Pre-existing medical conditions

northern_at_heart

I'm not sure if this should go on this board or the Travel board so apologies if I'm wrong.

I just wanted clarification on pre-existing medical conditions and travel insurance (single trip to US). It appears you usually have to let them know of any treatment you've had over the last 1 or 2 years: I've taken medication for anxiety over the last year or so but stopped a few months ago (I'm now fine and there's no way it would cause me problems on my hol) although I still have a valid prescription. I'm also taking medication for acne - surely this doesn't count as a pre-existing condition?! I've also had a colposcopy which turned out fine: ie. there was no medical problem there.

Does this mean if I don't mention this stuff I'm simply not covered for problems arising from these 'conditions' , or would it make my whole policy invalid if for example I broke my leg or lost my bags?

Quentin

If you don't answer the questions truthfully then they can invalidate the whole policy in the event of a claim.

foggytown

Quentin wrote: »

If you don't answer the questions truthfully then they can invalidate the whole policy in the event of a claim.

Out of curiosity, why is it that the FOS has been enlightened enough to declare that a mis-statement made on a home policy (e.g., proposal shows better door locks than actually exist) can't be used to deny a burglaryclaim if the poorer locks had nothing to do with the burglars' entry, but a unreported trivial medical condition can still be the basis of a denial for a totally unrelated medical claim?

FH_Brit

FOGGY - It's not a case of poorer locks, or a "trivial" medical condition.

First any omitted information means that it is not possible for the IC to assess the actual risk your condition creates.

Therefore as you have falsely obtained insurance by (technically) failing to tell the truth or missguide the IC in your statement when proposing the policy.

Every proposal will have that disclosure statement that reads (or to the effect) .......
I declare the information given is to the best of my knowledge correct and true.........
If you KNEW it was not correct or true then you have made a fraudulent statement.

swagman

Being the 'owner' of a fine collection of medical complaints I have been through this process often. An article in the Guardian several months ago found that the Post Office travel insurance would cover a woman of 84 with a heart condition and a history of cancer! You have to go through the facts with their call centre.

Club Direct, Covermytravels and Sun World Plus (you can Google for contact details) have all in the past given me cover and written into the policies cover for pre-existing medical conditions. A common requirement is that there should have been no change of medication for 12 months - ie that a condition is stable. It is OK to have had medication reduced.

Good luck

foggytown

FH_Brit wrote: »

FOGGY - It's not a case of poorer locks, or a "trivial" medical condition.

First any omitted information means that it is not possible for the IC to assess the actual risk your condition creates.

Therefore as you have falsely obtained insurance by (technically) failing to tell the truth or missguide the IC in your statement when proposing the policy.

Every proposal will have that disclosure statement that reads (or to the effect) .......
I declare the information given is to the best of my knowledge correct and true.........
If you KNEW it was not correct or true then you have made a fraudulent statement.

Perhaps you could read my post again and then answer the points made therein?

FH_Brit

FOGGY - Perhaps I am miss-reading or missunderstanding!!!

in both cases the proposal would be/is false. If your home policy states you have better locks than you do, then you are responsible to rectify the mistake (even if it is not your mistake) and as you fail to correct then it could be your fault if they then deny your claim because what would stand up in court is what is in the policy T&C's (as that is the legal binding contract).

The FOS is NOT LAW - any IC can challange the FOS' ruling and even not comply to it - I have a customer in this situation at the moment, the FOS Adudicator upheld the complaint (in favour of the policy holder) so the IC appealed and it went to the Ombudsman himself. He has ruled in favour of the patient (policy holder) now the ONLY action the patient can take is to sue the IC - I am sure the IC will face reprocussions but I don't know what that is.

Also the FOS probably have the same view as I do - it don't matter what locks are on, if they are going to rob you then they WILL get in - good locks are just a deterant not a prevention. All burgulars have master keys to every house (they are called bricks! - a brick through a window don't stop to look at what type of locks there are as it hits the glass!)

