Oireachtas Joint and Select Committees

Thursday, 4 May 2023

Committee on Public Petitions

Financial Services and Pensions Ombudsman Annual Report 2021 and Related Matters: Financial Services and Pensions Ombudsman

Ms MaryRose McGovern:

That would depend on the policy terms. Another resource in our digest is the digest of health insurance decisions, and likewise that concept of a pre-existing condition is very important. One of our case studies for health insurance was "Clara" who incepted a health insurance policy for the first time. The following day she headed off to the doctor because she had pain in her back. Sadly, for Clara, which is not her real name, it transpired that she had a tumour in her back. She did not know that she had a tumour in her back but because she had the symptoms before she incepted the policy for health insurance, she was not covered for that pre-existing condition. This is an industry standard for health insurance of five years. If a person upgrades his or her health insurance there is an industry standard waiting period of two years. The person will be covered but he or she will be covered on the basis of what the policy level was before he or she paid for that upgrade.

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