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How do I know if I need pre-existing coverage?

5 April 2013
How do I know if I need pre-existing coverage?
Travel Insurance FAQs

Travel insurance claims are often denied when the travel insurance company determines that the reason a traveler canceled their trip or sought medical care while traveling results from a pre-existing medical condition.

Here’s how travel insurance companies define a pre-existing condition: it’s any medical condition that the insured experienced the symptoms of or had diagnosed and treated during a specified time (called the look-back period) prior to their policy’s effective date.

What’s the look-back period? It’s the amount of time prior to your travel insurance policy’s effective date that the insurance company will review for evidence of a pre-existing condition if you file a claim. This amount of time varies from plan to plan, but is typically 60 to 180 days.

You Need Pre-existing Coverage If

If you sought a medical diagnosis or changed your prescription medications during that period, you need pre-existing condition coverage with your travel insurance plan to avoid claim denials. Remember, if you think you may have to cancel your trip due to someone else’s illness (like a parent’s for example), then the rules apply there as well.

Scenarios to Consider

The following scenario was pulled from complaints about travel insurance from one who purchased a plan:

My father was visiting from India. He was treated for hypertension several months prior but was free of high blood pressure and off medication before leaving India. While visiting the U.S., he was treated again for hypertension. Our travel insurance claims were denied. Why?

The specific dates of the plan were not clear in this case, but the insurance company determined their claims were due to pre-existing condition because the insured traveler’s symptoms began prior to coming to the U.S.

What went wrong? The family made the assumption that there would be no recurrence of their father’s high blood pressure.

Here’s another scenario from the comments:

My 35-year old husband had some low-grade chest pain which we thought was indigestion and a visit to our regular doctor didn’t reveal anything other than that. We booked our travel and purchased travel insurance. Weeks later, when his pain escalated and we went to the emergency room, the docs sent him for a stress test with a specialist. The specialist advised us the next day that we should not travel, but our claim was denied for a pre-existing condition.  We didn’t know it was that serious when we booked our travel.

What went wrong? In this case, the first doctor didn’t discover the seriousness of the husband’s health problem but the specialist did. It’s unfortunate but the claim was denied because the cancellation was directly or indirectly related to the conditions a person had symptoms of in the 120 days prior to the policy’s purchase.

Many travelers make assumptions like this, but it’s important to note that the travel insurance companies will review the records of patients for evidence of an existing medical condition. If a previous trip to the doctor’s office reveals that the condition now causing a travel insurance claim is connected, then that is cause for a claim denial.

See our review of pre-existing condition coverage for more information.

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Damian Tysdal
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DamianTysdal

Damian Tysdal is the founder of CoverTrip, and he believes travel insurance should be easier to understand. He started the first travel insurance blog in 2006.

Damian Tysdal is the founder of CoverTrip, and he believes travel insurance should be easier to understand. He started the first travel insurance blog in 2006.