When it comes to travel insurance, it’s essential that you understand your obligations to disclose your medical history, changes to your health and other personal information.
Failing to properly disclose these details can result in your policy being cancelled or your claim being denied if you require treatment while travelling, leaving you on the hook for hefty medical bills.
In fact, the number one reason why travel insurance claims are declined is for non-disclosure or misrepresentation.1
Understanding disclosure requirements is particularly important for snowbird, senior and boomer travellers, who tend to have more medical issues and changes to their health than other travellers.
To help you minimize the chances of having your travel insurance claim denied due to non-disclosure or a misstatement, we have developed our Top Travel Insurance Disclosure Requirement Tips.
Disclosure Requirements When Purchasing Your Travel Insurance
When applying for travel insurance, you will be asked to provide details like your name, age, travel destination, trip duration etc… Make sure you complete this information accurately.
Once you reach a certain age, you will also be required to complete a medical questionnaire when applying for travel medical insurance coverage.
The age when a medical questionnaire become mandatory varies among insurance companies, but typically starts between age 55 and 60, which means that most snowbirds, boomers and seniors will have to complete a medical questionnaire.
The format of the questionnaire and the questions you need to answer will also vary depending on the type of policy you are purchasing and the insurance company providing coverage.
Standard vs. Personalized Policies - Travel Insurance Medical Questionnaires
The format of the medical questionnaire you need to answer will be different depending on whether you are applying for a Standard or Personalized policy:
Standard travel medical insurance policies require you to answer a lengthy medical questionnaire that consists of several pre-defined questions about your health and medical history.
Standard policies also have a Stability Clause that requires your pre-existing medical conditions to be stable for a specified period of time (typically 90 or 180 days) prior to your departure date in order to be covered, so make sure your pre-existing medical conditions meet your policy’s stability clause requirements, or your claim relating to those pre-existing conditions could be denied.
Personalized travel medical insurance policies, on the other hand, don’t require you to complete a lengthy medical questionnaire.
Rather, you will simply need to answer a few pre-screening questions and disclose all of your past and current medical conditions (you may also be asked follow-up questions about each of those conditions).
While the process is easier, you will need to know your medical history and ensure you aren’t leaving anything out.
Personalized policies do NOT have a Stability Clause, so any pre-existing medical conditions you disclose at the time of purchase will be covered, regardless of how long they have been stable.
Some Important Notes
The following apply to both Standard and Personalized policies:
- Be aware that some medical conditions may make you ineligible for coverage.
- If your medical condition changes from the time of purchase to the date of departure, you will need to notify your insurer (see below for more details).
Full and Accurate Disclosure
Regardless of the type of policy you are applying for, it is essential that you always complete your entire insurance application - including the medical questionnaire - truthfully and accurately.
As mentioned previously, failure to fully and accurately disclose your medical history and other information is the number one reason for the denial of travel medical insurance claims and can be grounds for your insurance company to deny any claim you make under your policy, even if the claim is unrelated to a medical condition you failed to disclose.
Be aware that it doesn’t matter if your failure to disclose is intentional or unintentional, which means that even an honest mistake may result in your policy being voided or your claim being denied.
If you’re tempted to intentionally provide inaccurate or incomplete information in the hopes of getting a lower premium or coverage for an ineligible medical condition – don’t. If you ever make a claim, your insurance company will review your medical records and become aware of the missing or inaccurate information. At claim time, your insurance provider will obtain the medical case notes from the physician treating you at the destination as well as medical case notes from your family doctor and any specialist(s) you may have seen at home.
The same consequences apply even if you accidentally provide incomplete or inaccurate information about your medical conditions, so if you’re uncertain about your medical conditions or have any questions, make sure you speak to your doctor before submitting your travel insurance application.
An example of inadvertently providing incomplete or inaccurate information would be an individual who suffers from diabetes and has a heart condition as a result of their diabetes. The individual may honestly believe that they don’t have a heart condition because it is related to their diabetes, and as a result only disclose the diabetes. However, the individual would in fact be required to disclose both the diabetes and the heart condition. Typically, an insurer will have probing questions during the application process to help reduce the likelihood of a situation like this.
In the event of a claim, if the insurance company discovers that you have not truthfully and accurately answered the medical questionnaire, they can void your policy and refund your premiums. You will then be responsible for any medical expenses that were incurred as a result of your claim.
Disclosure Requirements After You Purchase Your Travel Insurance
It’s important to be aware that your obligation to fully and accurately disclose your medical conditions to your insurer doesn’t stop after you purchase your policy.
Travel medical insurance policies require you to inform your insurer of any change to your medical condition after you purchase your policy and prior to your departure date.
This ongoing disclosure requirement also applies if you travel back to your home province after you have departed on your trip, which essentially means you need to disclose any changes to your health that occur while in your home province during your coverage period.
And any changes really does mean any changes, which includes things you may not immediately think of including such as increases and decreases in medication dosages, starting or stopping medications, and having diagnostic tests for potential new medical conditions, even if those conditions are not yet diagnosed.
If you fail to disclose changes it can be grounds for denial of any claim made under your policy, even if the claim is for a medical issue that is unrelated to the change in your medical condition.
When you inform your insurer of changes to your medical condition it can result in one of three outcomes to your insurance policy, depending on the change to your health:
- No change in your premiums or coverage;
- An increase in your premium; or
- The cancellation of your policy and a refund of your premium if the new condition is severe enough that your insurer won’t cover it.
Standard vs. Personalized Policies – Ongoing Disclosure Requirements
While both Standard and Personalized policies require you to disclose any changes to your health after you purchase your policy and before you travel, the coverage consequences can be different under each type of policy.
For example, under a Standard policy, if you have a change to your health and you are still eligible for coverage, any medical conditions related to that change would be subject to a stability clause and may not be eligible for coverage.
However, under a Personalized policy, if your health changes and you are still eligible for coverage, any medical conditions related to that change would NOT be subject to a stability clause and would be eligible for coverage.
Tips to Remember
- Make sure you always complete your insurance application and medical questionnaire truthfully and accurately. When in doubt, speak to your physician about your medical conditions.
- Travel medical insurance policies have ongoing disclosure obligations that require you to inform your insurer of any change to your medical condition after you purchase your policy and prior to your departure date.
- Personalized policies have the advantage of providing coverage for pre-existing medical conditions with NO stability period.
1KPMG survey of Canadian insurance providers commissioned by the Travel Health Insurance Association of Canada (THIA) (November 2014)
Disclaimer: The material provided in the Snowbird Advisor Insurance Learning Centre is for informational purposes only and does NOT constitute insurance, legal, financial or other advice, and should not be relied on as such. If you require such advice, you should speak with a qualified professional to assist you.