Jun 15, 2017
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Travel Resources

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 – someone needs to take care of the kids. And while you’re lucky you avoided catching the pneumonia that took down your old classmate and would-be travel companion for that college reunion, you’re not going to be able make the trip happen solo.

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

If you do have travel insurance, 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 whichever insurance provider you select. But the biggest hurdle to meet is whether or not these illnesses are considered “covered illnesses.”

The scenarios we outlined above would widely be considered covered illnesses, but there are a number of exceptions and exclusions to be aware of. These include pre-existing conditions, as well as mental, nervous and emotional 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, think of it as certain conditions that illnesses need to meet. Namely, the illness must be serious enough to compel a reasonable individual to interrupt, cancel or or delay his or her trip.1

Of course, if it were this easy, anyone could claim they were bedridden, and thus unable to travel, with a benign cold or hum-hum seasonal allergies. That’s why another key criterion that a covered illness needs to meet is physician confirmation, i.e. a doctor’s note, stating that a patient shouldn’t travel. (In the case of Allianz Travel Insurance, policy holders must be seen by a physician and told to cancel or interrupt their trip, or in the scenario that isn’t possible, they must be examined by a physician within 72 hours.)2

What About a Pre-Existing Condition?

Ever since the Affordable Care act was implemented, those with and without a pre-existing condition have a lot more familiarity about what the terminology means.

As definitions for a pre-existing condition, also called an existing medical condition, can vary slightly, here is how Allianz Global Assistance defines it: “An Existing Medical Condition is an illness of injury that exhibited symptoms or was treated at any time 120 days prior to purchasing your plan.”

There are some travel insurance plans that cover pre-existing conditions and some that don’t. While having an existing medical condition can exclude travelers from meeting trip cancellation, delay or interruption conditions – solely from the covered illness perspective – some travel insurance companies have devised conditions that provide coverage even with the presence of a pre-existing condition. For example, with Allianz Global Assistance, you can still have an existing condition be considered a covered illness if the following conditions are met:

  • You purchased your plan within 14 days of making your first trip payment or first trip deposit
  • You purchased Trip Cancellation benefits that covers the full cost of all your non-refundable trip arrangements
  • You’re a U.S. resident and medically able to travel on the day your purchased the plan
  • The total cost of your trip does not exceed the maximum cost specified by your plan.3

The best approach to take when selecting a policy and knowing you have a pre-existing medical condition is to read all the fine print, and better yet, call a provider who can guide you to the best policy for you.

What's Not Covered by Travel Insurance?

Unfortunately, not all illnesses and conditions can be covered by travel insurance.

While you’ll want to check with your specific provider and policy, you’ll find that many of the same illnesses and injuries are omitted by many of the major travel insurance providers.

These include, but are not limited to:

  • Mental, nervous or emotional disorders that do not require immediate hospitalization;
  • Alzheimer’s and bi-polar disorder
  • Any illness and injury experienced while under the influence of illicit drugs or alcohol4

Is Pregnancy Covered?

Pregnancy is a pretty common exclusion for insurance providers. When talking about pregnancy as it pertains to travel insurance, Allianz Global Assistance and others refer to a “normal pregnancy,” which is absent of complications and other unanticipated conditions. That said, when unforeseen complications occur, such as gestational diabetes or pre-eclampsia, you may qualify for trip cancelation and interruption insurance, as well as emergency medical benefits (we’ll get to those in a bit.)

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 will most likely not be considered a covered illness.

One additional note: on Allianz Global Assistance policies that include a normal pregnancy as a covered reason for trip cancellation, this is referring to those pregnancies occurring after the effective date of coverage.5

What About the Fine Print?

It’s always important to have a thorough understanding of your travel insurance policy, most importantly, the specific steps you need to take to qualify and claim insurance benefits. We already mentioned that you can’t just claim to have a covered illness and that’s that. If you’re looking to claim a covered illness for trip cancellation, you’ll need a physician to confirm you’re unfit for travel before you cancel – or within 72 hours. If you’re travelling, and insured through Allianz Global Assistance, we’ll help you find a physician who can confirm that a trip interruption or delay is medically necessary and approved. There is one more step that folks sometimes fail to make – submitting the completed Physician Statement Form, as well as supporting documentation confirming the trip costs you’re seeking reimbursement for. (Allianz Global Assistance requires that its own Physician Statement Form be completed for the claim review process; other documentation may not be sufficient.) This may include unused tickets, documentation of refunds received from travel suppliers, letters from tour operators and more. (You can find a full list of Allianz Global Assistance required documentation by coverage reason.)6

Who's Covered?

You don’t ned to be the one who contracts a covered illness to seek out travel insurance benefits. You just need to be the one with the policy. It can be your travel companions – family, friends or co-workers, etc. – or an immediate family member back home. 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 Emergency Medical Care?

Those with covered illnesses may qualify for an emergency medical benefit. This is critically important because many who travel abroad won’t be covered by their existing health insurance policy. Instead of being handed a medical bill in a foreign language for the full amount of your emergency care, travel insurance may reimburse all or some of these costs. Additionally, travelers who fall ill may qualify for emergency medical transportation, not just the hefty fee that comes with this but also the logistics of arranging transportation to bring someone from remote locations to the nearest hospital.7    

At Allianz Global Assistance, we work hard to be completely up front and transparent about the conditions our policyholders need to meet to claim their benefits. Many contact us convinced that because they have a pre-existing condition, that we don’t have a plan for them. As you’ve learned by reading this article, that isn’t always true. That’s why it’s so important to take a closer look, and seek out answers to all your questions, when determining whether travel insurance is right for you.

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