What is a pre-existing condition and how does it impact travel insurance?

According to Will McAleer, executive director for the Travel Health Insurance Association of Canada, a pre-existing condition, broadly defined, is a condition known to you before you travel. . (Gratisography / Pexels)

TORONTO — As the weather gets colder, many Canadians are heading abroad—hoping to catch some sun or experience an adventure before the new year begins.

But with travel comes risk of injury and illness.

This week, a Canadian man was diagnosed with a brain tumour while vacationing in Thailand and was told that he needed brain surgery, chemotherapy and radiation immediately.

The insurance company initially said that they would not cover the cost of an air ambulance because the man had checked into an emergency room about a month ago with symptoms of the flu, including a headache.

On their website, Allianz Global Assistance defines a pre-existing condition as "an injury, illness or medical condition that caused someone to seek treatment, presented symptoms, or required medication."

"This may have taken place anytime within 120 days prior to and including the plan’s purchase date."

Here’s what you need to know about pre-existing condition before you go on your next vacation:

According to Will McAleer, executive director for the Travel Health Insurance Association of Canada, a pre-existing condition, broadly defined, is a condition known to you before you travel.

“It’s kind of like your backpack that you bring with you,” he said. “You may know what the condition is or you may just have a symptom.”

McAleer said that if you visit a medical professional and they give you a diagnosis, or even a suggestion to have some tests done or to investigate a situation further, that qualifies as a pre-existing condition for most insurance policies.

He recommends that consumers be honest about their health when they apply for or purchase travel insurance, as there is a period of time where companies require health to be stable. For a young healthy person, McAleer said that is about 90 days, depending on the company.

“That is really the key, knowing your health. Know what you are bringing to that table when you are writing down an application, so that then you can ask the questions.”

If your condition changes, it’s also important to update your insurer.

MORE: 5 tips on avoiding big medical bills on vacation

McAleer also said that some people deliberately leave information off an application in order to keep their premium low—but once they get to a hospital and have to disclose an illness, symptom or condition to receive proper care, the “truth comes out.”

“When you are sitting in an emergency room, it’s not the time to be looking at the fine print of an insurance policy. You’ve been asked the questions about your own history so you can have that carefree trip.”

95 per cent of travel insurance claims are approved in Canada

McAleer said that while he would like the number of approved travel insurance claims to be at 100 per cent, 95 per cent is a “pretty good percentage.”

He also said that consumers should be aware of the additional services available to them through their travel insurance. Some policies will connect hospitals with Canadian medical professionals to ensure the patient is getting the help they need. In some cases, that includes making arrangements for the patient to return to Canada.

“It’s much more than just paying a large bill,” he said.

If you have a cold or a mild flu, McAleer said that you still shouldn’t worry about your coverage.

At the same time, McAleer said that anyone who suffers from a common cold or flu should feel very confident in their policies, as most people do not need to go to the doctor to seek medical treatment.

“(Travel insurance) is not out-of-country, provincial medical care,” McAleer said. “It’s not for you to see the doctor just to see the doctor. It’s for sudden, unexpected emergencies.”