Pre-existing Medical Conditions

Existing Medical Conditions

TID received many enquiries about existing medical conditions, particularly Asthma and Allergies.

For information relating to policies purchased prior to 7 December 2017, please check the PDS provided with your purchase. You can contact us if you need this sent to you again.

For policies purchased from 7 December 2017:

Asthma 

Asthma is automatically covered for events that arise unexpectedly provided, at the date you buy your policy, you:
  • are under the age of 60 ;
  • have no other known or underlying respiratory conditions (including Sleep Apnoea);
  • haven’t required cortisone medication, except taken by inhaler or puffer; and
  • haven’t required hospitalisation for Asthma in the last two years, including as an outpatient.

Allergies

We automatically cover allergies for events that arise unexpectedly provided you follow advice in accordance with your medical practitioner (such as to carry EpiPens, antihistamines/other preventative medication at all times) and, at the date you buy your policy, you:
  • have no other known or underlying respiratory conditions or diseases (for example, Asthma); and
  • have not required treatment from a medical practitioner for your allergies in the last six months.
What we mean by an Existing Medical Condition
  • An existing medical condition is one for which, at the time of policy purchase, you have ever:
  • had symptoms or been diagnosed;
  • been prescribed medication;
  • received (or are waiting for) medical treatment;
  • received (or are waiting for) tests, investigations or specialist consultation;
  • received or been advised to attend a follow-up consultation; and/or
  • had surgery or attended a hospital or clinic (as an outpatient or inpatient).
It also includes any chronic or ongoing medical condition or terminal illness. 

This definition applies to you, a member of your travelling party, a close relative, and any other person.

Automatically covered conditions

The following are the 43 existing medical conditions covered as standard for events that unexpectedly arise from that condition, provided you satisfy all criteria listed:
  • Acne - You haven’t received treatment for your Acne from a medical practitioner in the three months prior to buying your policy.
  • Allergies - You follow advice in accordance with your medical practitioner (such as to carry EpiPens, antihistamines/other preventative medication at all times) and, at the date you buy your policy, you:
  1. have no other known or underlying respiratory conditions or diseases (for example, Asthma); and
  2. have not required treatment from a medical practitioner for your allergies in the last six months.
  • Anaemia (Iron Deficiency) - No criteria apply.
  • Asthma - At the date you buy your policy, you:
  1. are under 60 years of age;
  2. have no other known or underlying respiratory conditions (including Sleep Apnoea);
  3. haven’t required cortisone medication, except taken by inhaler or puffer; and
  4. haven’t required hospitalisation for Asthma in the last two years, including as an outpatient.
  • Bell’s Palsy - No criteria apply
  • Benign Positional Vertigo - At the date you buy your policy, you haven’t required hospitalisation for Benign Positional Vertigo in the last two years, including as an outpatient
  • Bunions -  At the date you buy your policy, you haven’t had surgery for Bunions in the last three months and have no surgery planned.
  • Carpal Tunnel Syndrome - At the date you buy your policy, you haven’t had surgery for Carpal Tunnel Syndrome in the last three months and have no surgery planned.
  • Cataracts - At the date you buy your policy, you have no ongoing complications, haven’t had surgery for Cataracts in the last three months, and have no surgery planned.
  • Coeliac Disease - At the date you buy your policy, you haven’t required hospitalisation for Coeliac Disease in the last two years, including as an outpatient.
  • Congenital Blindness - No criteria apply
  • Congenital Deafness - No criteria apply
  • Diabetes Mellitus (Types I and II) - At the date you buy your policy, you:
  1. were diagnosed more than six months ago;
  2. haven’t had any complications in the last six months;
  3. have no eye, kidney, nerve or vascular complications;
  4. have a blood sugar level reading between 4 and 12 or a HbA1C score of 9% or less; and 
  5. have no known cardiovascular/coronary heart disease.
  • Dry Eye Syndrome - No criteria apply
  • Ear Grommets - At the date you buy your policy, you have no current ear infection.
  • Epilepsy - At the date you buy your policy, you have:
  1. no underlying medical conditions (for example, previous head trauma, stroke);
  2. not changed your medication regime for Epilepsy in the last 12 months; and
  3. not required hospitalisation for Epilepsy in the last two years, including as an outpatient.
  • Folate Deficiency - No criteria apply
  • Gastric Reflux - Your Gastric Reflux doesn’t relate to another underlying diagnosis (examples: hernia or gastric ulcer).
  • Glaucoma - At the date you buy your policy, you have no ongoing complications, haven’t had surgery for Glaucoma in the last three months, and have no surgery planned.
  • Goitre -  The underlying medical cause excludes tumour.
  • Grave’s Disease - At the date you buy your policy, you haven’t received treatment from a medical practitioner for Grave’s Disease in the last six months.
  • Hashimoto’s Disease - The underlying medical cause excludes tumour.
  • Hiatus Hernia - At the date you buy your policy, you haven’t had surgery for Hiatus Hernia in the last six months and have no surgery planned.
  • Hypercholesterolemia/Hyperlipidaemia (High Cholesterol / High Lipids) - Provided you have no cardiovascular/coronary heart disease.
  • Hypertension (High Blood Pressure) - Provided at the date you buy your policy:
  1. you have no known cardiovascular/coronary heart disease; and
  2. your current blood pressure reading is lower than 165/95.
  • Hyperthyroidism (overactive thyroid) - The underlying medical cause excludes tumour.
  • Hypothyroidism (underactive thyroid) - The underlying medical cause excludes tumour.
  • Impaired Glucose Tolerance - At the date you buy your policy, you:
  1. were diagnosed more than six months ago;
  2. haven’t had any complications in the last six months;
  3. have no eye, kidney, nerve or vascular complications;
  4. have a blood sugar level reading between 4 and 12 or a HbA1C score of 9% or less; and 
  5. have no known cardiovascular/coronary heart disease.
  6. Incontinence -  You have no underlying gastrointestinal or urinary condition.
  7. Insulin Resistance - At the date you buy your policy, you have:
  8. no known cardiovascular/coronary heart disease; and
  9. not required hospitalisation for Insulin Resistance in the last two years, including as an outpatient.
  • Iron Deficiency - No criteria apply 
  • Macular Degeneration - No criteria apply
  • Migraine - You haven’t required hospitalisation for Migraines in the two years prior to buying your policy, including as an outpatient
  • Nocturnal Cramps - No criteria apply
  • Osteoporosis/ Osteopenia - At the date you buy your policy, you:
  1. haven’t had any fractures;
  2. don’t require more than one medication for this condition; and
  3. have no other conditions involving the neck or back.
  • Pernicious Anaemia - No criteria apply
  • Plantar Fasciitis -  At the date you buy your policy, you haven’t had surgery for Plantar Fasciitis in the last three months, and have no surgery planned.
  • Raynaud’s Disease - At the date you buy your policy, you haven’t required treatment by a medical practitioner for Raynaud’s Disease in the last six months.
  • Sleep Apnoea - At the date you buy your policy, you:
  1. have no other known or underlying respiratory conditions (including Asthma); and
  2. haven’t required hospitalisation for Sleep Apnoea in the last two years, including as an outpatient.
  • Solar Keratosis - Your condition has been confirmed as benign.
  • Trigeminal Neuralgia - You haven’t required treatment by a medical practitioner for Trigeminal Neuralgia in six months prior to buying your policy. 
  • Trigger Finger - At the date you buy your policy, you haven’t had surgery for Trigger Finger in the last three months, and have no surgery planned.
  • Vitamin B12 Deficiency- No criteria apply. 

