We have been with our (Australian) health fund for under 12 months (about 9) and our (2.5 y/o) daughter needs her tonsils out. We sincerely were unaware that she was having issues, so it was news to us that she needed them out.

The health fund has asked us to get our GP and the specialist to fill out a 'pre-existing' form to determine whether the condition was present in the 6 months BEFORE joining the fund.

Both doctors have signed it without a problem, but I am worried the health fund still won't accept the claim.

Has anyone been through this? What are the chances that the fund will pay on our claim? Any advise if we have to fight them on this?

Though I haven't dealt with this issue personally, I don't think it's uncommon for insurance companies to do some "pre-existing" checks prior to surgery since they have become so costly. It sounds like it's standard procedure to me. If both of the physicians have signed the forms, you should be good to go. Good luck - I'm sorry you have to worry about forms and insurance at a time like this.

I work in health insurance, and for most times, if there is no lapse in coverages (it depends on the state/country you're in.. it varies from 30-63 days) with insurance companies, it should all be covered. Call your insurance and ask specifically, trust me, we have all that information at our fingertips.