Getting the Pre-Existing Denial Waived

[HLGW60]

I thought I would make a new thread since I am still not 100%convinced that buying a policy with a pre-existing condition waiver will always protect you. It is based on this article I read:

 

Most issuers of travel insurance will waive the exemption for pre-existing conditions if you meet certain requirements. The same company cited above states that you, a traveling companion, or family member can have an existing medical condition and you will still be eligible for all coverage and assistance services, as long as:

 

You purchase your insurance within 14 days of making your first trip payment or first trip deposit.

You purchase trip-cancelation coverage that covers the full cost of all your nonrefundable trip arrangements.

You are medically able to travel on the day you purchased the plan.

The total cost of your trip is $50,000 per person or less.

As with the definition of conditions, those terms are typical. The main variation is that some companies establish a buying deadline as short as seven days; I've never seen any longer than 14 days.

 

I am just not convinced that you could purchase travel insurance from your hospital bed where you are being treated for a condition and that your travel insurance would pay for medical expenses related to the same condition when you required treatment on your cruise at a later date. :confused:

[GeezerCouple]

I thought I would make a new thread since I am still not 100%convinced that buying a policy with a pre-existing condition waiver will always protect you. It is based on this article I read:

 

Most issuers of travel insurance will waive the exemption for pre-existing conditions if you meet certain requirements. The same company cited above states that you, a traveling companion, or family member can have an existing medical condition and you will still be eligible for all coverage and assistance services, as long as:

 

You purchase your insurance within 14 days of making your first trip payment or first trip deposit.

You purchase trip-cancelation coverage that covers the full cost of all your nonrefundable trip arrangements.

You are medically able to travel on the day you purchased the plan.

The total cost of your trip is $50,000 per person or less.

As with the definition of conditions, those terms are typical. The main variation is that some companies establish a buying deadline as short as seven days; I've never seen any longer than 14 days.

 

I am just not convinced that you could purchase travel insurance from your hospital bed where you are being treated for a condition and that your travel insurance would pay for medical expenses related to the same condition when you required treatment on your cruise at a later date. :confused:

 

First, TravelInsured has policies that allow 21 days (or they did as of very recently when we purchased those plans).

 

Second, and far more important, -->>IF you are IN A HOSPITAL BED BEING TREATED, then you are not "able to travel at that time".

And it wouldn't matter if you needed to cancel for a related condition or not. Your claim would be denied because you were "unable to travel on the day you purchased the coverage".

 

You should really speak with Steve about this.

He can better answer your questions, and make sure that the insurance you purchase suits your needs and circumstances.

 

GeezerCouple

[HLGW60]

First, TravelInsured has policies that allow 21 days (or they did as of very recently when we purchased those plans).

 

Second, and far more important, -->>IF you are IN A HOSPITAL BED BEING TREATED, then you are not "able to travel at that time".

And it wouldn't matter if you needed to cancel for a related condition or not. Your claim would be denied because you were "unable to travel on the day you purchased the coverage".

 

You should really speak with Steve about this.

He can better answer your questions, and make sure that the insurance you purchase suits your needs and circumstances.

 

GeezerCouple

 

Yes, this is how I interpreted the policy. A person must be medically stable and able to travel on the date they initially bought the insurance or made their first deposit in order for their claim not to be denied. Thank you.

[GeezerCouple]

Also, to keep the terminology correct (and avoid any additional misunderstandings, because this can get pretty confusing "as is"), it would be a

 

"pre-existing condition exclusion waiver"

 

It's not actually the denial that would be waived.

If all was handled correctly, then the waiver of pre-existing condition exclusion would mean that any such claim would not be denied in the first place.

 

GeezerCouple

[HLGW60]

How can an insurance company automatically give a waiver for pre-existing conditions without first having verification from a physician that the traveler was medically stable at the time he/she bought the policy? It would seem more plausible to me that they would deny the pre-existing condition waiver at the time the person makes a claim. At that point in time, the insurance company could discover that the traveler did indeed have this medical condition at the time they purchased the insurance. I mean.....right now you could be laying in a hospital bed dying and still be able to buy a policy with this waiver online with no questions asked. It would only be much later when you filed a claim that they would discover the deception and refuse your claim.

 

I am happy with my policy but I feel many folks are lead to believe that a pre-existing condition waiver has no limitations. That's why it is important to carefully read your printed contract.

Edited February 3, 2015 by HLGW60

[GeezerCouple]

How can an insurance company automatically give a waiver for pre-existing conditions without first having verification from a physician that the traveler was medically stable at the time he/she bought the policy? It would seem more plausible to me that they would deny the pre-existing condition waiver at the time the person makes a claim. At that point in time, the insurance company could discover that the traveler did indeed have this medical condition at the time they purchased the insurance. I mean.....right now you could be laying in a hospital bed dying and still be able to buy a policy with this waiver online with no questions asked. It would only be much later when you filed a claim that they would discover the deception and refuse your claim.

