This form requests information from your medical practioner regarding your upcoming hospital admission. The medical referee appointed by us will use the information to make an informed pre-existing query assessment and allow us to determine the level of health insurance benefits to which you are entitled. We may disclose the information to you as part of the evidence considered in this matter.
A pre-existing ailment is defined in the Private Health Insurance Act 2007 (Cth), section 75-15 (1) as: ‘the person has an ailment, illness or condition, and in the opinion of a medical practitioner appointed by the insurer that issued the policy, the signs or symptoms of that ailment, illness or condition existed at any time in the period of six months ending on the day on which the person became insured under the policy.’
Please have this form completed by both the first person you saw relating to this condition and the treating specialist.
Pre-existing query form PDF Format