Pre-existing Health Conditions Pose Risk For Sellers Of Travel Insurance

Over time, travel agents learn so much about their clients. They experience marriages and divorces; they learn very private preferences that help shape itineraries. And very often, they become privy to health issues.

So when an agent hears that a client with a heart condition is thinking about a three-day backpacking safari in July, it’s hard to resist mentioning that pre-existing conditions often are not covered by travel insurance.

But once travel agents (who typically are not licensed insurance agents) start to discuss issues like pre-existing health conditions, they potentially set themselves up for liability.

“Travel agents need to be careful. That is the most complicated thing about this. Travel agents know a lot about their clients, and out of habit, the client talks with them about what travel insurance products might be best for them,” said Isaac Cymrot, vice president industry relations, Travel Insured International. “Our best advice is that as soon as the conversation transits from why is travel insurance important to trip-specific scenarios, they should get us on the phone, or direct the client to our website.”

It’s fine to be involved in the conversation, Cymrot noted, as long as they are not giving the details. “They can hear the answers from the insurance company, but they are safe legally.”

Beth Godlin, president of travel insurance broker Aon Affinity Travel Practice, agreed. “Have customers read the pre-existing conditions clause in their policy. If they have specific questions, you really should have them contact their carrier.”

Allianz Global Assistance has had “very few issues in the retail travel channel, because agents have gotten so smart about insurance,” said spokesperson Daniel Durazo. All three of its products—Basic, Classic, and Classic with Trip Plus—“offer coverage for existing medical conditions as long as you insure the total non-refundable value of your trip, and an agent is in a great position to ensure the traveler does that.”

Travelers also must purchase the insurance within 14 days of paying the first trip deposit and be medically able to travel on the day they purchase the policy, and the cost of the trip cannot be more than $50,000 per person.

Misconceptions and complexity abound

The traveling public generally knows little about pre-existing conditions and the specific requirements. “The biggest misconception is that travel insurance looks at pre-existing conditions the way health insurance does. That’s not always the case,” said Cymrot. “Clients might think they have a pre-existing condition because their healthcare company does, but it might not be defined that way in a travel insurance policy.”

Usually a pre-existing condition is something a traveler has had anywhere from 60-120 days. Consumers should review their travel policy to see what a carrier considers a pre-existing condition, because the definition can vary from one company to the next.

Additionally, the rules “may not just apply to you, the traveler,” Godlin added. “They could apply to the traveler, business partners, traveling companions, family. If you have a condition during this time period, you might not be able to get benefits.”

A condition that is being treated and controlled, like high-blood pressure, “won’t be considered a pre-existing condition,” Godlin said.

In most cases, once an initial deposit is placed for a trip, the client has anywhere from 10-21 days to purchase travel insurance and be covered. “If you miss that, you miss it all together,” Cymrot said.

A chief complication in ensuring a traveler is covered is the fact that itineraries often are booked in stages, Cymrot said. “On some trips, the ground portion is booked 18 months out, but the air is not available. When you get around to adding the air segments, more insurance needs to be purchased because the value of the trip went up,” and pre-existing condition exclusions could come into effect if a condition has changed.

Travel agents should suggest their customers contact the carrier to make sure they remain in compliance if things change, such as a doctor recommending or performing a diagnostic test or examination, or the traveler exhibits symptoms where care or treatment should have been sought. Any of these events could cause the traveler to lose coverage.

Finally, some conditions are never covered under travel insurance. For example, Allianz excludes “mental and nervous health conditions, bipolar disorder, and Alzheimer’s.”