Flexible
Underwriting
The plan provides flexible underwriting methods to extend
coverage to you. Your application may be underwritten by
Standard Underwriting or the Flexible Underwriting Rider.
Standard Issuance - There are two levels of
underwriting when all medical conditions have been disclosed and
they have not been specifically excluded or restricted by a rider
(subject to the foregoing limits and the other terms of the plan*).
The Silver, Gold and Gold Plus plan options
provide a $50,000 lifetime benefit for eligible pre-existing
conditions that existed at or prior to the effective date, subject
to a maximum of $5,000 per period of coverage after coverage has
been in effect for 24 continuous months. This benefit is payable
whether or not you have received consultation or treatment for the
condition(s) during the 24-month period of continuous coverage.
The following illnesses which exist, manifest themselves, are
treated or have treatment recommended prior to or during the first
180 days of coverage from the initial effective date are considered
pre-existing conditions and are subject to the waiting period and
other limitations of coverage described above: acne, asthma,
allergies, tonsillectomy, back conditions, adenoidectomy,
hemorrhoids or hemorrhoidectomy, disorders of the reproductive
system, hysterectomy, hernia, gall bladder or gall stones and kidney
stones, any condition of the breast, and any condition of the
prostate.
On the Platinum plan option, conditions that are
fully disclosed on the application and have not been excluded or
restricted by a rider will be covered the same as any illness.
Conditions, including any complications therefrom, that are not
fully disclosed on the application will not be covered.
Flexible Underwriting Rider - Where you may have
otherwise been declined for coverage, the Flexible Underwriting
Rider allows us to extend coverage to you. After 24 months of
continuous coverage, a disclosed pre-existing condition which has
not been specifically excluded by a rider will be covered as any
other pre-existing condition so long as in that 24 month period no
treatment has been received for that condition. If treatment has
been sought or should have been sought, then the 24 month period
starts over from the treatment date.
Other Exclusions & Limitations*
- Adult routine physical examinations are excluded under the
Silver plan option, and for the first 12 months for the Gold,
Gold Plus and Platinum plan options
- Out-patient mental and nervous is excluded for the first 12
months on all plan options
- In-patient mental and nervous is excluded under the Silver
plan option and for the first 12 months for the Gold, Gold Plus
and Platinum plan options
- Maternity, newborn and congenital care (unless the maternity
rider or Platinum plan option is purchased - see Benefits page
by clicking link above) Note: maternity expenses including
prenatal, delivery, postnatal, newborn and congenital disorders
are excluded when the pregnancy is a result of fertility
treatment
- Organ transplants not specifically listed
- Devices to correct sight or hearing are excluded under the
Silver, Gold and Gold Plus plan options
- Treatment or supplies not medically necessary
- Treatment not ordered or received by a physician
- Treatment by a relative or family member
- Treatment as a result of war, riot, or terrorism
- Treatment resulting from illegal activities
- Organized amateur or professional sports
- Services and treatment eligible for payment by any
government or other insurance
- Investigational, experimental or research procedures
- Routine foot care
- Elective cosmetic or plastic surgery
- Drug and alcohol abuse treatment
- Speech therapy
- Custodial care
- Weight modification
- Treatment of impotency
- Contraceptive medication or treatment
- Persons HIV+ at effective date
* This Web page contains only a consolidated
and summary description of all current benefits, conditions,
limitations and exclusions. A certificate containing the complete
Certificate Wording with all terms, conditions and exclusions will
be included in the fulfillment kit. These plans are amended,
modified or replaced from time to time, and IMG reserves the right
to issue the most current Certificate Wording for this insurance
plan in the event this Web page, application, and/or brochure has
expired, is modified, or is replaced with a newer version. Current
Certificate Wordings are available upon request.
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