 

I am happy with my policy but I feel many folks are lead to believe that a pre-existing condition waiver has no limitations. That's why it is important to carefully read your printed contract.

 

The vast majority of travel insurance policies do not result in a claim.

So it would be a complete waste of time/effort to vet each initial policy for accuracy/honesty.

 

This is one reason why getting a claim processed (for a medical reason) may take longer (perhaps a lot longer) if there was not a waiver of any pre-existing condition exclusions. The insurer would have the right to inspect any previous health records to "make sure" there wasn't some previous "related" condition that they could use as grounds for denial.

 

With that waiver, there is no need.

 

All that would be at question, if anything, would be whether the insured was actually fit to travel on that one day the policy was purchased, plus, of course, whether the claim itself was valid.

 

(As an aside, if the insured was truly in a hospital bed dying, then there probably wouldn't be any later claim anyway...)

 

GeezerCouple

[HLGW60]

You are certainly a good travel insurance advocate! I would hire you in a heartbeat:)

[Mr. Click]

The last time I was in a hospital bed thinking about cruise planning I was calling the airline to cancel and split the reservation so our friends could still travel, I was emailing our TA--it was 10pm--to tell him we had to cancel etc. I cannot image anyone booking a cruise while in the hospital....I have pre-exsisting conditions, I know it, I know the basics of my health and I think about those things when I book. I also call Steve immeditately after I book and start the insurance process....

[SwissDave]

I thought I would make a new thread since I am still not 100%convinced that buying a policy with a pre-existing condition waiver will always protect you. It is based on this article I read:

 

Most issuers of travel insurance will waive the exemption for pre-existing conditions if you meet certain requirements. The same company cited above states that you, a traveling companion, or family member can have an existing medical condition and you will still be eligible for all coverage and assistance services, as long as:

 

You purchase your insurance within 14 days of making your first trip payment or first trip deposit.

You purchase trip-cancelation coverage that covers the full cost of all your nonrefundable trip arrangements.

You are medically able to travel on the day you purchased the plan.

The total cost of your trip is $50,000 per person or less.

As with the definition of conditions, those terms are typical. The main variation is that some companies establish a buying deadline as short as seven days; I've never seen any longer than 14 days.

 

I am just not convinced that you could purchase travel insurance from your hospital bed where you are being treated for a condition and that your travel insurance would pay for medical expenses related to the same condition when you required treatment on your cruise at a later date. :confused:

 

Do you mean expenses related to a 'flare up' or recurrence of the condition being treated, or, for ongoing treatment while you are away?

 

If you need ongoing treatment after leaving hospital and then going on a cruise during the treament time, then I do not think the insurance would pay for that.

 

If the hospital/Dr signed you off as fit/cured/stable whatever, but then 6 months later on holiday you had a problem related to the original illness then that should be covered by the waiver.

[HLGW60]

Do you mean expenses related to a 'flare up' or recurrence of the condition being treated, or, for ongoing treatment while you are away?

 

If you need ongoing treatment after leaving hospital and then going on a cruise during the treament time, then I do not think the insurance would pay for that.

 

If the hospital/Dr signed you off as fit/cured/stable whatever, but then 6 months later on holiday you had a problem related to the original illness then that should be covered by the waiver.

 

I guess I am just a cynic and really don't believe that insurance companies will always honor the pre-existing condition waiver. My understanding is that you must be medically stable or medically fit on the date you purchase the insurance. For a person with a heart condition, diabetes, or cancer ( for example) I don't see how anyone could ever say nothing is unforeseen or expected to take a turn for the worst. With these type of medical conditions, there is always the possibly that something could happen. I don't believe any doctor could guarantee with 100% certainty that you could travel worry free. The real benefit IMO of buying a policy with the preexisting condition waiver would be to protect yourself from other medical conditions or accidents unrelated to your preexisting conditions plus buying your insurance from a reputable agent that would advocate in your favor if the worst should happen.

[GeezerCouple]

I guess I am just a cynic and really don't believe that insurance companies will always honor the pre-existing condition waiver. My understanding is that you must be medically stable or medically fit on the date you purchase the insurance. For a person with a heart condition, diabetes, or cancer ( for example) I don't see how anyone could ever say nothing is unforeseen or expected to take a turn for the worst. With these type of medical conditions, there is always the possibly that something could happen. I don't believe any doctor could guarantee with 100% certainty that you could travel worry free. The real benefit IMO of buying a policy with the preexisting condition waiver would be to protect yourself from other medical conditions or accidents unrelated to your preexisting conditions plus buying your insurance from a reputable agent that would advocate in your favor if the worst should happen.

