A pre-existing conditions scam?

By | April 8th, 2007

I’ve never been a big fan of travel insurance — or of any insurance, for that matter. You either have to pay a high deductible to use it (health insurance) or you have to die (life insurance) or it’s no good at all. That certainly seems to be the case with many forms of travel insurance these days.

How do insurance companies get away with denying scores of travel claims? Well, one increasingly popular way is to invoke the pre-existing conditions clause, according to some of the recent ombudsman cases I’ve received.

A pre-existing condition is usually defined as any injury that happened prior to and including the effective date of the insurance and any recent illness for which treatment by a licensed physician has been sought.

Here’s the problem: No one ever reads the fine print on insurance policies. Instead, they rely on a phone agent or travel advisor to tell them what’s in it. And since insurance policies can be very complex, and since travelers don’t always feel the need to disclose their medical histories to their travel agents, something invariably gets lost in the translation. Or just plain lost.

Even for those travelers who are diligent enough to take the time to read the fine print, many policies are confusing about what does and doesn’t constitute a pre-existing condition. For example, some policies allow for what’s called a “controlled condition” — something for which you don’t need to change your medication or treatment during a given period of time. Others allow you to purchase a waiver of the pre-exisiting clause, but with strings attached.

Related story:   How will the Qatar quagmire affect your next trip?

Result? Many travelers think they’re covered when, in fact, they aren’t.

It might be a stretch to call the confusion surrounding pre-existing conditions a scam. But I have no doubt that certain insurance companies are leveraging that confusion to their advantage — and to the detriment of their customers. (My success rate at overturning insurance denials is pretty low. It’s actually so dreadful that I’m embarrassed to cite numbers.)

My advice is to read all the fine print carefully and to ask any questions of your insurance company before buying your policy and booking your trip. Remember, it isn’t just your own health that’s an issue. It’s also your travel companions and other family members whose health may determine whether you travel or not. Be sure everyone is covered.

Finally, don’t cancel your trip and submit a claim unless you’ve checked with your travel insurance company first, to make sure the claim will be honored.

There’s nothing more frustrating that canceling a trip that you could have taken, just because you thought your insurance would cover you.

  • Emilyrudy

    Acess America biggest SCAM ever.

    Told me they will not refund me my 800 dollar flight cost. because get this…. a clogged ear is a pre existing condition for a brain tumor. I had  brain surgery, and because my first appointment with the ENT was 120 days before my flight departure it voids my policy. So now, not onLy am I laid up on disability, 2 disappointed children, I lose 800 dollars on a limited income. Who could possibly fly with 2 children to disney after brain surgery. ***DO NOT DEAL WITH ACCESS AMERICA****

  • jj

    My mom is being denied coverage because she was diagnosed with Breast Cancer on Sept. 12.  She purchased her tickets Aug. 30 with insurance on that date.  They have “lost” forms she has sent to them and they continually ask her to fill out more forms.  It’s a scam.  A giant scam.

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