With the PEMC I will say most (but probably every) policy proposal says something like you must disclose any PEMC, failure to do so may invalidate this policy (words to the effect of and they may, of course, have a list that excludes disclosure) and in non-disclosure you are clearly in breach of the terms which the policy was provided. Medical problems increase the risk to the IC and for risk assesment you HAVE to disclose.

kaz-mex

My mum took out travel ins with Liverpool & victoria via Nationwide for a year for herself and my dad declaring what pre-existing medical conditions they believed they had, unfortunatly my dad died 4 weeks before their holiday of an Aortic aneursym, on the medical certificate the doctor filled in it she mentioned that this had been detected 4 years ago however they were just gonna keep an eye on it, my dad never received any treatment, consultations, further tests, medication nothing was ever heard about this until about a week before he died when he had a cat scan. Liverpool & Victoria have rejected the claim because of this, is it worth challenging this as they didnt declare it due to them not thinking of it as a PEMC as my dad had not shown any symptoms and I believe they had quite simply forgot about it, they have lost a lot of of money approx £1200 they got a partial refund of 30% from Thomsons. Any advice will be grateful.

Quentin

You will find the policy will specifically refer to any heart problem "ever" needing to be declared.

bigjl

kaz-mex wrote: »

My mum took out travel ins with Liverpool & victoria via Nationwide for a year for herself and my dad declaring what pre-existing medical conditions they believed they had, unfortunatly my dad died 4 weeks before their holiday of an Aortic aneursym, on the medical certificate the doctor filled in it she mentioned that this had been detected 4 years ago however they were just gonna keep an eye on it, my dad never received any treatment, consultations, further tests, medication nothing was ever heard about this until about a week before he died when he had a cat scan. Liverpool & Victoria have rejected the claim because of this, is it worth challenging this as they didnt declare it due to them not thinking of it as a PEMC as my dad had not shown any symptoms and I believe they had quite simply forgot about it, they have lost a lot of of money approx £1200 they got a partial refund of 30% from Thomsons. Any advice will be grateful.

I would think most insurance companies would consider an AAA to be a medical condition, a medical condition doesn't have to be symptomatic to be considered a medical condition, as soon as it is spotted it then becomes relevant, in a perfect world the NHS would have the money to sort these problems out as soon as they are spotted, sadly with other posters on the forum trying to insist on an operation for minor cosmetic issues and the widespread problem of medical tourism the money isn't there.

Getting back to the OP, tell them everything and leave it up to the insurance company to decide if they think it is relevant, if it isn't it will make no difference to the premium paid, but the OP wouldn't be best pleased if the insurance wouldn't pay up for medical treatment and repatriation by private plane because they didn't mention a minor medical condition.

In the context of medical condition anything that is likely to affect you for a period of time or has the possibility of recurring is a medical condition, and insurance companies are very good at avoiding paying out over trivial issues. If they are acting within the T&C then they will do it to save money, that is the nature of the business.

kaz-mex

bigjl wrote: »

I would think most insurance companies would consider an AAA to be a medical condition, a medical condition doesn't have to be symptomatic to be considered a medical condition, as soon as it is spotted it then becomes relevant, in a perfect world the NHS would have the money to sort these problems out as soon as they are spotted, sadly with other posters on the forum trying to insist on an operation for minor cosmetic issues and the widespread problem of medical tourism the money isn't there.

Getting back to the OP, tell them everything and leave it up to the insurance company to decide if they think it is relevant, if it isn't it will make no difference to the premium paid, but the OP wouldn't be best pleased if the insurance wouldn't pay up for medical treatment and repatriation by private plane because they didn't mention a minor medical condition.

In the context of medical condition anything that is likely to affect you for a period of time or has the possibility of recurring is a medical condition, and insurance companies are very good at avoiding paying out over trivial issues. If they are acting within the T&C then they will do it to save money, that is the nature of the business.

Thankyou for your help, this was just the thing he never showed any symptoms until 4 years later when he was complaining of pain in his side and wasnt till a week and a half later when they did a cat scan that they found that it was leaking. He had been in hospital on afew occasions previously related to his COPD which they did declare and never had any problems with his heart. Just a sad fact that they declared what they thought to be all PEMC it wasnt done intentionally because he didnt receive any treatment for it or suffered from it.