Pre-Existing Medical Conditions

This policy only covers unforeseen medical events. Many pre-existing medical conditions are not covered.

We treat pre-existing medical condition(s) in one of two ways:

a) Automatically covered;

b) Medical assessment. This will involve completing a medical assessment online.

This Section explains which pre-existing medical conditions are covered automatically and how you can purchase cover for pre-existing medical conditions that are not automatically covered.

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

Frequently Asked Questions

  • Q: What Is A Pre-Existing Medical Condition?
  • 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 by the Pregnancy section on page XX.
    e) Any of the above conditions which are 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, or relative.
    We treat pre-existing medical condition(s) in one of two ways:
    a) Automatically covered;
    b) By application. 

 

  • Q: How Long Will It Take To Process My Medical Assessment?
  • Once you have completed your medical assessment online, you will find out immediately whether we are able to offer you cover, and if so, on what terms. You will then be given the option to purchase your policy.

 

  • 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 medical assessment below.

  • Graves’ disease
  • Hiatus hernia
  • Hypercholesterolaemia (high cholesterol)
  • Hyperlipidaemia (high blood lipids)  – provided you do not also suffer from a known cardiovascular disease
  • Hypothyroidism (underactive thyroid), including Hashimoto’s disease
  • Hypertension (High Blood Pressure) – provided you do not also suffer from a known cardiovascular disease and your most recent reading is less than 165/95
  • Impaired glucose tolerance (glucose intolerance, pre-diabetes), providing you are under 50 years of age at the date of policy issue
  • Incontinence
  • Insulin resistance
  • Menopause – provided you do not have osteoporosis
  • Nocturnal cramps
  • Pernicious anaemia
  • Raynaud’s disease
  • Sleep apnoea
  • Trigeminal neuralgia
  • Trigger finger
  • Vitamin B12 deficiency

Assessment By Application

You MUST apply for cover for any other pre-existing medical condition(s) that is not described above, even if you no longer receive treatment for them and you do not require any additional cover.

How To Tell Us About Or Apply For Cover For A Pre-Existing Medical Condition(s)

To add a pre-existing medical condition(s), you MUST let us know at the time you buy your policy and complete medical screening. We will ask you some questions about your health and then determine whether we can offer you cover and if so, on what terms.

Depending on your condition, we may decline to cover you, limit the amount of cover, exclude specific medical condition 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.

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.

Pregnancy

We Will Pay

You are covered under the policy while you are pregnant:

  • for single foetus pregnancies- up to and inclusive of the 24th week of gestation.
  • for multiple pregnancies- up to and inclusive of the 19th week of gestation.

If you have had complications of this pregnancy, or this pregnancy arises from assisted reproduction, you’ll need to complete medical screening.

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.

We Will Not Pay

In no circumstances we will pay any medical expenses for:

a) Regular antenatal care;

b) Childbirth at any gestation; or

c) Care of the newborn child. 

 

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