The qualifying period is the first 90 days of your policy, during which claims for cancer, heart attack, stroke, and coronary artery bypass surgery are generally not paid. It prevents claims by people who took out cover after symptoms began. This is general information, not personal advice.
Why a qualifying period exists
The qualifying period (sometimes called an exclusion period or elimination period) discourages adverse selection. Adverse selection occurs when someone takes out trauma cover already aware of impending symptoms or a likely diagnosis. By imposing a 90-day window on the highest-claim conditions, insurers can offer affordable premiums to the broader pool.
Conditions captured by the 90-day window
The four conditions almost universally subject to the 90-day window are:
- Cancer (of specified criteria)
- Heart attack
- Stroke
- Coronary artery bypass surgery
Accidental injuries, paralysis, severe burns, and most other listed events are usually covered immediately or after a shorter delay. Specifics vary by product.
How the panel applies the rule
- AIA Crisis Recovery: Cancer, Heart Attack, Stroke, and Coronary Artery Bypass Surgery are subject to a 3-month qualifying period. AIA Priority Protection PDS (9 November 2025), Section 4, page 59 (footnote 1 to Crisis Event table).
- Zurich Trauma cover: 90-day exclusion period applies to most trauma conditions. Zurich Wealth Protection PDS (1 November 2025).
- TAL Critical Illness Insurance: 3-month qualifying period applies to listed conditions, set out in Section 2.3 footnote. TAL Accelerated Protection PDS (12 December 2024).
- OnePath Trauma Cover: "Some insured trauma conditions have a 90-day" qualifying period. OnePath OneCare PDS (1 October 2025).
- Encompass Critical Illness Cover: 90-day exclusion period applies to listed critical illness events. Encompass Protection PDS (26 September 2025).
- NEOS and Futura: "Some Critical Illness Events are also subject to a qualifying period." NEOS Protection PDS (6 December 2024); Futura Protection PDS (1 October 2025).
- ClearView and Acenda: 90-day qualifying period for listed conditions per each Product Disclosure Statement.
When the clock starts
The 90 days run from the date the insurer formally accepts your policy, not the date you submitted the application. If you are diagnosed during the qualifying period, the insurer is generally not obliged to pay the trauma benefit. The rule applies even if all other policy terms are satisfied.
Portability and waivers when switching insurers
If you have already served a qualifying period with one insurer and you replace the cover with a new insurer, some products waive the new qualifying period. OnePath OneCare PDS includes an explicit waiver clause for replacement of comparable cover (OnePath OneCare PDS (1 October 2025), section on Replacement Cover). Conditions usually attached to a waiver:
- The original cover must have been fully in force.
- The original qualifying period must have been served.
- The replaced cover must be cancelled at the same time the new cover starts.
- The new sum insured generally must not exceed the original.
Check the relevant Product Disclosure Statement for the exact waiver wording.
Qualifying period vs survival period
The two concepts are often confused:
- The qualifying period (90 days) applies at the start of the policy and bars claims for listed conditions during that window.
- The survival period (typically 14 days) applies to every claim and requires the insured to remain alive for 14 days after diagnosis before benefits are paid.