Am I covered if I have an existing medical condition?

For information relating to policies purchased prior to 18 May 2022, please check the Policy Document provided with your purchase. You can contact us if you need this sent to you again. For policies purchased on or from 18 May 2022 please see below.

Got an existing medical condition and wondering if it can be covered? Read on for the answers...

What’s covered for existing medical conditions?

If you have an existing medical condition, it will be automatically covered if you can meet the following requirements:

it’s one of the listed automatically covered conditions (more than 40 listed in the 'Health conditions and your policy' section under 'How it works' in your Policy Document or see below.
the specific requirements noted for that condition are met.
you haven’t been hospitalised for any condition (and this includes day surgery or a visit to an Emergency Department) within the last two years.

What is an existing medical condition?

Under our policies an existing medical condition is any medical condition which at the time you buy your policy is:

chronic; or,
displaying symptom; or
under investigation; or
pending follow-up consultation, treatment or surgery; or where these are recommended or planned; or
metastatic or terminal; or

In the six months prior to the time you buy your policy there has been:

treatment by a medical practitioner; or,
medication prescribed or surgery; or
the condition first comes into existence, shows symptoms, is diagnosed or is treated while in New Zealand during a home visit which breaks your trip

More than 40 automatically covered conditions… and more

We automatically cover more than 40 conditions in our plans. Not only are you covered in some circumstances if you have existing medical conditions, but you’re also covered in relation to existing medical conditions of people you’re travelling with and your close relatives who are not listed on your policy. For example, say you’ve got a big trip booked and are covered by travel insurance, but before you leave your father has a sudden heart scare that puts him into hospital. Obviously your trip is off, but you could make a claim for cancellation costs with us. Another example: you’re travelling with your best buddy, and his knee gives up and he has to return home. We understand that you need to cancel your trip, too, and we offer cover.

The terms and conditions about existing medical conditions apply to your close relative or travelling companion/s too. If before you bought your policy your father had a heart condition, or your buddy had a knee reconstruction, those are existing medical conditions and benefit limits will apply. For claims involving someone who is not a close relative or a travelling companion, there is no cover.

What’s not covered

Be sure to read the terms, conditions, limits and exclusions of the Policy Document for what's covered. If you’re not sure, contact us.

If your existing medical condition is not on the list, you may not be covered for any expenses arising from, affected by or exacerbated by that existing medical condition.

If an existing medical condition is excluded from cover, you will still have cover for any sudden illness or serious injury that is unrelated to an excluded medical condition.

