Pre-Existing Medical Conditions

Our travel insurance provides cover for unforeseen medical events only. Therefore not all pre-existing medical conditions are covered, however 35 are automatically covered with our policies. Terms and conditions, limits and exclusions apply. Please see PDS for full details.

We treat pre-existing medical conditions in one of 4 ways:

Automatically Covered, Limited Cover, Compulsory Disclosure and Assessment By Application.

 

Frequently Asked Questions

  • Q: What Is A Pre-Existing Condition? 
  • A pre-existing medical condition is:
    a)       any medical or physical condition, defect, disease or illness including any mental illness, of which you were aware or should reasonably have been aware, and for which treatment, medication, preventative medication, advice, preventative advice or investigation have been received or prescribed by a medical or dental adviser in the 90 days prior to the relevant time; or
    b)       any chronic or ongoing (whether chronic or otherwise) medical or dental condition, illness or disease of which you were aware or should reasonably have been aware, and which is medically documented or under investigation prior to the relevant time; or
    c)       any surgery which you have undergone in the past 12 months; or
    d)       pregnancy that is not automatically covered
    e)       any of the above conditions which are the subject of an investigation, even if the condition has not been diagnosed.

    Relevant time in respect of:
    a)       Single trip policies means the time of issue of the policy.
    b)       Frequent traveller policies means the first time at which any part of the relevant trip is paid for or the time at which the policy is issued, whichever occurs last.

    This above definition applies to you, your travelling companion, a relative or any other person.
     

 

  • Q: How Long Will It Take To Process My Medical Form?
  • It will take between 24-48 working hours.

 

  • Q: Can I Apply For Pre-Existing Medical Condition Cover From Overseas?
  • No, you cannot apply for cover for a medical condition once you have left home.

 

Terms and conditions, limits and exclusions apply. Please see PDS for full details.

 

What Conditions Are Covered Automatically?

The pre-existing medical conditions listed in the table below are automatically covered under this policy without assessment or additional charge, provided:

  • the condition has been stable for more than 12 months; and
  • there is no planned surgery, treatment or specialist review; and
  • you have not attended hospital for treatment for the condition in the past 12 months.
  • cover does not extend to cover any routine treatment or management of your approved pre-existing medical condition(s); for example, blood test and prescription renewals.
     

If your condition is listed in the table, but you do not meet these criteria for automatic cover, you may still apply for cover – see By Application below.

 

 

What Conditions Cannot Be Covered?

We regret that we if you have any of the excluded pre-existing medical conditions listed below, you have no cover under the following sections of the policy and you cannot apply for cover for them:

Section 1 - Overseas Emergency Medical Assistance

Section 2 - Overseas Emergency Medical & Hospital Expenses (Including Dental Expenses)

Section 3 –Additional Accommodation & Travel Expense

Section 3B - Emergency Companion Cover

 Section 5 – Hospital Cash Allowance

Section 13 - Cancellation Fees & Lost Deposits

Section14 - Disruption of Journey

 

The excluded pre-existing medical conditions are:

a)       you have been given a terminal or palliative prognosis for any condition with a shortened life expectancy;

b)       you require home oxygen therapy or will require oxygen for the journey (including in flight);

c)       you have chronic renal failure treated by haemodialysis or peritoneal dialysis, or have been advised that you will require it in the future;

d)       you have an AIDS defining illness or any condition or treatment causing you immunosuppression; or

e)       you have had, or are on a waiting list for an organ transplant.

Compulsory Disclosure

When you apply for a policy you MUST tell us about the following medical conditions or circumstances, even if you no longer receive treatment for them and you don’t require any additional cover. 

a)       Cardiac or heart conditions;

b)       Respiratory or lung conditions (other than asthma satisfying the auto acceptance conditions or where you are on home oxygen as above);

c)       Metastatic or secondary cancer;

d)       Dementia or medically documented memory loss; or

e)       If you are being accompanied on your Journey by a full time carer.

We will assess your application and decide whether and to what extent we can offer you insurance for your condition and/or journey.

If you have not told us about a pre-existing medical condition when you were required to do so, we may refuse your claim or reduce it to the amount we would have paid had you told us about the condition.

 

By Application

You can apply for cover for any other pre-existing medical condition that is not described above.

 

To tell us about or apply for cover for a pre-existing medical condition, please provide us with a completed Pre Existing Medical Declaration form.

In some cases, we will require your treating doctor to provide a further declaration– we will tell you if this is required.

Depending on your condition, we may decline to cover you, limit the amount of cover, exclude specific medical conditions and/or agree to provide cover for an additional premium.

Each condition that we agree to cover will be noted on your certificate of insurance after you pay any applicable additional premium. You are not covered unless the condition is noted on your certificate of insurance.

We will only pay for treatment that was not expected at the time we agreed to insure you.

 

Pregnancy

You are covered under the policy while you are pregnant:

  • For single foetus pregnancies – up to the 24th week of gestation.
  • For multiple pregnancies – up to the 19th week of gestation.

If you have experienced complications or your pregnancy arose from medical intervention, assisted conception or fertility treatment, you must provide us with a completed Pre-Existing Medical Declaration Form. You can obtain the form by calling us on 1300 368 344.

In some cases, we may require your treating doctor to provide a further declaration– we will tell you if this is required.

We will assess your application and decide whether and to what extent we can offer you insurance for your pregnancy and/or journey.

Depending on the circumstances, we may decline to cover you, limit your cover and/or agree to provide cover for an additional premium. Any limitation on cover will be noted on your certificate of insurance.

If you have not told us about the circumstances of your pregnancy when you were required to do so, we may refuse your claim or reduce it to the amount we would have paid had you given us the required information.

 

In no circumstances will we pay any medical expenses for:

  • regular antenatal care;
  • childbirth at any gestation; or
  • care of the newborn child.

 

 

Download A Medical Declaration Form

 

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