obtain treatment for the pre-existing condition;
• You must be traveling outside your Home Country.