List of automatically covered conditions

Medical Condition	Criteria
Acne	You haven’t received treatment for your acne from a medical practitioner in the three months prior to buying your policy.
Allergies	You follow advice in accordance with your medical practitioner (such as to carry EpiPens, antihistamines/other preventative medication at all time) and, at the time you buy your policy, you: have no other known or underlying respiratory conditions or diseases (for example, asthma); and have not required treatment from a medical practitioner for your allergies in the last six months.
Anaemia (Iron Deficiency)	No criteria apply.
Asthma	At the time you buy your policy, you: are under 60 years of age; have no other known or underlying respiratory conditions (including sleep apnoea); haven’t required cortisone medication, except taken by inhaler or puffer; and haven’t required hospitalisation for asthma in the last two years, including as an outpatient.
Bell’s Palsy	No criteria apply
Benign Positional Vertigo	At the time you buy your policy, you haven’t required hospitalisation for benign positional vertigo in the last two years, including as an outpatient.
Bunions	At the time you buy your policy, you haven’t had surgery for bunions in the last three months and have no surgery planned.
Carpal Tunnel Syndrome	At the time you buy your policy, you haven’t had surgery for carpal tunnel syndrome in the last three months and have no surgery planned.
Cataracts	At the time you buy your policy, you have no ongoing complications, haven’t had surgery for cataracts in the last three months, and have no surgery planned.
Coeliac Disease	At the time you buy your policy, you haven’t required hospitalisation for coeliac disease in the past two years, including as an outpatient.
Congenital Blindness	No criteria apply
Congenital Deafness	No criteria apply
Diabetes Mellitus (Types I and II)	At the time you buy your policy, you: were diagnosed more than six months ago; haven’t had any complications in the last six months; have no eye, kidney, nerve or vascular complications; have a blood sugar level reading between 4 and 12 or a HbA1C score of 9% or less; and have no known cardiovascular/coronary heart disease.
Dry Eye Syndrome	No criteria apply
Ear Grommets	At the time you buy your policy, you have no current ear infection.
Epilepsy	At the time you buy your policy, you’ve: no underlying medical conditions (for example, previous head trauma, stroke); not changed your medication regime for epilepsy in the last 12 months; and not required hospitalisation for epilepsy in the last two years, including as an outpatient.
Folate Deficiency	No criteria apply
Gastric Reflux	Your gastric reflux doesn’t relate to another underlying diagnosis (example: hernia or gastric ulcer.
Glaucoma	At the time you buy your policy, you have no ongoing complications, haven’t had surgery for glaucoma in the last three months, and have no surgery planned.
Goitre	The underlying medical cause excludes tumour.
Graves’ Disease	At the time you buy your policy, you haven’t received treatment from a medical practitioner for Graves’ disease in the last six months.
Hashimoto’s Disease	The underlying medical cause excludes tumour.
Hiatus Hernia	At the time you buy your policy, you haven’t had surgery for hiatus hernia in the last six months and have no surgery planned.
Hypercholesterolemia/ Hyperlipidaemiatension (High Cholesterol/ High Lipids)	Provided you have no cardiovascular/ coronary heart disease.
Hypertension (High Blood Pressure)	Provided at the time you buy your policy: you have no known cardiovascular/coronary heart disease; and your current blood pressure reading is lower than 165/95.
Hypothyroidism (underactive thyroid)	The underlying medical cause excludes tumour.
Hyperthyroidism (overactive thyroid)	The underlying medical cause excludes tumour.
Impaired Glucose Tolerance	At the time you buy your policy, you: were diagnosed more than six months ago; haven’t had any complications in the last six months; have no eye, kidney, nerve or vascular complications; have a blood sugar level reading between 4 and 12 or a HbA1C score of 9% or less; and have no known cardiovascular/coronary heart disease.
Incontinence	You have no underlying gastrointestinal or urinary condition.
Insulin Resistance	At the time you buy your policy, you’ve: no known cardiovascular/coronary heart disease, and not required hospitalisation for insulin resistance in the last two years, including as an outpatient.
Iron Deficiency	No criteria apply.
Macular Degeneration	No criteria apply.
Migraine	You haven’t required hospitalisation for migraines in the two years prior to buying your policy, including as an outpatient.
Nocturnal Cramps	No criteria apply.
Osteoporosis/ Osteopenia	At the time you buy your policy, you: haven’t had any fractures; don’t require more than one medication for this condition; and have no other conditions involving the neck or back.
Pernicious Anaemia	No criteria apply
Plantar Fasciitis	At the time you buy your policy, you haven’t required surgery for plantar fasciitis in the last three months, and have no surgery planned.
Raynaud’s Disease	At the time you buy your policy, you haven’t required treatment by a medical practitioner for Raynaud’s disease in the last six months.
Sleep Apnoea	At the time you buy your policy, you: have no other known or underlying respiratory conditions (including asthma); and haven’t required hospitalisation for sleep apnoea in the last two years, including as an outpatient.
Solar Keratosis	Your condition has been confirmed as benign.
Trigeminal Neuralgia	You haven’t required treatment by a medical practitioner for trigeminal neuralgia in six months prior to buying your policy.
Trigger Finger	At the time you buy your policy, you haven’t had surgery for trigger finger in the last three months, and have no surgery planned.
Vitamin B12 Deficiency	No criteria apply.

This is only a summary of cover and does not include the full terms, conditions, limits, and exclusions of the policy. You should read your Policy Document in full, so you understand what is and isn’t covered. If you are unsure about your level of travel cover, please contact us for help.

Last updated: Apr 03, 2023 07:01 PM

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Am I covered if I have an existing medical condition?

What’s covered for existing medical conditions?

What is an existing medical condition?

More than 40 automatically covered conditions… and more

What’s not covered

List of automatically covered conditions

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