Fillable Medical Certificate Form - Bupa (Page 2 of 2) in pdf

Pre-existing condition

Privacy and your personal information

A pre-existing condition is any ailment, illness, or condition that you

Your privacy is important to Bupa. This statement summarises how

had signs or symptoms of during the six months before you joined or

we handle your personal information. For further information about

upgraded to a higher level of cover with us. It is not necessary that you

our information handling practices, please refer to our Information

or your doctor knew what your condition was or that the condition had

Handling Policy, available on our website or by calling us. When you join,

been diagnosed.

you agree to the handling of your personal information as set out here

and in our Information Handling Policy.

A condition can still be classed as pre-existing even if you hadn’t seen

your doctor about it before joining or upgrading to a higher level of cover.

We will only collect personal information that we require to provide,

manage and administer our products and services and to operate an

If you knew you weren’t well, or had signs of an condition that a doctor

efficient and sustainable business. We are required to collect certain

would have detected (if you had seen one) during the six months prior to

information from you to comply with the Private Health Insurance Act

joining or upgrading, then the condition would be classed as pre-existing.

2007 (Cth). We may also collect information about you from health

A doctor appointed by us decides whether your condition is pre-existing,

service providers for the purposes of administering or verifying any

not you or your doctor. The appointed doctor must consider your treating

claim, and from your employer, broker or agent if you are on a corporate

doctors’ opinions on the signs and symptoms of your condition, but is not

health plan or have joined through a broker or agent. We may disclose

bound to agree with them.

your personal information to our related entities, and to third parties

including healthcare providers, government and regulatory bodies,

When to contact the fund

other private health insurers, and any persons or entities engaged by

If you have less than 12 months membership on your current hospital

us or acting or our behalf. If you are on a corporate health plan, we may

cover, make sure you contact us before you are admitted to hospital

disclose your information to your employer to verify your eligibility to

and find out whether the pre-existing ailment waiting period applies

be on that corporate plan. The policy holder is responsible for ensuring

to you.

that each person on their policy is aware that we handle their personal

We need about 5 working days to make the pre-existing ailment

information as set out here and in our Information Handling Policy.

assessment, subject to the timely receipt of information from your

Each person on a policy aged 17 or over may complete a ‘Keeping your

treating medical practitioner(s).

personal information confidential’ form to specify who should receive

Make sure you allow for this timeframe when you agree to a hospital

information about their health claims. You are entitled to reasonable

admission date. If you proceed with the admission without confirming

access to your personal information. We reserve the right to charge a

benefit entitlements and we (the health fund) subsequently determine

fee for collating such information. If you or any insured person does not

your condition to be pre-existing, you will be required to pay all

consent to the way we handle personal information, or does not provide

hospital charges and medical charges not covered by Medicare.

us with the information we require, we may be unable to provide you

with our products and services. We may use your personal (including

Emergency admissions

health) information to contact you to advise you of health management

In an emergency, we may not have time to determine if you are

programs, products and services. When you take out cover with us, you

affected by the pre-existing ailment rule before your admission.

consent to us using your personal information to contact you (by phone,

Consequently, if you have less than 12 months membership on your

email, SMS or post) about products and services that may be of interest

current hospital cover you might have to pay for some or all of the

to you. If you do not wish to receive this information, you may opt out

hospital and medical charges if:

by contacting us.

• You are admitted to hospital and you choose to be treated as

a private patient; and

• We later determine that your condition was pre-existing.

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10239-04-13S

Medical Certificate Form - Bupa Page 2

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