Medical Conditions

A Pre-existing Medical Condition means any physical or mental illness, disease, injury, condition, disability or symptom – whether diagnosed or not – that existed at or before the date of policy purchase.

This includes any condition that:

• is being experienced, treated, investigated (including while awaiting tests, results, specialist review or surgery), or managed with prescribed medication
• has been diagnosed, treated, investigated or required surgery or consultation with a Medical Practitioner
• has caused symptoms that were noticed or felt by the person (even if medical advice wasn’t sought) or
• is ongoing, chronic, recurring or has led to

This definition applies to any person whose health may affect the cover under this policy, including any Insured Person, Relative, Travelling Companion or anyone else upon whose health the Trip depends.

Declaration Rules

You must declare a Pre-existing Medical Condition for any traveller listed on this policy if:

• it is listed under “Conditions that must always be declared”, and/or
• it has required medical attention, treatment, medication or investigation in the 2 years before the policy commences and is not listed as an Automatically Covered Condition meeting all eligibility criteria.

If anyof Your Pre-existing Medical Conditions is not automatically covered, You must declare allof your conditions – including those that might otherwise qualify for automatic cover.

If You are unsure whether a condition qualifies, We recommend declaring it during the medical screening or contacting Us to discuss Your specific situation before purchasing Your policy

Our approach to Pre-existing Medical Conditions

Pre-existing Medical Conditions fall into three categories:

1. Conditions that are automatically covered
2. Conditions that must be declared (either always or based on timing)
3. Conditions that cannot be covered under any circumstance

If You want to be covered for a Pre-existing Medical Condition, it’s important You follow these steps:

1. Check the Automatically Covered Conditions list. If Your condition is listed and You meet all eligibility criteria, You do not need to declare it.
2. If Your condition is not automatically covered, or if You do not meet the automatic cover criteria, You must complete a medical screening.

We will assess Your medical screening and confirm whether We are able to offer cover.

Automatically Covered Pre-existing Medical Conditions

Eligibility Criteria for Automatic Cover

To qualify for automatic cover, allof the following must apply:

1. The condition is listed under “Automatically Covered Pre-existing Medical Conditions” below.
2. You have not:
   • Been hospitalised (including day surgery or A&E attendance) in the past 2 years; or
   • Received treatment (other than continued, unaltered medication) for the condition in the 90 days before purchasing the policy (or 30 days before travel for Annual Multi-Trip policies).
3. You meet all condition-specific criteria outlined below.
4. You do not have any condition listed under “Conditions that must always be declared.”

Important:

• If You have both high blood pressure and high cholesterol, automatic cover does not apply – even if each condition would qualify on its own. You must complete medical screening and declare both conditions.
• If You have either of those conditions and also have diabetes or a heart condition, You must declare all of these conditions.

 

Examples:

• You meet the automatic criteria for asthma but also have Chronic Obstructive Pulmonary Disease (COPD) and sleep apnoea. You must declare all respiratory conditions.
• You qualify for automatic cover for high blood pressure but have also had coronary stents You must declare both conditions.
• You had a hip replacement 15 years ago. Automatic cover only applies if the procedure was performed more than 1 year but less than 10 years ago. You must declare this.

 

Automatically Covered Pre-existing Medical Conditions

Provided You meet the eligibility criteria noted above, the following Pre-existing Medical Conditions are covered automatically:

