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Travel Insurance 101: Covered Illnesses

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A nasty case of gastroenteritis is a total buzzkill when it happens in the middle of your food and wine tour of Tuscany. When your spouse contracts hepatitis A from a bad batch of strawberries in Chicago while you’re on a business trip in China, you need to rush home and take care of the kids. And while you’re lucky you avoided catching the pneumonia that took down your travel companion for that college reunion, you’re not going to be able to make the trip happen solo. 

There is no way around it: cancelling, cutting short or altering your travel plans due to illness is a total bummer. But there are more than memories at stake; your money and health are on the line, too. If you have non-refundable prepaid costs invested in these impacted trips, including airline tickets and tour fees, you may be out of luck if you don’t have travel insurance.

If you do have travel insurance with trip cancellation/trip interruption benefits, and you follow a few required steps such as seeing a physician and completing the necessary paperwork, then you may be eligible for reimbursement of these costs. Of course, there are a few conditions you need to meet, which are outlined in the policies of your travel insurance provider. But the biggest hurdle to meet is whether or not these illnesses are considered “covered illnesses.”

The scenarios we outlined above could generally be considered covered illnesses, but there are a number of exceptions and exclusions to be aware of. These include pre-existing medical conditions, as well as mental and nervous health disorders. Here is a closer look at covered illnesses.

What Are Covered Illnesses?

In the world of travel insurance, covered illnesses aren’t so much a comprehensive list of all the different ailments that cause travel insurance benefits to kick in. Instead, they’re defined by certain conditions that must be met. First, the illness (or injury, or medical condition) must be disabling enough to make a reasonable person cancel their trip.

Of course, if it were this easy, anyone could claim they were bedridden, and thus unable to travel, with a benign cold or seasonal allergies. That’s why another key criterion for a covered illness is physician confirmation. Allianz Global Assistance requires that a doctor advise you (or a traveling companion) to cancel your trip before you cancel it. If this isn’t possible, a doctor must either examine or consult with you or the traveling companion within 72 hours after the cancellation to confirm the decision to cancel.

You don’t need to be the one who contracts a covered illness to use your travel insurance benefits. You just need to be the one with the policy. If your travel companion or a family member back home experiences a serious covered illness, that may be a covered reason for trip interruption/trip cancellation. Again, these folks would need to meet specific conditions outlined in your policy, but this should provide you more peace of mind as you gear up for your trip.

What About a Pre-Existing Medical Condition?

People sometimes think that travel insurance won’t cover them if they have a pre-existing medical condition. It can! But to ensure you’re protected, you’ll need to meet certain requirements.

Here is how Allianz Global Assistance defines a pre-existing medical condition:

An injury, illness, or medical condition that, within the 120 days prior to and including the purchase date of your policy:

  1. Caused a person to seek medical examination, diagnosis, care, or treatment by a doctor;
  2. Presented symptoms; or
  3. Required a person to take medication prescribed by a doctor (unless the condition or symptoms are controlled by that prescription, and the prescription has not changed).

It’s important to know that the illness, injury, or medical condition does not need to be formally diagnosed in order to be considered a pre-existing medical condition.

Some travel insurance plans include coverage for pre-existing conditions, and some don’t. At the bottom of this page, you’ll see a list of all Allianz Global Assistance travel insurance plans that can cover losses caused by pre-existing medical conditions if the following conditions are met:

  1. Your policy was purchased within the time frame specified in your plan (usually 14 days of the date of the first trip payment or deposit.)
  2. You were a U.S. resident when the policy was purchased;
  3. You were medically able to travel when the policy was purchased;
  4. On the policy purchase date, you insured the full non-refundable cost of your trip with Allianz Global Assistance — including trip arrangements that will become non-refundable or subject to cancellation penalties between the policy purchase date and the departure date.

If you incur additional non-refundable trip expenses after you purchase your policy, you must insure them with us within 14 days of their purchase. If you do not, those expenses will still be subject to the pre-existing medical condition exclusion.

The best approach to take when selecting a policy that can cover a pre-existing medical condition is to read all the fine print and to contact us if you have any questions.

What's Not Covered by Travel Insurance?

Not all illnesses and conditions can be covered by travel insurance. Before you travel, read your plan documents so you understand what kinds of things are excluded. These include, but are not limited to:

  • A mental or nervous health disorder, as recognized by the American Psychiatric Association, including but not limited to Alzheimer’s disease, anxiety, dementia, depression, neurosis, psychosis, or any related physical symptoms. (This exclusion applies only to trip cancellation coverage, trip interruption coverage, emergency transportation coverage, and emergency medical/dental coverage.
  • An epidemic
  • Any illness and injury caused by the use or abuse of alcohol or drugs, or any related physical symptoms.

Is Pregnancy Covered?

Normal pregnancy or childbirth is not covered by travel insurance from Allianz Global Assistance, except as a covered reason for trip cancellation (if you find out you are pregnant after purchasing your policy, or you need to attend the birth of a family member’s child.)

“Normal pregnancy” means one free of complications. So, for example, if you receive routine medical care for your normal pregnancy while traveling, or you have a normal childbirth while traveling, these medical expenses would not be covered. Travel insurance from Allianz Global Assistance can cover losses resulting from unforeseen pregnancy complications, such as pre-eclampsia or gestational diabetes. So if you’re traveling, and you require emergency medical care for a pregnancy complication, you may qualify for trip cancellation and interruption benefits, as well as emergency medical benefits.

As with all covered illnesses, in order for such conditions to be considered covered, you’ll need a physician’s sign-off. And if a doctor simply advises an expectant mother to rest and avoid flying without a specific medical diagnosis, this would not be considered a covered illness.

Read more: Travel During Pregnancy: What Does Travel Insurance Cover?

Filing a Claim for a Covered Illness

In order to be reimbursed for losses caused by a covered illness, you’ll need to file a claim within 90 days of your loss. We make it as simple as possible to file a claim: You can do it online or even on your phone, with the free TravelSmart™ app. Submit all the requested documentation, which may include a Physician Statement Form, statements and records from treating doctors, documentation of refunds received from travel suppliers and more. Here’s a full list of Allianz Global Assistance’s required documentation by coverage reason.) Don’t get overwhelmed — if you need help filing a claim, we’re happy to assist you! Contact us anytime, online or by phone.

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Aug 30, 2018