7 Jun 2025

How a health problem you don't know about could disrupt insurance

11:40 pm on 7 June 2025
Blank travel insurance form and map on background

Changes in medication for ongoing conditions could also be an issue. Photo: 123RF

You don't need to be diagnosed with a health condition to have it stop a travel insurance claim from being paid, the Insurance and Financial Services Ombudsman says.

Karen Stevens' scheme is one of several external dispute resolution services, which deal with complaints that cannot be resolved directly between consumers and financial services providers.

She said people were often caught out when they went to claim on travel insurance policies, particularly when it came to pre-existing health conditions.

Insurers usually required people to disclose all health conditions when they take out travel insurance, and then decide whether to charge an extra premium to cover them or exclude them from the policy.

Stevens said travel insurers had different ways of collecting information and sometimes people did not realise they had a health condition to declare.

"People think they're okay and they're not."

Many policies would count previous symptoms, not just diagnoses, as an existing health condition.

"They don't have to know they have a particular thing called something, all they need to know is they had a sore back or a cough they didn't have before," she said.

Changes in medication for ongoing conditions, such as asthma or blood pressure, could also be an issue.

People may have claims turned down, because of their relatives' health or age. Someone who cancelled a trip because of a parent's health, for example, could find their insurer would not pay, if their parent had a pre-existing condition.

In a case dealt with by another dispute provider - Financial Services Complaints Ltd - a man spent $24,000 on a trip through North America and Europe. Between booking the trip and travelling, the man was told he had small kidney stones that did not need further treatment.

He did not tell his insurer, believing the situation would resolve on its own, but his symptoms flared up while he was overseas and he was admitted to hospital. The trip was cut short.

He made an insurance claim that was declined, because the policy excluded pre-existing medical conditions. He and his partner had to pay several thousand dollars for international medical bills and other expenses, said FSCL, which did not uphold his complaint.

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