• Acne
• Asthma, , provided You are under 60 years of age, have no other known or underlying respiratory conditions (including but not limited to chronic bronchitis, Chronic Obstructive Pulmonary Disease (COPD), emphysema or pulmonary fibrosis and/or sleep apnoea), haven’t required cortisone medication except taken by inhaler or puffer, haven’t required hospital treatment for asthma in the last two years and You have been a non- smoker for at least 18 months.
• Blindness and low vision
• Cataracts
• Corneal graft/corneal transplant
• Coeliac Disease
• Deafness
• Dermatitis
• Ear grommets
• Eczema
• Food allergy (provided You do not suffer Anaphylaxis following consumption of or exposure to the allergen)
• Gastric reflux
• Gout
• Hay fever
• Hiatus hernia
• High Cholesterol/Hypercholesterolemia provided it is managed in regular consultation with Your Medical Practitioner and is below 6.0 millimoles per litre and You do not also suffer from high blood pressure, other known cardiovascular disease and/or diabetes. Note: If You have high cholesterol and also high blood pressure, diabetes and/or any form of cardiovascular disease, You will need to complete medical screening to see if you can include cover for these conditions.
• High blood pressure/Hypertension provided it is managed in regular consultation with Your Medical Practitioner and You do not also suffer from high cholesterol, You do not take more than 2 medications and there has been no change in medication or dosage in the last 6 months and You have been a non-smoker for at least 18 months. Note: If You have high blood pressure and also high cholesterol, diabetes and/or any form of cardiovascular disease, You will need to complete medical screening to see if you can include cover for these conditions
• Hip replacement (if the procedure was performed over 12 months ago but less than 10 years ago)
• Knee replacement (if the procedure was performed over 12 months ago but less than 10 years ago)
• Macular degeneration
• Menopause provided You do not suffer from Osteoporosis
• Overactive / underactive thyroid provided the condition is not caused by a tumour Note: Automatic cover does not extend to autoimmune thyroid conditions such as Hashimoto’s. You will need to complete medical screening to see if You can include cover for these conditions.
• Peptic ulcer
• Psoriasis
• Pregnancy (subject to General Exclusion 33)
• Rhinitis
• Sinusitis
• Skin cancer (limited to basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) only)
• Urticaria (Hives) (provided they are not associated with anaphylaxis or any other life-threatening allergic reaction

 

Pre-existing Medical Conditions that must be declared if they occurred in the last 2 years

You must also declare any condition not listed above if, within the 2 years before policy commencement, it:

• Was known to You (or should have been);
• Required medical treatment, advice, investigation, medication, or referral; and/or
• Resulted in surgery or hospitalisation

Examples include:

• Recent injuries (e.g. fractures, dislocations, tendonitis, bursitis, recovery from surgery such as arthroscopy or rotator cuff repair)
• Respiratory infections (e.g. pneumonia, bronchitis, chest infections requiring antibiotics)
• Other infections (e.g. UTIs, gastroenteritis, cellulitis, shingles, anaphylaxis)
• ENT issues (e.g. ear infections, vertigo, tonsillitis)
• Conditions related to significantly high or low Body Mass Index (BMI) (i.e. BMI >35 or <18.5, including diagnosed obesity or underweight)
• Acute gastrointestinal complaints (e.g. gastritis, gallbladder attacks)
• Any short-term condition requiring emergency treatment (e.g. chest pain, fainting, abnormal tests)

If You are unsure, We recommend You declare it during the medical screening or contact Us to discuss Your specific situation before purchasing Your policy.

 

Consequences of medical non-disclosure

It’s very important to tell Us about all of Your Pre-existing Medical Conditions. If You don’t, We will assess any claim based on how serious the omission is. This could result in:

1. Requiring You to pay an additional premium if cover would have been granted;
2. Declining the claim entirely if the condition is material and would not have been covered;
3. Cancelling the policy from inception (voiding it) if the non-disclosure was fraudulent.

 

If Your health changes after policy purchase but before You travel

If You develop a new medical condition, new symptoms or a known condition worsens after purchasing Your policy but before travelling, You can either:

• Notify Us as soon as possible so We can reassess Your cover; or
• Obtain written confirmation from a Medical Practitioner before You travel confirming that You are fit to undertake the entire planned Trip (see definition of Fit to Travel).

Important:

• If You don’t do either of the above before departure, We may not provide cover for any claim arising from, related to or exacerbated by that condition.
• A Fit to Travel certificate can help show that You were fit to travel at the time of departure. Any claim related to that condition will still be assessed based on Your medical status when You started Your Trip. You should only travel if You are confident that You are medically fit. If You are not, You may not be covered for medical-related claims that arise during the Trip — although You may be able to lodge a Cancellation claim instead.
• To be considered, the certificate must:
  1. Be issued within 7 days of departure;
  2. Confirm that You are fit to travel for the entire duration of the Trip, taking into account Your itinerary and planned activities; and
  3. Be provided by a Medical Practitioner who meets the definition in this policy and has appropriate qualifications for the condition being assessed and sufficient knowledge of Your medical history to make an informed judgement. This may be Your treating specialist or another doctor with access to Your relevant medical records.
• If You notify Us, We will review the change in Your health and confirm whether any updates to Your cover are We reserve the right to amend Your policy to reflect changes in Your health or risk. Any changes will be confirmed in writing and, where appropriate, We will discuss what options may be available to You.

 

 

Please see the PDS below for full terms and conditions.

Product Disclosure Statement