Dear valued intermediary,
In response to your requests, during this time of unprecedented financial burden, Kaelo has negotiated with your insurers to apply an open window period for all corporate voluntary Kaelo Gap and all corporate Western Gap clients in May, June and July 2020. The underwriting parameters will be applied as per below:
Kaelo Gap:
- We will waive the three month general waiting period
- The twelve month pre-existing conditions waiting period still applies
Existing policyholders who are still within their three month general waiting period, will also have their remaining general waiting period waived.
Western Gap:
- We will waive the three month general waiting period
- The six month waiting period is reduced to a three month waiting period with the following specific conditions covered/not covered during the three months:
- Covered:
- Nasal and sinus surgery
- Hernia repairs
- Hysterectomy
- Dentistry and cataract procedures where medically advised
- Diagnosis: Where care or treatment was recommended or received for the condition within a period of months preceding the day on which the policy was entered into
- Not covered:
- Joint surgery
- Tonsillectomy
- Adenoidectomy
- Grommets
- Endoscopic and arthroscopic procedures
- Cardiac surgery
- Spinal surgery
- The ten month maternity specific waiting period still applies
- Previously diagnosed cancer, within a period of twelve months preceding the date of inception, will be regarded as a pre-existing condition and oncology cover will be excluded for twelve months
We encourage all intermediaries to assist their clients to understand their full financial liability prior to any planned procedures as your Gap Cover benefits are dependent on your medical scheme benefits.
Example: Gap Cover policies will not cover any benefits not covered by a Medical Scheme due to waiting periods applied.
Thank you for your ongoing engagement and support in these extraordinary times. I trust you and your family are safely home and healthy.