 

Sorry, but you keep repeating yourself.

 

There are just too, too many of us who have had claims (sometimes large claims) paid with policies that had the waiver, and the insurer never even tried to invoke any sort of "pre-existing condition exclusion".

 

For most of us who are a bit older, and some who are not, there would probably be quite a number of medical conditions that an insurer could try to use to deny a claim, if that's what their game was.

 

In our case, they never even checked whether DH was "fit to travel" the day we purchased the insurance policy (which was months earlier). He was quite fit back then. The medical emergency was just that, an unexpected and serious medical condition that required aggressive treatment.

 

And there are several conditions that they "could have used" to TRY to deny a claim, or at least try to string us along, and hope we gave up.

 

But there was none of that.

 

A check was sent promptly.

 

You can read other first-hand reports like this from others.

 

GeezerCouple

Edited February 3, 2015 by GeezerCouple

[HLGW60]

U

Sorry, but you keep repeating yourself.

 

There are just too, too many of us who have had claims (sometimes large claims) paid with policies that had the waiver, and the insurer never even tried to invoke any sort of "pre-existing condition exclusion".

 

For most of us who are a bit older, and some who are not, there would probably be quite a number of medical conditions that an insurer could try to use to deny a claim, if that's what their game was.

 

In our case, they never even checked whether DH was "fit to travel" the day we purchased the insurance policy (which was months earlier). He was quite fit back then. The medical emergency was just that, an unexpected and serious medical condition that required aggressive treatment.

 

And there are several conditions that they "could have used" to TRY to deny a claim, or at least try to string us along, and hope we gave up.

 

But there was none of that.

 

A check was sent promptly.

 

You can read other first-hand reports like this from others.

 

GeezerCouple

 

I don't mean to offend you but my last response was to SwissDave.....not you. It was him that I quoted.

 

I am glad you and others have had good experiences with your insurance carrier and can testify to positive outcomes with your insurance agent.

 

However, I tend to put more trust in the wording of the legal document and that is why it is recommended to always read your policy over just taking someone else's word or recommendation. Afterall, insurance companies/agents are in the business of selling policies and making profits. I am sorry that I am not as trusting as you that an insurance company will always have my best interests at heart versus theirs. Good day and good health.

Edited February 3, 2015 by HLGW60

[sirwired]

The waiver means exactly what it says: you must be fit to travel as of the day you purchase the insurance.

 

Chronic conditions that do not render you unfit to travel as of the time of booking, such as minor heart conditions, diabetes, or cancer in remission, ARE eligible for a claim should they flare up before (or during) your trip if you must cancel (or receive treatment while traveling.)

 

WITHOUT the pre-ex waiver, those chronic conditions CAN, and DO cause problems (and often final denials) during claims.

[mrs201099]

Even though I had the preexisting exclusion waived, my claim was denied because my doctor did not think it advisable for me to cruise. Since I had been treated for and took medication for that condition within the previous 180 days (before purchase of the policy), denied.

[sirwired]

Even though I had the preexisting exclusion waived, my claim was denied because my doctor did not think it advisable for me to cruise. Since I had been treated for and took medication for that condition within the previous 180 days (before purchase of the policy), denied.

 

If you aren't fit to travel as of the day you purchase the insurance, the 180 day lookback period doesn't have anything to do with it.

[GeezerCouple]

Even though I had the preexisting exclusion waived, my claim was denied because my doctor did not think it advisable for me to cruise. Since I had been treated for and took medication for that condition within the previous 180 days (before purchase of the policy), denied.

 

 

If you aren't fit to travel as of the day you purchase the insurance, the 180 day lookback period doesn't have anything to do with it.

 

 

It isn't quite clear if mrs201099 had her doctor say she should not travel "when she purchased the insurance" or if she wasn't supposed to depart on the trip.

(Sorry if I missed something earlier.)

 

If it is the former, then what sirwired wrote is both relevant and correct. The insurance would not be valid because she was not able to travel when the insurance was purchased. Others have posted some typical insurance wording elsewhere. (This is really similar to purchasing homeowner's insurance when there is already something smoldering, and then expecting the insurer to pay for the subsequent fire damage.)

 

As sirwired wrote, whether or not there was medication and/or treatments (before or after the insurance was purchased) would be irrelevant.

 

If, on the other hand, mrs201099 was fit to travel when the insurance was purchased, but the doctor later advised against travel and she went *anyway*... it's no surprise the insurer didn't pay for whatever happened.

