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InsuranceHealth insuranceGlossary

Reservations / provisos / qualifications

Health insurance providers may impose temporary or permanent provisos for supplemental insurance if they consider an applicant's state of health to be an unfavourable risk. This means that the policyholder will not receive benefits for treatment of an illness addressed in the reservation.

Example: You suffer from hay fever and apply for a supplemental insurance that covers alternative medical treatment. The insurance provider will accept your application imposing the proviso that the treatment costs for hay fever and its consequences are not covered in this insurance class. If you desire treatment against hay fever from a natural health practitioner, you must bear the full costs yourself. Your supplemental insurance will not pay any related benefits.

However, you may request treatment performed by a physician practising conventional medicine. Their methods are scientifically recognised and covered by basic health insurance.

In the context of supplemental insurance, health insurance providers have the right to make retroactive qualifications if it is later determined that false or incomplete information was provided on the application form.

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