TravelCare

TravelCare

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Pre-existing medical conditions

Pre-existing conditions are not automatically covered under your travel insurance policy. We want to help you understand what a pre-existing medical condition is and what you need to do if you have any so that you know what you are covered for under your travel insurance policy.

What is a pre-existing medical condition?

We consider a pre-existing medical condition to be any illness or injury of any person named on your Certificate of Insurance, which that person is aware of, or a reasonable person in that person’s circumstances ought to have been aware of, which in the last 3 years prior to your:

  • start date of insurance (on the Single Trip Policy); or
  • issue date of insurance (on the Annual Multi-Trip Policy),

that person has sought, received, been recommended or is waiting for:

  • advice from a health professional;
  • tests, investigations or specialist consultations;
  • care, treatment, or medical attention including surgery; or
  • medication or a script for medication,

whether or not a medical diagnosis has been made.

If you are completing the online application for other people, make sure you know their medical history.

How do I know if I have a pre-existing medical condition?

If you are unsure about the name or details of your pre-existing medical condition, please check this with your doctor and get a copy of your medical records. If you have questions around what you should or shouldn’t declare on your travel insurance policy, please contact us.

It is important to remember that it is your (the customer’s) responsibility to declare any pre-existing medical conditions you wish to seek cover for.

What conditions must I declare?

If you have type 2 diabetes or a heart, vascular or lung illness including hypertension/high blood pressure, high cholesterol, heart attack, angina, atrial fibrillation, palpitations, stroke or asthma, you must declare these as well as any other pre-existing medical conditions that you may have when completing the online medical assessment tool during the application process. If you don’t tell us about all of your pre-existing medical conditions, it could affect your cover, and we may not be able to look after you on your journey. We will let you know whether or not we can offer cover for these for you, and if we can, you can still decide whether or not to add cover for them.

What happens if I don’t tell you about my pre-existing medical condition?

If you have any heart, vascular or lung illnesses or type 2 diabetes, you must tell us about these and any other pre-existing medical conditions that you may have otherwise it may affect your cover and we may not be able to look after you on your journey.

Any other pre-existing medical conditions that you choose not to seek cover for, or do not tell us about, won’t be covered under your policy. You can still buy a policy with us, but you will not be covered for any claims directly or indirectly related to your pre-existing medical conditions.

What do I need to do to seek cover?

During the policy application process, you will be asked a few questions about whether you have any pre-existing medical conditions.

If you have type 2 diabetes or a heart, vascular or lung illness, which you must declare with all other pre-existing medical conditions, you will be taken to an online medical assessment to complete.

If you do not have type 2 diabetes or a heart, vascular or lung illness but you have other pre-existing medical conditions, you will be given the option to complete a medical assessment. If you wish to apply for cover for your pre-existing medical conditions, you must tell us about of all of them, otherwise it could affect you cover.

Following the medical assessment, the outcome of whether we can offer you cover for your condition(s), and any additional premium required, will be displayed to you before you decide whether to proceed with the policy. If we are able to offer cover for your pre-existing medical conditions and you would like to have the cover under your policy, you must pay the additional premium. Once we have received any additional premium, you will receive an email from us confirming cover for your pre-existing medical conditions, which will be listed as covered conditions on your Certificate of Insurance.

If we do not offer cover, or if you decline to pay the additional premium to have cover for your pre-existing medical condition(s), they will not be covered under your policy and we will not pay any claims, costs or losses under any section of your policy, directly or indirectly arising from, related to or associated with your pre-existing medical conditions. The exception to this is that your pre-existing medical conditions are covered under your policy for funeral expenses/return of mortal remains (unless a terminal condition is confirmed before your start date of journey).

How do I seek cover for my pre-existing medical condition after purchasing my policy?

Once we have issued your policy, you are no longer able to declare any pre-existing medical conditions and we will not pay any claims directly or indirectly related to these pre-existing medical conditions.

If you have forgotten to seek cover for your pre-existing medical conditions during the application process, you will need to apply for a new policy to complete a medical assessment. Once the outcome of the medical assessment is displayed to you, you can decide if you wish to proceed with the extra cover and purchase a new policy, and then cancel your old policy. This can all be done on our website.

If you’ve selected a Single Trip Policy and you cancel your cover more than 14 days after your start date of insurance but prior to your start date of journey, you are entitled to a refund, less a $35 cancellation premium, provided you have not made a claim.

If you’ve selected an Annual Multi-Trip Policy and you cancel your cover more than 14 days after your issue date of insurance but prior to your start date of insurance, you are entitled to a full refund.

Are there any pre-existing medical conditions you do not cover?

We do not offer cover for pre-existing medical conditions in the following conditions:

  • Any pre-existing condition which is not a covered condition
  • A sexually transmitted infection (STI) (excluding covered conditions relating to HIV)
  • Travel exhaustion
  • Travelling against medical advice at any time
  • Elective or cosmetic procedures or treatment, including any complications that arise from any such procedure or treatment; The exception is that cover will be provided under this policy if:
    • you have had an elective or cosmetic procedure or treatment that was medically necessary and performed for medical purposes by a registered surgeon prior to your journey;
    • you have been declared by a medical practitioner as fit to travel;
    • the elective or cosmetic procedure or treatment is a covered condition; and
    • you or someone acting on your behalf, contacts Southern Cross Emergency Travel for prior approval before any medical expenses are incurred on your journey;
  • Your refusal to return to New Zealand after the date when you may, in the opinion of our medical adviser, have safely been evacuated to New Zealand.
  • Undergoing an abortion where it is not deemed medically necessary to do so by a registered medical practitioner.
  • Pregnancy except for pregnancy up to and including the 20th week, providing the pregnancy was without complication prior to your start date of insurance. Cover is for medical complications only. Common symptoms, including breast tenderness, constipation, fatigue, frequent urination, heartburn and nausea (morning sickness) are not covered.

