We’ve all heard a travel insurance claim horror story like the person who needed emergency heart surgery in an overseas hospital, made a claim on their travel insurance only to find out it was ‘rejected’ because of a pre-existing condition and they’ve had to foot a $100,000 hospital bill.
But if you have a preexisting medical condition, these stories aren’t any comfort. You want to be able to go on a holiday with peace of mind knowing that if something did happen you would be covered.
Now there is a reason why every travel insurer and comparison sites like Mozo will have somewhere in bold writing: READ THE PRODUCT DISCLOSURE STATEMENT (PDS) before you take out travel insurance. The PDS is where you will find the information about the policy exclusions, insurance eligibility and limits and it shouldn’t be only read by people with a preexisting condition but by everyone before they step foot on the plane or cruise.
In this guide we’ll run through some of the must-knows about pre-existing conditions and travel insurance so that when it comes to selecting a policy you’ll have a good understanding of what to look for and the questions you should ask the insurer.
Generally speaking, a pre-existing condition is an injury, sickness or condition that you’ve had advice for, symptoms of or treatment for.
Every insurer will have a list of conditions that they will provide cover for, here are some common conditions:
Depending on the condition as well, the insurer may have specific eligibility requirements or state a period of time that your condition must not have worsened or changed in any way. This can be anything from 30 days to a year depending on the condition.
If you are pregnant for instance, most travel insurance policies will allow you to travel up to 26 weeks but only if the pregnancy was conceived naturally (no IVF) and there were not any prior complications or issues with previous pregnancies.
Even if you don’t think your condition is particularly serious you should always tell your insurer about it as it is better to be safe than sorry.
Will I have to pay an extra premium?
Not always. Many travel insurers have standard policies that will include cover for a set number of pre-existing medical conditions at no extra cost. The important thing is to disclose any condition so that if you do need to pay extra or get additional documentation to prove you are fit to travel you can.
If you’ve had a serious injury or illness such as heart conditions or cancer it is likely that you will need to get specialist cover and this will require you to pay an extra premium.
Will I need to get a medical evaluation?
Many insurers will have an online medical screening process as part of the application and this will let you explain your medical condition and history. In many instances you are not required to get a doctor’s certificate, the insurer will be able to advise you whether they can cover you or not online or over the phone.
Some insurers on the other hand will require to you get a medical evaluation or doctors report to prove that you are fit to travel. It will all depend on your medical history and condition.
When should I buy my insurance?
You should buy your insurance as soon as you make your travel plans and pay for any accommodation, flights or prebooked tours.
At the time of purchasing your insurance you’ll need to be ‘fit to travel’ even if your trip is several months away. You will only be covered for trip cancellation if you need to cancel due to unforeseen circumstances related to your pre-existing condition. If you have been ill in the trip lead-up you may not be covered. Your insurer will have the right, should you make a claim, to look back at your medical history.
How can I compare travel insurers that provide cover for my condition?
Mozo’s made this easy. Our database includes policy information from over 50 insurers. Just enter your travel plans and then when you get to the results page you can filter by existing conditions. This will then resort your results so that you can choose a provider that covers for that condition. We don’t list every single ailment so you might need to select a similar condition and then contact the insurer to see if they will cover you for your medical condition. Compare 50 + travel insurers.
What if my condition can’t be covered?
If your condition can’t be covered you have two options: modify your travel plans or take the risk. You’ll still be able to get travel insurance for everything else like luggage, car rental excess, cancellation and other illness not related to your condition, but claims arising from or related to your condition won’t be covered.
Other than medical, what other cover should I get?
When you take out a travel insurance policy you will have a number of options from a basic policy to a comprehensive cover. If you’ve got a preexisting condition it is likely that you’ll want the highest possible medical cover available, but travel insurance covers you for many extras including:
If you need to make a claim on your insurance you will need:
A police report. If you’ve had items lost or stolen you will need to have a copy of a police or security report that details when, when and what was lost or stolen and the value of the items.
Copies of all receipts related to the claim. If you’re claiming for trip cancellations or lost luggage you’ll need to show copies of receipts or invoices that detail deposit amounts and total cost of items.
Your policy number. You will need to submit a claim form (usually online) with details of your policy number and traveller details.
Pay the excess. You’ll need to pay the excess for every event you are claiming for on your policy.
Mozo top tip: It’s a good idea to file your claim in a timely manner as soon as you return home as many insurers will have deadlines for making claims. Generally you will have around 30 days from your date of return.
If you feel that your insurance claim has been rejected for no just reason you can lodge a complaint with the financial ombudsman service.
The first step however would be to contact the insurer and ask for a detailed explanation why they are rejecting the claim. If this doesn’t resolve the issue you can then lodge a formal complaint.