Existing medical conditions
Find out what cover is available if you are travelling with an existing medical condition
Existing medical conditions
One minute you’re taking a cruise down the Seine in Paris, the next you’re on your way to hospital dealing with another attack of that chronic condition you’d hoped wouldn’t join you on your holiday. The question is – will your travel insurance cover it?
Will nib Travel Insurance cover me if I have an existing medical condition?
nib Travel plans offer travel insurance cover for more than 40 existing medical conditions, but you should be aware that there are conditions attached to these which you will need to meet in order for them to be covered.
And if you have an existing medical condition that isn’t automatically covered, you can apply to add the condition as a ‘Specified medical condition’ (Not available on the Essentials Plan).
What is considered an existing medical condition?
Simply put it is a condition that, at the time you bought the travel insurance policy, you or a reasonable person in your situation should have known existed. This includes conditions for which you may not be diagnosed but have been experiencing symptoms.
The full definition in the PDS further outlines what this means but common sense can help. For example:
- If you’ve had a chronic condition such as diverticulitis on and off for a few years, then it’s likely considered an existing medical condition.
- If you have a family history of heart problems and you’ve been experiencing symptoms of a heart problem, that’s likely an existing medical condition. And you should probably go to the doctor to get it checked out ASAP.
You can view the full definition in the Domestic and International PDS. If you’ve still got questions, you can contact us for further help.
What cover is available if my condition is on the list of automatically covered conditions?
You can view the list of automatically covered existing conditions in the Domestic and International PDS. We offer cover for more than 40 of our more common conditions such as asthma, diabetes, vertigo and common allergies. If your condition is included, and you satisfy all the criteria related to that condition, then you’re covered for events that arise from that condition as part of our standard cover. Exclusions may apply in the event of a claim.
How do I apply to add my condition to my policy?
If your condition is not automatically covered you can apply to add the condition as a ‘Specified Medical Condition’ to our domestic and international comprehensive plans which will ensure you’re covered for events that arise from that condition, although an additional premium and excess may apply. This additional option is not available on the Essentials Plan.
Steps to apply for a Specified Medical Condition to be added to your policy
- You must be purchasing an Australian Travel, Comprehensive or Annual Multi Trip plan plan.
- Once you’ve confirmed the right plan type, you must let us know when buying your policy that you have a medical condition that is not on the list of automatically covered conditions.
- You’ll then be asked to complete a medical screening which includes some questions about your health. We will then determine if we can offer you cover and, if so, on what terms.
- If we accept your application, you’ll need to pay an additional premium when you purchase your policy and possibly have an additional excess apply.
- The condition then becomes a Specified Medical Condition covered under your policy, and the premium and any additional excess that subsequently applies will be shown on your Certificate of Insurance.
- You’ll then be covered for claimable events that arise from the specified medical condition(s).
If your condition is not automatically covered under the policy, and you haven’t added it as a specified medical condition, then you’re not covered for any claim that arises from that existing medical condition.
If I’m eligible, what will I be covered for?
If your condition is automatically covered, or we’ve accepted and added it to your Certificate of Insurance as a Specified Medical Condition (Excludes Essential Plan), you are eligible for cover under our plans. This cover includes:
- Cancellation
- 24/7 Emergency Assistance
- Overseas Medical assistance
- Evacuation to medical facilities
- Repatriation back home to Australia
What’s not covered?
Travel insurance is designed to help with those unexpected events that can occur while travelling but doesn’t cover everything – some things we don’t cover include:
- A loss arising from any existing medical condition of you, a member of the travelling party, a non-travelling close relative or business partner, which is NOT automatically covered, which you did not disclose and which is not an accepted Specified Medical Condition.
- Any illness or death that arises from a metastatic or terminal prognosis that was made prior to the issue of the Certificate of Insurance.
- A loss arising from any condition for which you have declined treatment or further investigation recommended by a medical practitioner.
- Any medical treatment or care that is not required as an emergency, or any alternative therapy, health spa or rehabilitation centre costs, unless it has been agreed to by us.
- Elective or cosmetic treatment or surgery that is not medically necessary, or any loss arising from these treatments or their complications.
There are many terms, conditions, limitations and exclusions that relate to existing medical conditions. Read your policy carefully and contact us if you have any queries.
Frequently Asked Questions
- What is an existing medical condition under a nib Travel plan?
- An existing medical condition is one in which:
- at the time you buy your policy,
- you or a reasonable person in the same position could be expected to have been aware of the condition.
More fully, an existing medical condition is any medical condition which, at the time you buy your policy, is:
- chronic; or
- displaying symptoms; or
- under investigation; or
- pending follow-up consultation, treatment or surgery; or
- where these are recommended or planned; or
- metastatic; or
- terminal; or
- in the six months prior to the time you buy your policy there has been:
- treatment by a medical practitioner; or
- medication prescribed; or
- surgery.
Still not sure? Contact us and we can help.
- Am I covered if I have to cancel due to Coronavirus?
- The Coronavirus travel costs benefit is available on the International Comprehensive, Australian Travel and Annual Multi Trip plans. It offers cover for trip cancellation if you are diagnosed with coronavirus. You should note this section has its own benefit limit which will apply to claims related to the coronavirus-related events outlined in the PDS.
- How much cover is available if my claim for travel insurance for a cancellation is successful?
- We will pay the non-refundable portion of your pre-paid travel arrangements and cancellation fees charged by your travel agent; or the cost to rearrange your trip, if the cost is not more than the cancellation amount that would be incurred. The amount of cancellation cover is per trip for all insured travellers. The maximum amount payable is the amount that was chosen at the time of policy purchase; this chosen limit will be shown on your Certificate of Insurance.
- Is Pregnancy an existing medical condition?
- We don’t consider pregnancy to be an existing medical condition, however there are limitations and exclusions on the cover depending on how far along you are, and your conditions before and after you fell pregnant.
If you’re pregnant at the time you buy your policy, or fall pregnant afterwards, you’ll have cover under the benefits of this policy for any event that arises from your pregnancy, provided that the event that causes your claim:
- is covered by this policy;
- is a pregnancy-related illness; and
- occurs up to the end of the 26th week of your pregnancy.
We don’t consider pregnancy to be an existing medical condition. However, pregnancy-related illnesses such as hyperemesis (severe morning sickness), gestational diabetes, and any other pregnancy-related illness must have first developed unexpectedly after you bought your policy.
There is no cover for any existing medical condition related to your pregnancy, unless it has been added to your policy as a specified medical condition following a medical screening and our written offer to cover (this option is only available under the Comprehensive or Annual Multi Trip Plans, see Getting cover for existing medical conditions).
It doesn’t matter how you fell pregnant – these conditions apply whether you fall pregnant naturally or with medical assistance such as using IVF.
Looking to fall pregnant?
You don’t need to currently be pregnant to apply for cover for a pregnancy-related existing medical condition. If you’re thinking about having a baby and you have an existing medical condition related to a previous pregnancy, follow the steps above to apply for a Specified Medical Condition to be added to your policy.
- How long do I have to wait for a claim to be settled?
- Our claims service standard is to settle your claims within 10 working days upon the receipt of a completed Claim Form and all necessary supporting information. It may take longer if we don’t have all the information we need.
- Am I covered if I or a travelling companion has a change of mind about the trip?
- No – change of mind is not a covered reason for cancellation cover.
- What is the list of automatically covered existing conditions?
- You can view the list of automatically covered existing conditions in the Domestic and International PDS.