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Medical conditions cover

Overview

By way of basic overview, We do not cover any claims under the Policy benefits Arising from any Medical condition or Pregnancy condition that existed during:

unless We agree to list the relevant Medical condition or Pregnancy condition as covered on Your Certificate of insurance. If any Changes in health occur after We have listed any Medical condition or Pregnancy condition as covered and before the date of departure for Your Trip, the cover for those listed conditions are automatically excluded from the time the Changes in health occurred, unless You undertake an additional medical screening and We agree to list them as covered.

Any cover is subject to the other terms and conditions (including exclusions and limits) of the Policy which may otherwise affect cover. Any rights We have will only be exercised to the extent permitted by applicable law. See General Exclusions that apply to all benefits.

After the date of departure for Your Trip, We will not agree to list a Medical condition as covered on Your Certificate of insurance.

No cover is provided under this Policy for any claims Arising from, or any way related to a Medical condition or Pregnancy condition which existed within the period of 3 years prior to the Policy issue date, of any person who is not named on Your Certificate of insurance, except as specifically considered as Close relative conditions under Benefit 5: Trip Cancellation Expenses, Benefit 6: Trip Disruption Expenses or Benefit 7: Trip Resumption Expenses.

What is a Medical condition?​

A Medical condition means any bodily or physical Injury, physical defect, illness, disease or other medical or dental condition or sign or symptom of these things, the applicable person:

  • required prescription medication for or has been prescribed medication from a Medical practitioner in writing for,
  • sought or received medical advice from a Medical practitioner or other health care professional for,
  • had tests, investigations, care, treatment or medical attention including surgery for,
  • been admitted to Hospital for (including emergency department or day surgery procedure), or
  • became aware of or which a reasonable person in the circumstances would have been aware of.

It includes but is not limited to:

  • the suffering or treatment of Mental illness,
  • a brain, heart (such as any cardiovascular or coronary heart disease or any condition related to a heart or blood vessels), kidney, liver, respiratory, circulatory (such as high blood pressure, stroke, or transient ischaemic attack), cancer or cancerous condition,
  • reduced or deficient immune system,
  • a sign or symptom of the above matters,
  • an allergy or food intolerance,
  • a persistent and lasting health condition such as constant pain or long-suffering pain or pain with a pattern of relapse and remission, or
  • any conditions related to previous and current pregnancy as detailed below in “What is a Pregnancy condition?” and Pregnancy Cover.

What is a Pregnancy condition?​

A Pregnancy condition means You are pregnant and any of the following circumstances apply to You: 

  • You are experiencing complications with the pregnancy that fall within the definition of Complications of pregnancy and childbirth in Table 1.1, or
  • You experienced complications with any previous pregnancy that fall within the definition of Complications of pregnancy and childbirth in Table 1.1, or 
  • You are having multiple children (e.g. twins, triplets or more), or 
  • Your conception was medically assisted (e.g. hormone therapy or IVF). 

Our screening process​

To apply for cover in relation to any Medical condition and/or Pregnancy condition You need to do the following:

Step 1 - When You apply for cover

If You have or have had any such conditions during the period of 3 years prior to Your Policy issue date You need to complete Our online or over the phone medical screening process as part of Your application for cover. The medical screening may also include questions about Your general health.

If We are able to provide cover in relation to the conditions You disclose, We will tell You, and if You want the cover You will need to pay the additional premium We apply for the cover by the time required, and We will list the conditions as covered on Your Certificate of insurance.

If We do not list such conditions as covered (or You do not disclose any such condition to Us), there is no cover provided in relation to it (to the extent permitted by applicable law).

Step 2 – After purchase and any Changes in health occurs

If any Changes in health occurs (see explanation below) after Your Policy issue date and before the date of departure for Your Trip, You need to contact Us and undertake a further screening process to determine what premium adjustment may be required.

This is because We automatically exclude cover for:

See General Exclusions that apply to all benefits, in particular General Exclusion 20.

Based on the rescreening We may (to the extent permitted by applicable law):

  • Agree to provide cover for the existing listed conditions and add the new listed conditions as covered. You may choose to accept this cover or not. If You do not, You will not be covered in relation to the conditions not listed as covered, or
  • Not agree to provide cover, where based on the changes, Our underwriting rules require Us to do so.

On being advised of the changes, We will adjust the premium payable (up or down) to reflect the premium that is payable by reason of the changes in accordance with Our underwriting rules.

Remember, if further Changes in health occur before the date of departure for Your Trip, You may need to undertake this screening process more than once as the above Changes in health exclusion would automatically apply again from the time any further Changes in health occur.

In all of the above cases, if You are not happy with Our decision You may exercise Your cooling off rights where applicable or cancel the Policy before the date of departure for Your Trip and obtain a refund in accordance with the Policy terms.

What are Changes in health?​

See Changes in health special meaning for details, but by way of limited example Changes in health includes:

You must have confirmation that You are fit to travel

Before the date of departure for Your Trip, You must have written confirmation from Your Medical practitioner that You are fit to travel for any Changes in health listed as covered on Your Certificate of insurance. The written confirmation does not need to be sent to Us, however it may be required in the event of a claim.

What We need from You to complete a medical screening​

You will need reasonable knowledge of all of Your Medical conditions, Pregnancy conditions or Changes in health, which include but are not limited to, the names of Your Medical conditions or Pregnancy conditions.

Check with Your Medical practitioner if You are unsure of the name because You will not be able to complete the medical screening if You only know the medication You are taking or the treatment You are receiving.

As some Medical conditions may be interconnected, You must declare all of Your Medical conditions, Pregnancy conditions or Changes in health, regardless of whether or not You:

  • Want cover for them, or
  • Consider them treated, dormant or under control, or
  • Do not consider them important or related to any of Your other conditions.

If You do not declare all of Your Medical conditions or Pregnancy conditions, You may not have cover for Your Medical conditions or Pregnancy conditions that are listed as covered on Your Certificate of insurance.