Document ID: chunk:federal_register_of_legislation:C2025C00097:section:5:p6
Version: federal_register_of_legislation:C2025C00097
Segment Type: section
Provision Reference: s 5 (pt 6/56)
Character Range: 96932–99652

*waiting period that applies to a person who did not *transfer to the policy is no longer than:
 (a) for a benefit for *hospital treatment or *hospital‑substitute treatment that is obstetric treatment or treatment for a *pre‑existing condition (other than treatment covered by paragraph (b))—12 months; and
 (b) for a benefit for hospital treatment or hospital‑substitute treatment that is psychiatric care, rehabilitation or palliative care (whether or not for a pre‑existing condition)—2 months; and
 (c) for any other benefit for hospital treatment or hospital‑substitute treatment—2 months.
 (2) The Private Health Insurance (Complying Product) Rules may modify the requirements in subsection (1) in relation to all or particular kinds of private health insurers, benefits or insured persons. To the extent the Rules do so, the waiting period requirements in this Division are taken to be met if the conditions in the Rules are met.
Note: If a private health insurer provides an insured person with, or arranges for an insured person to be provided with, treatment, it is treated as a benefit for the purposes of this Division (see subsection 69‑5(3)).

75‑5  Meaning of waiting period
  The waiting period that applies to a person for a benefit under an insurance policy is the period:
 (a) starting at the time the person becomes insured under the policy; and
 (b) ending at the time specified in the policy;
during which the person is not entitled to the benefit.

75‑10  Meaning of transfers
  A person transfers to a policy (the new policy) from another policy (the old policy) if:
 (a) either:
 (i) the person is insured under the old policy at the time the person becomes insured under the new policy; or
 (ii) the person ceased to be insured under the old policy no more than 7 days, or a longer number of days allowed by the new policy's insurer for this purpose, before becoming insured under the new policy; and
 (b) the old policy is a *complying health insurance policy; and
 (c) the person's premium payments under the old policy were up to date at the time the person became insured under the new policy.
Note: See section 99‑1 about transfer certificates.

75‑15  Meaning of pre‑existing condition
 (1) A person insured under an insurance policy has a pre‑existing condition if:
 (a) the person has an ailment, illness or condition; and
 (b) 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 6 months ending on the day on which the person became insured under the policy.
 (2) In forming an opinion for the purposes of paragraph (1)(b), the *medical practitioner