Why do I need to submit a medical certificate with my application for membership?

A membership application form must be completed and submitted to the administrator offices by the applicant. This membership application form, once accepted by the Fund, shall be a contract of agreement. Any false declaration by the applicant may render the agreement ‘null and void’ and may result in immediate cancellation of membership. Where membership is cancelled, such members will be required to reimburse the Fund of all claims paid during the period of membership. Monthly contributions paid during this period will be forfeited.

The declaration of health contained in the membership application form must be filled out and signed by all members applying for membership with the Fund. In the case of individual members, such declaration of health must be completed and signed by a medical practitioner. Employees and/or their dependants, who have not applied for membership with the Fund within the stipulated 3-month period after accepting full-time employment with an employer group, must also have the declaration of health completed and signed by a medical practitioner.

As part of the underwriting process, the Fund reserves the right to request additional information regarding the medical history and a doctor’s certificate, relating to the member’s health and family medical history, from either the member or medical practitioner. Pro-rated day-to-day benefits will apply as from the date of joining, unless the joining date is 1 January.

Any failure to disclose any conditions, whether intentionally or unintentionally, which manifested or originated from the causes prior to admission as a member, or within 120 days from the date of such admission (“the underwriting review period”), will at the sole discretion of the NHP, be met with the following consequences:

• If NHP, in its sole discretion believes any condition for which benefits claimed during the underwriting period, may have existed or originated before commencement of membership, benefits will be put on hold until submission of such proof.
• If the member cannot prove beyond reasonable doubt that such medical condition was not present at the time of commencement of membership, then NHP, at its sole discretion, reserves the right to withhold benefits relating to the treatment required.
• NHP may exclude or limit any benefits in respect of the undisclosed condition and/or NHP may unilaterally terminate membership.