You will be caught out and it could end very badly like it did for someone in Zambia!
Read on to find out how.
Way too many people are guilty of this and it’s going to hurt them.
When filling in an application form to join a Medical Plan, you must ALWAYS declare ALL Material Facts if they ask you to!
A Material Fact is generally defined as a confirmed or validated event, item of information, or state of affairs crucial to the interpretation of a phenomenon or a subject matter, or to the determination of an issue at hand.
This folly (issue) normally presents itself at the time of treatment because the member forgets that they failed to declare important facts on their application form and the doctor reveals everything in the medical report.
The cancellation even happens if the current treatment is in no way related to the undeclared material facts.
Here’s a classic example that happened over a pre-existing medical condition that was not declared on the application form.
The gentleman concerned, failed to declare he was on blood pressure medication.
He then fell ill and required emergency air ambulance evacuation to Johannesburg for treatment. [The illness was unrelated to his heart condition.]
The treating doctor made a note of his heart Meds and how long he’d been on them and submitted that in the medical report to the insurer.
The insurer checked everything against his application form and cancelled his cover immediately.
The gentleman passed away because he did not have the funds to cover the air ambulance costs to South Africa.
The Insurer was well within their rights to cancel cover as it stated in the contract that they have the right to cancel cover for undeclared material facts.
So, as a word of encouragement, if you failed to declare all material facts on your current cover, and it was a prerequisite to joining, please immediately contact your health insurer and tell them (in writing) what you failed to declare.
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