I asked for clarification in writing of something and after refusing to call the firm as I wanted it in writing for future use, I received this.
>>We have checked the Policy Wordings and have extracted the definition of Pre-existing condition as shown below:
Pre-existing Any disease, illness or injury including
condition related medical conditions for which:
• You have received a consultation,
medication, monitoring advice or
treatment; or
• You were made aware of or had
experienced symptoms of (whether
or not a diagnosis has been made)
In the 12 months before the start date or
the amendment date shown in your
schedule.
As you are still receiving annual consultations, this would mean that this would be excluded as a pre-existing condition.<<
Now try as I may I cannot decide whether the phrase 'this would be excluded as a pre-existing condition' means it IS or IS NOT a pre-existing condition.
I accept I may be incredibly thick but this needs to be watertight.
Help please, thanks in advance!
Pat
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It is excluded as it is considered a pre- existing condition.
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Thanks Mark, that's what I wanted to know.
Pat
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Now try as I may I cannot decide whether the phrase 'this would be excluded as a pre-existing condition' means it IS or IS NOT a pre-existing condition."
The condition is excluded. You are still receiving annual consultations and therefore the condition falls within the policy definition of a pre-existing condition.
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Thanks CG, that means it will go on forever then!
Pat
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Is this a travel insurance policy Pat?
Depending on what the condition is you may be able to have the condition included at at an additional cost. Plenty of specialist insurers on line or see a broker.
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No it's not CG, it's income protection......just me panicking, that's all!
Pat
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I agree Pat, it's very badly worded. I wouldn't word it quite like this either, but this might make it clearer:
As you are still receiving annual consultations, this would mean that this would be excluded [from being eligible for benefits] as [it is] a pre-existing condition.
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Thanks Mapmaker, I needed to be sure of the position and that's why I insisted on it in writing.
Pat
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>> As you are still receiving annual consultations, this would mean that this would be excluded
>> as a pre-existing condition.<<
I think it can be read two ways.
1, whatever you are having annual consultations about is excluded...etc
2, it will not be considered a pre-existing condition, because it would be 'excluded as a pre-existing condition'.
I think there needed to be a comma after the word 'excluded' for it to read better. However, I have little doubt they intended it to mean option 1.
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I have little doubt it's ambiguous to avoid paying out on a claim!
Pat
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Legal speak generally avoids punctuation so as not to be ambiguous! Or that's the theory anyway.
While some phrases are have one meaning regardless of punctuation, others most certainly are not.
An apple a day keeps the doctor away doesn't change meaning regardless of where commas are littered. The parrot said Aunt Matilda is a drunken mess is ambiguous without punctuation, and with an added comma, either the parrot or the Aunt is a drunk. But at least it is clear.
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>The parrot said Aunt Matilda is a drunken mess is ambiguous without punctuation
No, I don't think so.
Isn't the principle that without punctuation you build your understanding from the left? In this case "The parrot said" occurs before "said Aunt Matilda" and so takes precedence.
Punctuation may override that building from the left as in "The parrot, said Aunt Matilda.."
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Say it to yourself with evenly spaced words and no inflexion. Even if you are right in theory, would you trust others to agree? A bit of punctuation goes a long way.
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>>
>> Isn't the principle that without punctuation you build your understanding from the left? In this
>> case "The parrot said" occurs before "said Aunt Matilda" and so takes precedence.
>>
That's good - I hadn't heard that principle before.
So "This would be excluded" comes before "excluded as a condition".
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The insurance industry uses the word "exclude" to refer to stuff excluded from their cover.
The Financial Ombudsman service has a page dedicated to "pre-existing" medical conditions, as it gets quite a few disputes about the meaning referred to it.
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Jargon - No FM2R
