An illness or condition shall be considered Pre-existing if, during the period prior to the Effective Date of the Agreement or the approval date of reinstatement in case of lapsation, a) any professional advise or treatment was given for such illness or condition; b) such illness or condition was in any way evident to the member; or c) the pathogenesis of such illness or condition has started whether or not the member is aware of such illness or condition.

The following ailments and their complications, among others, when occurring during the first year of coverage after the Effective Date or reinstatement date shall be considered Pre-existing:

(a) cancer and tumors of the internal organs including the brain and the thyroid glands
(b) endometriosis
(c) hemorrhoids
(d) diseased tonsils requiring surgery
(e) pathological abnormalities of nasal septum and turbinates
(f)hyperthyroidism/goiter
(g) cataracts
(h) sinus condition requiring surgery
(i) epilepsy
(j) asthma
(k) cirrhosis of the liver
(l) tuberculosis
(m) anal fistulae
(n) cholecystitis / cholelithiasis
(o)calculi of the urinary system
(p) gastric or duodenal ulcer
(q) hallux valgus
(r) all the tumors of the skin, muscular tissue, breast, bone, or malignancies of blood or bone marrow
(s) diabetes mellitus
(t) hypertension
(u) collagen disease
(v) cardiovascular diseases
(w) hernia
(x) HIV/AIDS

II. DREADED DISEASES

The following illnesses/conditions and their complications are considered dreaded and are subject to the Maximum Sum Per Disability stated in your schedule:

(a) Neurological
(b) Blood Dyscracias
(c) Collagen / Immunologic disorders
(d) Liver cirrhosis
(e) Chronic pulmonary/Renal
(f) Cardiovascular
(g) Cancer
(h) Any condition which will necessitate the use of the ICU
(i) AIDS
(j) Accidental Injuries

For Individual/Family Members the total liability of PhilamCare on any dreaded disease and its complications during the entire lifetime of a member shall be limited to the Maximum Sum Per Disability.