Medical Conditions and Pregnancy

Tokio Marine & Nichido Fire Insurance Co Ltd (ABN 80 000 438 291 AFSL 246 548) is the issuer of RACV Travel Insurance. View the RACV Travel Insurance Product Disclosure Statement (PDS) which includes the policy wording. You should consider the PDS in deciding whether to acquire or to continue to hold a policy.

The RACV Travel Insurance policy does not cover all medical conditions (Medical Conditions) or all stages of pregnancy. Please read the information below for a summary of what Medical Conditions are covered. Full policy wording on Medical Conditions and the stages of pregnancy which are covered is set out in the PDS. If you are unsure, need clarification or wish to ask specific questions, then please call us on 13 13 29.

Once you purchase or amend your policy, any specific conditions which you have listed and which the insurer, Tokio Marine & Nichido Fire Insurance Co Ltd (ABN 80 000 438 291 AFSL 246 548) (Insurer) has offered cover for, and which you have accepted by paying any applicable premium, will be shown on your certificate of insurance.

Claims directly or indirectly arising from or made worse by a Medical Condition are not covered under this policy, unless you have listed the Medical Condition and the Insurer has offered cover which you have accepted by paying any applicable premium.

What is a Medical Condition?

A Medical Condition means any medical or physical condition, disorder, disease, disability or illness, including any Mental Illness, which at the relevant time, you were aware of, or a reasonable person in the circumstances could be expected to have been aware of, and at the relevant time:

1. is chronic, ongoing, terminal, or has affected or involved one or more of the following:

a. heart, circulatory system, lungs or respiratory system, brain, kidneys, liver, or cancer;

b. surgery involving the back, neck, joints, or abdomen; or

2. in the last 24 months had:

a. presented symptoms which would have caused an ordinarily prudent person to seek medical opinion or treatment;

b. become exacerbated or complicated; or

c. been diagnosed, treated or treatment was recommended by a Treating Doctor. A medical condition does not prevent you from purchasing this policy.

Please read section below, ‘How the insurer covers medical conditions’, which explains:

a. Medical Conditions the insurer will automatically cover; and

b. all other Medical Conditions We need to assess.

You should disclose any medical condition that is not automatically covered under this policy, and if accepted by the insurer, pay any additional premium to have coverage for that condition, or you run the risk of a claim being reduced or denied.

Please see below for further information.

How the insurer covers Medical Conditions.

Not all-Medical Conditions are covered under the policy. Refer to ‘General Exclusions’ in the Product Disclosure Statement for details.

If you require cover for a medical condition not listed in the ‘Medical Conditions the insurer automatically covers’ section below, you may apply for coverage by completing a medical assessment and if accepted, pay any additional premium which may be payable for coverage of that medical condition, which will be specifically listed on your certificate of insurance.

If a disclosed medical condition is not accepted, or you chose not to take out cover for that medical condition, it will be noted on your certificate of insurance and you will not be covered for that condition.

Medical Conditions the insurer automatically cover.

This section outlines those medical conditions automatically included, where you, at the relevant time:

a. have not required hospitalisation or treatment (where treatment does not include an annual or routine medical check-up, blood testing or a visit to a medical practitioner to obtain a regular prescription) by any treating doctor within the last 24 months (unless a different time-period is specifically listed in the list below) for the medical condition;

b. are not awaiting the outcome of any investigation, tests, surgery or other treatment for the medical condition; and

c. meet any additional criteria set out in the medical conditions the insurer automatically cover listed below.