In this case, presumably what should have occurred was for mrs201099 to cancel the trip, based upon doctor's statement, and have the trip costs reimbursed per the terms of the insurance.

 

In terms of the "medication issues", IF one purchases insurance with a waiver of pre-existing condition exclusions, then it does not matter if one is taking medication or if the medication types or dosage have been adjusted recently or not --> as long as the insured was medically fit to travel when the insurance was purchased.

 

NOTE: Some people are not aware that *some* types of insurance require that ALL non-refundable costs be insured, not just some or most. So if someone forgets to include coverage for some non-refundable costs, the insurer might not pay for any costs, because the terms of the insurance were violated.

 

It is absolutely critical to read ALL of the terms of a policy before purchasing it, to make sure it has the coverage one desires AND so that one doesn't inadvertently violate the terms and thus negate the policy.

 

This is where someone like Steve (or his staff) at

TripInsuranceStore.com

 

can be exceedingly helpful and important, IF one discusses one's situation and insurance needs with them while deciding which policy to purchase.

 

We had a good/important example of this:

 

As we mentioned previously, we had a last-minute medical cancellation of our first "big trip", and because we had the waiver of pre-existing condition exclusions, the refund was straightforward and prompt.

 

However, DH's recovery took longer (much longer) than expected.

 

No surprise, we were eager to make plans for more travel, in part to offset the disappointment of the cancelled trip.

 

Much to our surprise (we have learned a LOT from Steve), when we made plans for several future cruises for the next 2 years, and also a major air/land trip...

Oooops!

We could NOT insure those trips that were being planned while DH was still recovering.

 

So we had to cancel several trips and get our initial refundable deposits back (and thus miss out on several specific suites that we wanted).

 

Based upon what we learned, we made certain that before we made any more travel plans, we waited until we had a signed letter from DH's physician that he *could* now travel.

THEN... we made a bunch of reservations again, and we've enjoyed three of those trips thus far, with several more to go :)

 

There have been a few other specific questions that we've asked Steve, and he has been extremely helpful.

 

And here we'd both like to thank the other members of CruiseCritic.com...

 

Because of some of the questions raised here, and situations discussed, we asked Steve some important questions about our own travel insurance needs, and made some important adjustments to how we insured some of our future trips.

 

CruiseCritic members have been terrific in so many ways, and not just in recommending tour guides or cabin choices - something we certainly didn't expect when we first started reading this Forum and later joined.

 

Thanks to all.

 

GeezerCouple

[iamtrustworthy]

I thought I would make a new thread since I am still not 100% convinced that buying a policy with a pre-existing condition waiver will always protect you. It is based on this article I read:

 

Most issuers of travel insurance will waive the exemption for pre-existing conditions if you meet certain requirements. The same company cited above states that you, a traveling companion, or family member can have an existing medical condition and you will still be eligible for all coverage and assistance services, as long as:

 

You purchase your insurance within 14 days of making your first trip payment or first trip deposit.

You purchase trip-cancelation coverage that covers the full cost of all your nonrefundable trip arrangements.

You are medically able to travel on the day you purchased the plan.

The total cost of your trip is $50,000 per person or less.

As with the definition of conditions, those terms are typical. The main variation is that some companies establish a buying deadline as short as seven days; I've never seen any longer than 14 days.

 

Hi HLGW60,

 

I'm sorry I didn't get to this thread until today. Due to being a workaholic, I came down with pnuemonia. Thankfully, I'm almost back to normal.

 

I won't get into the "medically able to travel on the day you purchased the plan" as that's been settled by all of you already. I need to learn to type faster. I'm sure GeezerCouple would beat me in any time competition.

 

Instead, I want to address the last thing that article you read said: "The main variation is that some companies establish a buying deadline as short as seven days; I've never seen any longer than 14 days."

 

I know plans that you can get within 15 - 30 days of the initial trip deposit date and others that you can get until the final payment that have the Pre-Existing Medical Condition Exclusion Waiver.

 

In addition, I know of five plans that don’t require the full prepaid trip cost to be insured as long as you insure a trip cost of at least $1.

 

Next, the reason there's a Lookback Period in all Travel Insurance policies is that everything the insured states is assumed to be true until there's a claim. At claim time all the requirements that needed to be met to have the Pre-Existing Medical Condition Exclusion Waiver must be proved.

 

Like GeezerCouple stated, an insurance company may not ask for everything, but they have that right. I know a claim where the doctor specifically told the insured (and they furnished that proof to the insurance company as part of the claim) not to travel 6 months before they bought travel insurance. The agent that sold it to them specifically asked if they could travel on that day and they said "Yes we can. It's ok with our doctor."

 

I hope this helps,

 

Steve