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The primary purpose of insurance is to cover the cost of the unexpected and the unforeseen. Health insurance companies may apply a special condition to a policy when it is clear from the information provided that the insured is either receiving ongoing treatment or has a foreseeable need to receive treatment for a specific medical condition, as this condition constitutes a known risk. Treatment for the ongoing condition may be in the form of consultations with a medical practitioner, tests, investigations or medication to control the condition and/or its symptoms.

When a special condition is applied to an insurance policy, the company may not assist towards any costs incurred for that specific condition, nor for conditions which arise directly from that excluded condition. A hypothetical example would be when an exclusion had been applied for High Cholesterol and the patient later developed heart attack as a direct result of the High Cholesterol. Benefit would not be available for any treatment of the High Cholesterol, nor for treatment of the heart attack.

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Panama Kevin