Acute Onset of Pre-existing Conditions – Covered up to Policy Maximum for Age Below 70 Years
With the Patriot America Plus plan, insured persons under the age of 70 could be covered up to the overall policy maximum if they experience an acute onset of a pre-existing conditions condition. You should know what a pre-existing condition is because it will help you understand how it relates to an acute onset of a pre-existing condition.
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 three (3) years prior to the Effective Date of this insurance, whether or not previously manifested, symptomatic or known, diagnosed, Treated, or disclosed to the Company prior to the Effective Date, and including any and all subsequent, chronic or recurring complications or consequences related thereto or resulting or arising therefrom.
Acute Onset of a Pre-Existing Condition
A sudden and unexpected outbreak or reoccurrence that is of short duration, is rapidly progressive, and requires urgent medical care. A Pre-existing Condition that is chronic or congenital, or that gradually becomes worse over time is not an Acute Onset of 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) were told that he/she must or should receive, any medical care, drugs or Treatment.
If you are under age 70 you may be covered for an acute onset of a pre-existing condition up to the overall policy maximum. Emergency Medical Evacuation has a $25,000 limit and is only available to Participating Members under the age of 70.
Conditions and Restrictions
To be eligible for the foregoing limited coverage and benefits for an Acute Onset of a Pre-Existing Condition, the Insured Person must be in compliance with all Terms of this insurance. The Company will provide such coverage and benefits only when all of the following conditions and restrictions have been met. At the time of the Acute Onset of Pre-existing Condition: treatment must be obtained within twenty-four (24) hours of the sudden and Unexpected outbreak or reoccurrence; the Insured Person must be under seventy (70) years of age; the Insured Person must not be traveling against or in disregard of the recommendations, established Treatment programs, or medical advice of a Physician or other healthcare provider; the Insured Person must not be traveling with the intent or purpose to seek or obtain Treatment for the Pre-existing Condition; the Insured Person must not be traveling during a period of time when the Insured Person is preparing or waiting for, involved in, or undertaking a new, changed or modified Treatment program with respect to the Pre-existing Condition, and is not traveling subsequent to any such new, changed or modified Treatment program having been advised or recommended; the Pre-existing Condition must have been stabilized for at least thirty (30) days prior to the Effective Date without change in Treatment; the Insured Person must be traveling outside their Country of Residence.
Any infection of the urinary tract (including, without limitation, infection of the kidney, ureter, bladder, prostate or urethra) and any complication, medical condition or other Illness directly or indirectly arising therefrom, that occurs within ninety (90) days of the Effective Date of this Insurance and that requires Treatment of the Insured Person in a Hospital as an Inpatient.