The Validity of the Pre-existing Condition Clause under the Obligation of Disclosure of the Insurance Law
As one of the most common clauses in commercial health insurance,the pre-existing condition clause has a more strin-gent effect on the disclosure obligation rule,thus it is widely criticized by the judicial and theoretical societies and regulatory bodies.However,current opinions and comparative law-based discussions cannot completely disprove the pre-existing condition's provisions on"scope of coverage"and"objectivism".This has also given rise to the controversy over the interpretation of the pre-existing condition clause.Tracing back the history of this clause's application,we can see that it first originated in group insur-ance,aiming to realize the goal of"accepting membership to the largest extent".However,when it was applied to individual insur-ance,this clause shifted to"prevent against adverse selection".When judging on the validity of the pre-existing condition clause when the rule of disclosure obligation is applied,we should follow the Civil Code's theoretical development on the validity of legal actions which violate mandatory regulations.Moreover,we should make differentiated assessment on the pre-existing condition clause for group insurance and individual insurance with the comparison of their different purposes,and apply different standards to the interpretation of pre-existing conditions.
pre-existing condition clauseduty of disclosurerelative mandatory rulesgroup insuranceobjective comparison
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