Case Commentary – Travel Insurance Claims and Preexisting Conditions

If you are planning on escaping the bitter cold with a vacation somewhere warm this New Year, travel insurance is one thing you can’t forget to pack. For those Canadians that have a preexisting health condition, buying travel insurance can be more complicated. As a recent case illustrates, it can also be more complicated in the event of an illness or injury that necessitates a claim.

About preexisting conditions and travel insurance

If you have any underlying chronic or preexisting conditions, or have had any recent medical interventions beyond regular checkups and minor ailments, it is important to discuss these with your insurance provider before purchasing travel insurance.

Depending on the policy, you may not be covered for any medical emergencies that relate to a pre-existing condition. In some cases, an insurer may even take the position that failure to disclose a pre-existing condition invalidates the policy altogether.

In some cases, supplemental insurance can be purchased to cover chronic or preexisting conditions, and your insurance broker can help you find a policy that meets your needs, and protects you while you’re traveling away from home.

Stable preexisting conditions – Fletcher v. RSA Insurance Company

This case arose when an insured’s claim for medical expenses was denied by his travel insurance company. The insured had been hospitalized after suffering chest pain, and required surgery before returning home. The insurer refused to pay for any medical expenses, on the basis that these related to a prior medical condition, and that medical evidence showed a reasonable expectation that the insured would require treatment while travelling.

The court ruled in favour of the insured, whose medical records corroborated that his condition was stable according to his GP and cardiologist. They both agreed that he was healthy enough to travel as planned, and that there was no expectation that he would be hospitalized while travelling. The insurer was required to pay his medical expenses.

Legal advice relating to travel insurance claims and denials

If you have a preexisting health condition and are forced to make a travel insurance claim, your insurer may deny it, even if your physician cleared you to travel. At Derfel Injury Law, our team advises clients about their travel insurance claim, and also assists where a claim has been denied. As experienced personal injury and insurance lawyers, we can help you ensure you get compensated fairly, and in accordance with the terms of your policy.

Contact us online or call 416-847-3580 to make an appointment. We meet clients at convenient locations in Toronto.