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Travel Insurance - What does Pre-existing condition mean?

It’s the deep heart of winter for Canada and the country is under a blanket of snow, fighting freezing temperatures, so the natural thing is to think about travel to warmer climates.  Many people have group insurance polices that cover out of province and out of country travel but how often to they look at the restrictions? 

Travel insurance coverage, whether it be part of a group plan or purchased individually, is a necessity to avoid potentially huge costs born personally for medical expenses while out of province or country.  However, there is a devil in the details and that is something called a pre-existing clause and it is not uniform to all insurance products.  To avoid a surprise bill after you receive treatment for illness or accident while away, taking time to understand pre-existing conditions is important.

A pre-existing clause is something insurers place on a possible to limit their exposure to loss, particularly loss that is more likely to happen.   A clause will usually state that any person with a pre-existing condition, no manner how minor, will not be eligible to receive coverage under the policy should they receive treatment for that condition.  If a person had high blood pressure and was hospitalized while away for an illness or event related to their high blood pressure condition, they would not be eligible for coverage under the policy due to the pre-existing condition. 

However, when pre-existing conditions exist it’s not always clear cut as not every insurance company treats pre-existing conditions the same way.  For instance, if a person received treatment via medication for a pre-existing condition and the dosage or prescription of that medication has not changed in a year then the pre-existing condition clause would not apply.  Another aspect that affects the use of pre-existing conditions is the age of the insured.  Some insurance companies will allow someone of a younger age to have a pre-existing condition and be stable for a shorter amount of time.  This could mean not receiving treatment for that condition after 30 days of diagnosis.  A person might have a 90 day or 180-day requirement depending on their age. 

One other complicated issue is when a woman is pregnant and buys an insurance policy that includes both travel health and tour package coverage 6 months before the trip.  While she is healthy to travel, and her doctor might approve she could be within a time frame unacceptable to the insurance company’s conditions.  Should she go into labor early while traveling that cost might not be covered by the insurance company. 

Any of these events could costs hundreds to hundreds of thousands of dollars that could be the responsibility of the person, not the insurance company.  The best way to avoid these costs is to ensure you know your recent medical history and you review it with your insurance agent when you buy the policy.  Almost all applications require some sort of review or disclosure but being up front and understanding what you are covered for and what not can allow you to make a sound purchase when it comes to your travel insurance policy. 

21.01.20
Written By: BSI