Unexpected Recurrence of Pre-Existing Condition – Up to $20,000 of Covered Expenses up to age 65 or up to $10,000 of Covered Expenses for age 65 or Over

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 36 months 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. This specifically includes but is not limited to any medical condition, Sickness, Injury, Illness, disease, Mental Illness or Mental Nervous Disorder, for which medical advice, diagnosis, care or Treatment was recommended or received or for which a reasonably prudent person would have sought Treatment during the 36 month period immediately preceding the Effective Date of Coverage under this Certificate. A Pre-Existing Condition which is a chronic or congenital condition or that gradually becomes worse over time and/or known, scheduled, required, or expected medical care, drugs or Treatments existing or necessary prior to the Effective Date are not considered to be an Acute Onset.

Unexpected Reoccurrence of a Pre-existing Condition

“Unexpected recurrence of a pre-existing condition” means a sudden and unexpected outbreak or recurrence of a pre- existing condition which:

• occurs spontaneously and without advance warning either in the form of physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent and immediate medical care;
• is a minimum of 48 hours after the effective date of the policy; and
• begins prior to the age shown in the schedule of benefits/limits with treatment being obtained within 24 hours of the sudden and unexpected outbreak or recurrence. A pre-existing condition that is a congenital condition or that gradually becomes worse over time will not be considered an unexpected recurrence.

This plan shall pay, up to $20,000 for those up to age 65 and $10,000 for those age 65 and over subject to the chosen Deductible and Coinsurance for Covered Expenses resulting from a sudden, unexpected recurrence of a Pre-Existing Condition while traveling outside the Covered Person’s Home Country. This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs or treatments existent or necessary prior to the Effective Date of coverage.