Undiagnosed health conditions

As we can’t assess:

  1. your undiagnosed pre-existing medical condition(s); or
  2. any new undiagnosed illness or injury that occurs between your:
    1. start date of insurance and your start date of journey (on the Single Trip Policy); or
    2. issue date of insurance and your first start date of journey, or prior to your start date of journey for each journey (on the Annual Multi-Trip Policy),

we cannot offer cover for these health conditions and we will not pay any claims, costs or losses under any section of this policy, directly or indirectly arising from, related to or associated with (a) and (b) above.

The exception to this is that your pre-existing medical conditions are covered under your policy for funeral expenses/return of mortal remains (unless a terminal condition is confirmed before your start date of journey).

What is a covered condition?

A covered condition(s) means in relation to each person named on your Certificate of Insurance:

  • any pre-existing medical condition(s); or
  • any change to your covered condition(s) (including without limitation, any change in the prognosis of a covered condition); or
  • any new illness or injury:
    • between your start date of insurance and your start date of journey (on the Single Trip Policy); or
    • between your issue date of insurance and your first start date of journey or prior to the start date of journey for each journey (on the Annual Multi-Trip Policy),

that you have disclosed to us, for which any additional premium required by us has been received by us and we have confirmed cover to you on your Certificate of Insurance and/or an Endorsement to your Certificate of Insurance.

What if my health changes before I depart?

You must call us if you have any changes to your covered conditions (including a change in the prognosis of a covered condition) or develop any new illness or injury a) between your start date of insurance and your start date of journey (on the Single Trip Policy) or b) between your issue date of insurance and your first first start date of journey or prior to your start date of (journey for each journey (on the Annual Multi-Trip Policy) so we can carry out a medical assessment.

We will let you know if we are able to offer you cover, what you are covered for and any additional premium required for this cover. We will confirm any change to your cover in writing, so you can relax on your holiday, knowing exactly what you’re covered for.

If you do not tell us about any change to your health, you will not be covered for any claims, costs or losses directly or indirectly arising from, related to or associated with that change to your covered condition or that new illness or injury in health whilst you are overseas. The exceptions to this are:

  1. that any illnesses or injuries are covered under Section D1.6 of the Policy, Funeral expenses/return of mortal remains (unless a terminal condition is confirmed before your start date of journey); and
  2. where we agree to cover the change to your covered

Any further deposits or payments made in relation to your journey after you become aware of any change to your covered conditions (including any change in the prognosis of your covered condition) or any new illness or injury, are at your own risk and may not be covered under your policy.

Your cover if you are on a waiting list or scheduled to receive a procedure

You will not be covered under for cancellation or changes to your journey before you leave or once you have left for any claims, costs or losses directly or indirectly arising from, related to or associated with healthcare services and procedures (including overnight or day surgery), which you were on a waiting list for, or scheduled to receive, prior to your start date of insurance.

This applies even if your health conditions are listed as covered conditions on your Certificate of Insurance or an Endorsement to your Certificate of Insurance.

What happens if I have to make a medical claim?

If for any reason you have to make a medical claim, we would look at the medical report from the overseas treating doctors, as well as any relevant history from your local GP, to determine if the claim is related to a pre-existing medical condition or not.

If you are unsure whether you have a pre-existing medical condition, we recommend that you contact us directly to speak to one of our experts.

Need some help?

If you would like to get in touch, we’re here to help. Please feel free to email us info@scti.co.nz at any time, or speak to one of our friendly insurance experts on 0800 800 571. Our office hours are Monday - Friday 8:30am – 5:00pm AEST/AEDT.

When calling from overseas, our worldwide emergency assistance team is available 24 hours a day, 7 days a week on +64 9 359 1600.

*Terms and conditions apply to the promotion and to the purchase of a TravelCare policy.

Issued and underwritten by Southern Cross Benefits Limited trading as Southern Cross Travel Insurance. 

We are a Registered Financial Service Provider and a member of the Insurance & Financial Services Ombudsman Scheme.  Southern Cross Benefits Limited has an A (Strong) financial strength rating given by Standard & Poor's (Australia) Pty Ltd. The rating scale is: AAA (Extremely Strong) AA (Very Strong) A (Strong) BBB (Good) BB (Marginal) B (Weak) CCC (Very Weak) CC (Extremely Weak) SD or D (Selective Default or Default) R (Regulatory Supervision) NR (Not Rated). Ratings from 'AA' to 'CCC' may be modified by the addition of a plus (+) or minus (-) sign to show relative standing within the major rating categories.  Full details of the rating scale are available at www.standardandpoors.com. Standard & Poor's (Australia) Pty Ltd is an approved agency under the Insurance (Prudential Supervision) Act 2010.

All our travel insurance policies (including but not limited to the benefits, terms, conditions and exclusions) and premiums quoted are subject to change.

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