Pre-existing coverage plans in travel insurance

Travel insurance for pre-existing conditions

A pre existing condition is defined as any condition, ailment or injury or related condition(s) for which the insured had signs or symptoms, which was diagnosed and for which the insured received medical advice/ treatment, within 48 months prior to commencement of the first Policy issued by the Insurer.

This means that if the insured is traveling abroad with a pre existing condition and avails of any treatment abroad, the insurance company will not be liable for paying the claim.

The insurance company normally goes by the guidance of the attending physician in the medical facility abroad while deciding whether a condition is pre existing or not. If the attending physician declares that the cause of the treatment is a pre existing condition carried by the insured, then the treatment costs will not be reimbursed under the policy.

Some insurance companies offer a limited coverage for medical expenses arising due to pre existing conditions, when the situation is Life threatening in nature (between $1,000 and upto 10% of Accident & Sickness Sum Insured). This coverage is only available till the insured traveller can be made medically stable.

A Life threatening condition is an unforeseen medical emergency, which puts the life of the insured at extreme risk. In such event, measures solely designed to relieve acute pain or make the insured medically stable, provided to the Insured by the Physician for Disease/accident arising out of a pre-existing condition would be reimbursed upto a limit specified in the policy terms and conditions. The treatment for these emergency measures would be paid till the insured becomes medically stable or is relieved from acute pain. All further medical cost to improve or maintain medically stable state or to prevent the onset of acute pain would have to be borne by the Insured.

It is important to be noted that all plans displayed on the eindiainsurance website do not offer coverage for pre existing conditions. Hence the traveller should review the plan prior to purchasing the same, if they are looking for such a cover. If the traveller still has clarifications regarding the same, it is better to speak to our customer service executive.

Most policy certificates of the insurance companies explicitly state the non availability of coverage for pre-existing diseases on the face of the policy certificate, and the policy terms and conditions which are shared with your along with the certificate, will state that this coverage is not available as well.

For example if the insured traveller is a diabetic and are is under continuous medication for diabetes, the same will be treated as a pre-existing condition and excluded under the policy. This means that if there is any treatment undertaken by the insured while abroad, and the attending physician deems that this is related to his/her diabetic condition, then the insurance company has the right to repudiate the claim. It is important to however note that if there is any treatment availed by the insured which is not related to the diabetic condition, then the same is covered under the policy. Similarly, for a heart patient, if they are under continuous medication for the condition, the same will be treated as pre-existing.

Also If they have had the bypass surgery within 48 months prior to commencement of your travel/trip, then the same will be treated as a pre-existing condition under the policy and any claim/treatment occurring as a result of the surgery, will not be covered under the policy. Similarly if 48 months have elapsed since the surgery, but you are still under continuous medication for the bypass, the same will be treated as a pre-existing condition and excluded under the policy. However if there is any treatment availed by the insured which is not related to the diabetic condition, then the same is covered under the policy.

The good news for all travellers with a pre existing condition is that there are some insurance companies which provide this coverage subject to prescribed limits, terms and conditions. The traveller can log onto eindiainsurance and check out the Pre Existing Coverage section to opt for such plans. It is strongly recommended that if the traveller has a pre existing medical condition, they avail a suitable plan (even if the coverage for such conditions is limited) prior to departing on their trip.