What should I do if I have an existing medical condition not on the above list?

If you have an existing medical condition that’s not listed as automatically covered above or you don’t satisfy all criteria for any listed condition, we will not cover you for any claim arising from or attributable to that condition.

You can still buy a policy with us if you have one of these conditions; however, any claims which arise in relation to this condition will be excluded from the policy. 

This means, for example, that for claims arising from an existing medical condition that is not automatically covered we will not be able to pay:
  • your medical expenses whatsoever;
  • your evacuation or repatriation;
  • your trip cancellation or rearrangement costs; nor
  • any out of pocket expenses or additional expenses.

If you have an unlisted condition, you are welcome to contact nib Travel Insurance who offer a screening for existing medical conditions. Assessment of your existing medical condition is available online during the quote process or over the phone. You may ring 1300 410 272 to be assessed; just have details of your medical history ready when you call.

What if I develop a medical condition after buying my policy but before I travel?

If you develop a new medical condition (or the symptoms of one) after you buy your policy but before you depart on your trip, you must check with your medical practitioner for written confirmation that you’re fit to travel. If you don’t get your medical practitioner’s written confirmation before you travel, and/or are unfit to travel due to your medical condition, you won’t be covered for any claim that arises either directly or indirectly from that condition if you still travel. Don’t forget, if you had symptoms of a condition or were undergoing investigations for it at the time you bought your policy, we consider that to be an existing medical condition.

Existing medical conditions - close relatives

Cover is available to you when your travel plans are interrupted when a close relative is hospitalised or dies unexpectedly in Australia or New Zealand as a result of a sudden illness or serious injury arising from their existing medical condition(s). Your close relative must be residing in Australia or New Zealand at the time and not travelling with you on any part of your trip.

At the time of the policy issue, you had to have been unaware of the likelihood of such hospitalisation or death.

The most we will pay in respect of all claims arising from the existing medical condition of a close relative under all sections of the policy combined is $2,000 for a single policy and $4,000 for a family policy.

Existing medical conditions – other people

We will not pay for claims made under this policy which arise from an existing medical condition suffered by people other than those named on the Certificate of Insurance or for a close relative as noted above.


Travelling while pregnant

From 7 December 2017, we’ve also changed the cover for pregnancy and pregnancy complications. Details of changes can be found here. Refer to the policy wording under Section 6.0 Pregnancy While Travelling and the full policy wording for more information.

For information on cover for pregnancy prior to 7 December 2017, refer to the previous policy wording under Section 5.0 Pre-existing Medical Conditions.

This article was written by Travel Insurance Direct.

Full terms, conditions, limitations and exclusions are available in the PDS.
This article was written by Travel Insurance Direct.
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