I think I am going a bit mad here. Every time I see this mentioned I get more confused. I interpret it as meaning that all underwriting is at the claims stage, but pre-existing conditions are excluded. If this is the case, surely they need to know that these conditions exist so surely there must have been some initial underwriting?
I think that at the claim stage they look back to the individual's health at the time the policy incepted. They can identify many pre-existing conditions by seeing if the individual had reported any symptoms (or had any treatment) from doctors' records etc. Of course, anything that was pre-existing that had not been reported or treated would not be identified as a pre-existing condition. But those cases might slip through the net with initial underwriting too, especially if the individual was not required to provide a doctors' report or undergo a medical examination at the outset.