If the criteria above are satisfied, cover is automatically included for the following medical conditions:

1. Acne

2. Allergies limited to Rhinitis, Chronic Sinusitis, Eczema, Food Intolerance, Hay Fever, however this excludes any Anaphylaxis as part of any such condition

3. Asthma providing You:

a. have no other lung disease; and

b. are under 60 years of age at time you purchase the policy

4. Bell’s Palsy

5. Benign Positional Vertigo

6. Bunions

7. Carpal Tunnel Syndrome

8. Cataracts

9. Coeliac Disease

10. Congenital Blindness

11. Congenital Deafness

12. Diabetes Mellitus (Type 1) providing you:

a. were diagnosed over 24 months ago;

b. have no eye, kidney, nerve or vascular complications;

c. do not also suffer from a known cardiovascular disease, hypertension or hypercholesterolaemia; and

d. are under 50 years of age at the date of policy purchase

13. Diabetes Mellitus (Type 2) providing You:

a. were diagnosed over 24 months ago;

b. have no eye, kidney, nerve or vascular complications;

c. do not also suffer from a known cardiovascular disease, Hypertension or Hypercholesterolaemia; and

d. are under 50 years of age at the date of policy purchase

14. Dry Eye Syndrome

15. Epilepsy providing:

a. there has been no change to Your medication regime in the past 24 months; and

b. You are on no more than one anticonvulsant medication

16. Gastric Reflux

17. Gastric/Peptic Ulcer

18. Glaucoma

19. Gout

20. Graves’ Disease

21. Hiatus Hernia

22. Hip/Knee replacement if performed more than 24 months ago but less than 10 years ago

23. Hypercholesteroleamia (High Cholesterol) providing you do not also suffer from a known cardiovascular disease and/or Diabetes

24. Hyperlipidaemia (High Blood Lipids) providing you do not also suffer from a known cardiovascular disease and/or Diabetes

25. Hypertension (High Blood Pressure) providing you do not also suffer from a known cardiovascular disease and/or Diabetes

26. Hypothyroidism, including Hashimoto’s Disease

27. Incontinence

28. Insulin Resistance

29. Macular Degeneration

30. Meniere’s Disease

31. Migraine

32. Nocturnal Cramps

33. Plantar Fasciitis

34. Raynaud’s Disease

35. Sleep Apnoea

36. Solar Keratosis

37. Trigeminal Neuralgia

38. Trigger Finger

Please note if your condition does not meet the automatically covered conditions criteria, you must complete a medical assessment to have cover. 

For example - if you have asthma, and you were hospitalised for asthma 6 months prior to the policy purchase, you no longer meet the automatically covered conditions list. This means to have cover for asthma you must complete a medical assessment to have cover.

Conditions which the insurer needs to assess

If your Medical Condition does not meet the automatically covered criteria, you will need to complete an online medical assessment. If your medical condition is accepted, you will be required to pay any additional Premium. This will be shown on your Certificate of Insurance. You can complete this as part of your travel insurance quote online or call 13 13 29 for additional assistance.

Changes in Your health

If before starting your trip, you become aware of, a change in your health:

• that has, or is likely to have, an effect on the diagnosis, severity, or management of a medical condition, such as a change in treatment, medication or dosage, a new symptom or change of a condition of a medical condition, that the insurer have accepted on your certificate of insurance; or
• which is a new medical or physical condition, disorder, disease, disability or illness, including any mental illness that manifests itself, and that is not otherwise covered under the ‘medical conditions the insurer automatically cover’ section, after the relevant time;

You must contact us on 13 13 29 as soon as reasonably practicable and prior to starting your trip to update or complete a medical assessment.

If you do not complete an online medical assessment as described in this section there is no cover available for any medical Conditions or related medical Conditions not declared, unless it is clearly a condition the insurer covers automatically. This means you run the risk of a claim being declined if you choose to not declare your Medical Conditions.

Refer PDS for full details.

Pregnancy

RACV Travel Insurance policies provide limited cover for pregnancy. The following restrictions will apply for any person where a claim may arise in any way and is related to pregnancy regardless of whether it has been assessed or not.

Cover is included automatically up to the end of the 25th week of pregnancy for:

a. single non-complicated pregnancies;

b. unexpected pregnancy complications; and

c. childbirth which was accelerated by accidental injury in limited circumstances.

For all other pregnancies a medical assessment must be completed.

As with all travel insurance it is important that expectant mothers consider if they should travel, seek their doctor’s advice and ensure RACV Travel Insurance policy provides the coverage they need. Refer PDS for full details.