Existing medical conditions

Are you looking to book a holiday, and have an existing medical condition? See what our plans can cover you for before you head off. Read more here:

Are you looking to book a holiday, and have an existing medical condition? See what our plans can cover you for before you head off.

Will COTA Insurance cover me if I have an existing medical condition?

COTA Travel Insurance plans offer cover for more than 40 existing medical conditions, but you should be aware that there are conditions attached to these which you will need to meet in order for them to be covered.

If you have an existing medical condition that isn’t automatically covered, you can apply to add the condition as a ‘Specified Medical Condition’ (Not available on the Essentials Plan).

What is considered an existing medical condition?

Simply put it is a condition that, at the time you bought the travel insurance policy, you or a reasonable person in your situation should have known existed.  This includes conditions for which you may not be diagnosed but have been experiencing symptoms.

The full definition in the PDS further outlines what this means but common sense can help. For example:

• If you’ve had a chronic condition such as diverticulitis on and off for a few years, then it’s likely considered an existing medical condition.
• If you have a family history of heart problems and you’ve been experiencing symptoms of a heart problem, that’s likely an existing medical condition. And you should probably go to the doctor to get it checked out ASAP.

You can view the full definition in the Domestic  and International PDS.  If you’ve still got questions, you can contact us for further help.

What cover is available if my condition is on the list of automatically covered conditions?

You can view the list of automatically covered existing conditions in the Domestic and International PDS .  We offer cover for more than 40 of our more common conditions such as asthma, diabetes, vertigo and common allergies.  If your condition is included, and you satisfy all the criteria related to that condition, then you’re covered for events that arise from that condition as part of our standard cover. Exclusions may apply in the event of a claim.

How do I apply to add my condition to my policy?

If your condition is not automatically covered you can apply to add the condition as a ‘Specified Medical Condition’ to our domestic and international comprehensive plans which will ensure you’re covered for events that arise from that condition, although an additional premium and excess may apply.  This additional option is not available on the Essentials Plan.

Steps to apply for a Specified Medical Condition to be added to your policy

1. You must be purchasing an Australian Travel, Comprehensive or Annual Multi Trip plan.
2. Once you’ve confirmed the right plan type, you must let us know when buying your policy that you have a medical condition that is not on the list of automatically covered conditions.
3. You’ll then be asked to complete a medical screening which includes some questions about your health. We will then determine if we can offer you cover and, if so, on what terms.
4. If we accept your application, you’ll need to pay an additional premium when you purchase your policy and possibly have an additional excess apply.
5. The condition then becomes a Specified Medical Condition covered under your policy, and the premium and any additional excess that subsequently applies will be shown on your Certificate of Insurance.
6. You’ll then be covered for claimable events that arise from the specified medical condition(s).

What happens if I choose not to get cover for my existing medical condition?
 
If your condition is not automatically covered under the policy, and you haven’t added it as a specified medical condition, then you’re not covered for any claim that arises from that existing medical condition.
 

If I’m eligible, what will I be covered for?

If your condition is automatically covered, or we’ve accepted and added it to your Certificate of Insurance as a Specified Medical Condition (Excludes Essential Plan), you are eligible for cover under our plans.  This cover includes:

• Cancellation
• 24/7 Emergency Assistance
• Overseas Medical assistance
• Evacuation to medical facilities
• Repatriation back home to Australia

What’s not covered?

Travel insurance is designed to help with those unexpected events that can occur while travelling but doesn’t cover everything – some things we don’t cover include:

• A loss arising from any existing medical condition of you, a member of the travelling party, a non-travelling close relative or business partner, which is NOT automatically covered, which you did not disclose and which is not an accepted Specified Medical Condition.
• Any illness or death that arises from a metastatic or terminal prognosis that was made prior to the issue of the Certificate of Insurance.
• A loss arising from any condition for which you have declined treatment or further investigation recommended by a medical practitioner.
• Any medical treatment or care that is not required as an emergency, or any alternative therapy, health spa or rehabilitation centre costs, unless it has been agreed to by us.
• Elective or cosmetic treatment or surgery that is not medically necessary, or any loss arising from these treatments or their complications.

There are many terms, conditions, limitations and exclusions that relate to existing medical conditions.  Read your policy carefully and contact  us if you have any queries.

Contact COTA Insurance today to get a quote for Travel Insurance policy via our website or speak to one of our friendly staff by calling 1300 1300 50.

Insurance and Membership Services Limited ABN 59 057 159 743, AR 246235 trading as COTA Travel Insurance is an authorised representative of nib Travel Services (Australia) Pty Ltd, ABN 81 115 932 173, AFS Licence No 308461 and act as nib’s agent and not as your agent. This is general advice only. Before you buy, you should consider your needs, the Product Disclosure Statement (PDS), Financial Services Guide (FSG) and Target Market Determination (TMD) available from us. This insurance is underwritten by Pacific International Insurance Pty Ltd, ABN 83 169 311 193.