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Can I Still be Eligible for VHIS with an ACL Injury?

Author Bowtie Team
Updated on 2025-07-10

 

Disclaimer: This article is translated with the assistance of AI.

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What is Anterior Cruciate Ligament Injury?

The cruciate ligaments are two strong bands inside the knee joint that connect the femur and tibia, specifically the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). They provide stability for forward-backward movements and rotations, which are essential for everyday activities and sports.

According to CUHK statistics , Hong Kong sees over 2,000 new cases of ACL injury or ruptures each year on average. An ACL injury is a common sports injury, especially in situations like:

  • Sudden changes in direction
  • Abrupt stops
  • Slowing down while running
  • Incorrect landing from a jump
  • Direct contact or collisions, such as tackling in soccer or rugby

Underwriting Considerations for ACL Injury History

During the VHIS underwriting process, applicants must honestly disclose their medical history. If the insured has experienced a cruciate ligament injury, the insurance company will consider factors like:

1. What treatment did the insured receive? (Including medication/surgery)

The type of treatment can affect overall health risks. So, we evaluate the methods used, such as whether cruciate ligament reconstruction was performed or if conservative treatment was the only option.

2. Has the insured fully recovered? Are there any lingering issues?

We assess the extent of recovery, including factors like the date of the last treatment, the date of full recovery, and the absence of any complications (such as chronic pain, limited knee movement, or stiffness and weakness in the knee).

Underwriting Outcomes for Cruciate Ligament Injury History

1. Successful Policy Issuance

If the insured has undergone cruciate ligament reconstruction and has fully recovered for more than two years without any complications, coverage can be provided at standard levels.

2. Successful Policy Issuance with Increased Premiums and/or Exclusions

If no cruciate ligament reconstruction surgery was performed and/or recovery is not complete and/or there are complications, the insurance company may still approve the policy but will adjust premiums accordingly (known as loading) and/or add exclusions based on these factors.

3. Direct Policy Decline

If the insured has not fully recovered, has other complications, or requires further treatment, we may decide to decline the policy based on the specific circumstances.

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*Full coverage shall mean no itemized benefit sub-limits, and applies to designated benefit items only. The benefit payable shall be subject to the remaining deductible (if applicable), annual benefit limit, lifetime benefit limit and other limitations such as reasonable and customary charges, a pre-existing condition, “List of Designated Hospitals in Mainland China” and receiving medical treatment in the United States. For detailed terms and conditions, product risks, and exclusions, please refer to the relevant product website and policy.
^For example, with Bowtie Pink (Ward) and the deductible option HK$80,000, the monthly premium for a 30-year-old non-smoker is HK$197. The premium comparison above is based on similar medical insurance plans with the ward level (data source on 27, July 2023), HK$50,000 to HK$80,000 deductibles, for a 30-year-old non-smoker. Different medical insurance plans have different coverage and benefit limits. For details, please refer to the relevant insurance policy and its terms and conditions.

 

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