CHOICE membership

Travel Insurance for Pre-existing Conditions


#21

Thanks for that reply. I think you have nailed what I was trying to say very well, and raised a couple of very important points along the way. In my quest for travel insurance I have found that there are indeed very few available options despite an apparent plethora of choices. Most of those “choices” are in fact the same choice cloaked in the veneer of different companies. The underlying computer checks are essentially the same and the phrasing and processes suggest that I am in fact not dealing with more than a couple of separate entities.

It is like so many of these corporate hierarchies, which disguise subsets of the same organisation under a layer of apparently distinct companies. It may be legal, but it is deceptive and immoral in my view.

I think that your comment that “Technically, the industry could be discriminating illegally” is probably correct, and it concerns me that even a group such as Choice is unable to penetrate the secrecy behind insurance company behavior.
Perhaps Choice could use its influence to initiate a political agenda to strip away some of the secrecy and to make insurance generally a fairer and more transparent area. We all need insurance; we all have insurance, but insurers also need us. Perhaps it is time the Government required the insurance industry to be more accountable and responsible, and to return to the original premise which was not to make a lot of money, but to provide protection for the community as a whole.


#22

Sorry but that is not true. You can travel whether you have travel insurance or not, the only person stopping your travel is you because the risk of travel without insurance to cover your pre-existing condition is too high for you. Just to be the devil’s advocate here for a moment, maybe the risk is too high for them to offer you cover and you want to make it an obligation for them to cover you, this could be seen as not a fair contract/negotiation.

I think it stinks that they do not cover you if you are willing to pay a premium on that risk (and that premium by the same token may be much higher than you are willing to bear) but as I don’t know how they assess it is hard to say if it is right or wrong in your case. Why not make a complaint to the Financial Services Ombudsman’s Office (https://www.fos.org.au/resolving-disputes/our-new-process/) about the process? Perhaps you may receive a clearer answer, you may not but the more information you receive, I am sure, will help Choice and other interested parties get a clearer picture of how this system operates or doesn’t operate.

Insurance companies have always been about making money, protection against some of the risk for the community was only a service that allowed them to make money (not all risk unless the buyer paid huge premiums). Many Governments do provide varieties of insurance such as Work Cover to cover people but this has grown out of a socially required response as normal insurers did not supply this kind of cover and if they do, it is not generally supplied by the other insurers at anywhere near the level of the Government run ones.

In other posts about businesses not caring about consumers I have pointed out the Corporations Act requires the Corporations to maximise the returns to their investors…that has always been their premise and purpose. Way back when this Capitalism started it was “caveat emptor” (https://www.investopedia.com/terms/c/caveatemptor.asp) and “Laissez-Faire” (https://www.investopedia.com/terms/l/laissezfaire.asp). Insurance has and will continue to be a way for investors to get dividends.


#23

There is also the exemption of…“in a case where no such actuarial or statistical data is available and cannot reasonably be obtained—the discrimination is reasonable having regard to any other relevant factors

Relevant factors isn’t defined in the Disability Discrimination Act 1992, but it could be assumed that this would be any information provided to support the request for cover. I also expect the insurance companies would argue that any pre-existing condition which could be triggered by travel, for example strenuous activities or failure to take medications would increase the risk levels to their business. A company (and the potential policy holder) would not know if the policyholder would be subject to conditions through travel which triggered the pre-existing condition.

I am a bit perplexed by this statement. If T&Cs of every policy excluded pre-existing conditions, then possibly yes like that tested in the mental illness case. But it appears this is not the case and cover based on risk is possible at some cost.

If the company considers relevant factors, and refuse cover, they possibly would be exempted.

What they should do in any case is provide information of why cover was declined by responding directly to information provided. For example they could say unacceptable risk due to…or even insufficient information to make informed decision. The later would allow negotiations to provide information necessary to make an informed decision in the affirmative or negative.

Responding as such would confirm that they have considered the relevant factors as required by legislation. If they don’t, then it would be difficult to determine if they have/haven’t to meet their legislative obligations.


#24

I am a member of a professional association that includes travel insurance as a benefit for members. This is an annual corporate policy that cover both business and leisure travel. As the insurance is automatically available to all members of the association, the individual insured person is not assessed and the policy does not exclude pre-existing conditions. I have been told that as long as I was fit to travel I will be covered for medical expenses incurred when travelling.

So it may be worth looking at whether you can to obtain a Corporate travel policy through a business or association.


#25

That is the crux of this matter. For example you ‘feel fit’ but have a pre-existing condition, they then could possibly void the policy or reduce benefits for any part of an incident if you suffered an incident that had some relationship to your pre-existing condition because they could argue even thought you felt fit you were not fit on assessment of your claim. This detail should certainly be covered in their Product Disclosure Statement (PDS) which you should examine to ensure you are really covered.

