These situations become difficult for both the insurer and the insured.
Unless a pre-existing condition has been divulged in an application to an insurer prior to the travel commencing, it can be challenging getting claims paid.
It is vitally important to disclose any medical conditions to an insurer so they are fully aware of both past and current health status. This will mitigate any risks of an insurer declining a claim due to complications associated with a pre-existing condition. The approach that an insurer uses to assess an application will generally be of a holistic view to determine what other health events or symptoms could potentially arise in someone with a particular medical condition. Such conversations are similar to those that naturally take place between a doctor and a patient, where the doctor might provide a diagnosis and advise the patient of the potential symptoms to look for as a prompt to gain further medical attention.
It is wise to alert an insurer to one’s health status upfront, as it allows insurers to assess risk and is the best opportunity for the traveller to have conditions covered before embarking on an overseas experience, particularly when there is an ongoing chronic condition involved. Insurers have a team of medical advisers that highlight possible health complications in individuals that have medical conditions, so it is much more straight forward and less risky for the traveller to be clear on what the insurer might consider an exemption under the policy. This protects the traveller from having to meet medical costs if the worst occurs, particularly as costs often run into the tens of thousands of dollars. It will also save them untold time and stress.
If on the other hand a pre-existing condition is disclosed on an application and the insurer does not exclude the condition, the cost of any medical care in relation to that condition and any complications that might arise, are covered and the insurer is duty-bound to pay.
Consulting an experienced adviser can help with navigating this area, fraught with pitfalls.