Sickness
Illness or disease that originates while the policy is in force, as opposed to an injury from an accident. Policies often distinguish sickness originating after the effective date.
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Practice This Concept
In a policy that pays benefits for sickness, how does the length of the elimination period affect the premium?
A longer elimination period generally results in a lower premium — The elimination period is the waiting period after disability or sickness begins during which no benefits are payable. Because a longer elimination period shifts more of the early-loss burden to the insured and away from the insurer, the insurer's expected claim cost falls and the premium is generally lower. Choosing a longer elimination period is the time-based equivalent of selecting a higher deductible: the insured assumes more initial exposure in exchange for a reduced premium. The elimination period operates as a deductible in time rather than dollars: the longer it runs, the fewer days of benefits the insurer must fund. Because that shifts more of the initial loss to the insured, the premium falls as the elimination period lengthens.
National insurance concept
A health policy states that 'no benefits will be paid for sickness commencing during the first 30 days the policy is in force.' This provision is a:
Probationary period — A probationary period is a specified number of days at the start of the policy during which no benefits are payable for covered losses, here sicknesses that begin in the first 30 days. It is measured from the policy date and applies regardless of whether the illness existed before the policy. This distinguishes it from a preexisting condition exclusion, which reaches back to conditions existing before the policy date; from an elimination period, which runs after a disability begins; and from a grace period, which concerns late premium payments.
National insurance concept
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