Also as an example of automatically available cover I have once before in another post pointed to the Gold Mastercard PDS https://www.commbank.com.au/personal/apply-online/download-printed-forms/ADB631.pdf. That document indicates any user of the Card is eligible for the cover automatically but on reading further, things like Pre-existing Conditions and the resultant effects of these are not covered unless the Insurer agrees to cover these conditions/events/circumstances (not guaranteed to do so) and payments to cover these are made before booking and travel are undertaken.

They, the Gold/Platinum/Diamond card insurers also totally exclude cover for a number of issues such as age (ie if 80 years old or over), certain health conditions including HIV, and a number of others and no agreement to cover these are available.


#26

FWIW you will find similar wording in most insurance PDS regardless of kind, in various flavours. It is often just a simple wording like ‘accepting the claim’.


#27

We pretty much always go through our health insurer GMHBA but it’s really an Allianz policy.
https://enhance.agatravelinsurance.com.au/gmhba

My wife has Crohns & IF I read & understand the T&C correctly she is covered at extra cost within limits - like no recent in-hospital, but I’m not truly confident if we ever had to make a claim… They sort of a have a pseudo online self-assessment process but it’s not exactly transparent. The policy itself appears to be reasonable for our needs in comparison to others & the premiums I think are very competitive.


#28

The problem lies mainly with the move from human based assessment to computer based assessment. There is no provision to clarify questions or to add supportive information. Questions such as “Has your medication changed in the last x months” do not allow for situations where medication has been reduced, and so if your condition improves answering this question will suggest that it has worsened.

I have no objection to insurers assessing the risk, but only if the assessment truly takes into account all variables rather than trying to fit everything into a package that makes no allowance for important factors, or which allows ambiguities to exist. Having a human assessment option easily available would resolve this to a large extent.


#29

“ambiguities” - yes! Like “Have you been in hospital for your condition in the last 2 years” YES/NO - actual answer - Well yes, BUT, only for a routine scope/check as the specialist keeps tabs on things… :confused:


#30

Exactly! The process is full of these small but important traps for the unwary. There are a few of these questions which simply do not allow you to provide accurate information, and they are also framed in such a way as to allow them an “out” if anything happens. Win win for the insurers.


#31

Maybe it’s time for a class action lawsuit to get a common law precedent…


#32

I’d love to test this assertion in the High Court…


#33

Similarly, I also have a heart condition, only picked up in exercise ECG. ‘Have you had a heart attack?’ was the question. ‘Not knowingly, but can guess when it was due to strange feeling’ was my reply.

The ‘heart attack’ was 12 years ago, I’m 71 and row 3000 metres each morning on a Water Rower and have had nil surgery .

The past week I’ve been endeavouring to get cover for my condition to travel to the USA for 3 weeks.
Have contacted about 12 companies, including those with a ‘Seniors score’ over 65 in the current Choice review.

One of those will cover me for $2,000 odd, the balance declined me, including the top rated.

Another (a major which asked for specialist’s reports, finally approved me with heavy qualifications including an excess of $1,000 per event and a maximum all up cover of $100,000 - only a couple of days treatment in USA.

First, Choice should run through these with a fine tooth comb and ascertain those which will entertain heart cover. With a filter to ascertain that I’m sure a heap of members would be grateful for an less stressful pre holiday chore.

Second, get this included in current Royal Commissions.

cheers
Dennis


#34

I am confident that your experience is mirrored throughout the community, especially as the population ages. I am shortly to embark once again on what I know will be a long and hard battle to obtain insurance. This is despite numerous medical tests showing that my health is not likely to pose a significant obstacle to my travelling enjoyment. The only barrier is the refusal of insurance companies to provide cover at a reasonable rate.
It should be apparent to those companies that they are missing out on a potential goldmine, given that there are so many cashed up retirees looking to travel.
I do believe that Choice is not taking up this sort of issue in the way that they both could and should. Testing an electric kettle is nowhere as important as lobbying for better treatment of seniors, especially as we cannot individually achieve much on our own.
Choice has the power and the resources which we lack, but apparently no-one is interested in taking on the might and political clout of the big insurers. We have our banking investigation, so why not an investigation of a similarly recalcitrant sector of our society which clearly makes a lot of money by simply refusing to insure anyone with any element of risk attached. That’s not what insurance was originally designed to achieve.


#35

Thanks for the feedback @boblorel and @d_oflynn. I’ll be sure to share your comments with our travel insurance reviewers to see if there more we can do in the future.