A Better Way to Define a Pre-existing Condition

All travel insurance policies contain an exclusion for pre-existing medical conditions.  These exclusions all have “look back” periods used to determine if a condition is pre-existing and therefore not covered.  The longest look back period is 180 days prior to the effective date of coverage – usually the day after purchase.  A condition is determined to be pre-existing if there has been care or treatment or symptoms during this “look back” period.

The problem with using the effective date as the “look back” starting point is that it causes some clients to wait until they have had 180 days free of care or treatment during which time something else might occur that then becomes a new pre-existing condition.  This is more prone to happen when a trip is several months in the future.

A fairer way to determine what is a pre-existing medical condition would be to use the date of first symptoms or treatment of the condition causing the claim as the anchor date for the “look back” period.  In many cases this is a moot point because a traveler can qualify for a “waiver of pre-existing conditions” however, many travelers are either misinformed or not informed at all about the availability of “waiving” the pre-existing conditions exclusion and have no option but to buy a plan that excludes pre-existing conditions.  Changing when the “look back” period begins would allow travelers to buy coverage earlier without having to go 180 days care or treatment free before buying coverage and it would still provide insurance companies protection against “adverse selection” which is the basis for the exclusion in the first place.