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?

“Medical Condition” means:

a) any physical condition, illness, disease, or complication, reasonably known to you, for which treatment, medication, surgery or advice (including investigation) has been received or prescribed by a medical practitioner, dental or health professional in the 24 months prior to your purchase of the policy; and/or

b) any chronic or ongoing (whether chronic or otherwise) medical or dental condition, illness or disease medically documented prior to your purchase of the policy; and/or

c) any new physical condition, illness, Mental Illness, disease or assessment that becomes reasonably known to you after your purchase of this policy and prior to your trip departure as shown as the period of insurance on your certificate of insurance; and/or

d) any change to a current physical condition, illness, Mental Illness, disease or assessment that becomes reasonably known to you after your purchase of this policy and prior to your trip departure as shown as the period of insurance on your certificate of insurance; and/or

e) any condition medically documented that involves/ involved your heart, brain, circulatory system/blood vessels, your lung or respiratory conditions, any type of cancer, or any Mental Illness, reasonably known to you, for which treatment, medication, surgery or advice has ever been received or prescribed by a medical practitioner or health professional prior to your purchase of the policy and prior to your trip departure as shown as the period of Insurance on your certificate of insurance

This definition applies to you, your Travelling Companion, a Relative or any other person

"Mental Illness" means any sickness, disorder or condition recognised or provided for in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, where a clinical diagnosis has been made and treatment has been prescribed by a medical practitioner or health professional, prior to the trip departure. A clinical diagnosis for Mental Illness can also be made after the trip departure by a medical practitioner or a health professional.

"Relative" means a relative who is your spouse or de facto spouse of either gender, parent, parent-in-law, daughter, son, daughter or son-in-law, brother, sister, brother or sister-in-law, niece or nephew, grandchild, grandparent, step-parent, stepdaughter, stepson, aunt, uncle, cousin, fiancée, fiancé or guardian.

"Travelling Companion" means the person who is to travel with you for at least 50% of the trip and who made arrangements to accompany you before you began the trip. They must arrive and depart with you.

Cover provided for Medical Conditions

 There are three categories of Medical Conditions:

• Medical Conditions the Insurer automatically covers; and
• Medical Conditions which the Insurer needs to assess;
• Medical Conditions which  the Insurer cannot cover;
   

Medical Conditions automatically covered

This section outlines the Medical Conditions that are covered.

These are covered automatically with no additional premium, provided:

• they are not associated with any conditions you list as part of the medical assessment,
• you have not been hospitalised (including day surgery or emergency department attendance) for any of the 38 automatically covered conditions in the past 24 months, and
• specific Requirements are met as outlined in the automatically covered conditions list:
   

1. Acne

2. Allergies limited to Rhinitis, Chronic Sinusitis, Eczema, Food Intolerance, Hay Fever 

3. Asthma providing You:

a) have no other lung disease; and

b) are less than 60 years of age at the time You purchased 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 I) providing You:

a) were diagnosed over 12 months ago; and 

b) have no eye, kidney, nerve or vascular complications; and 

c) do not suffer from a known cardiovascular disease, hypertension, or hypercholesterolemia; and

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

13. Diabetes Mellitus (Type II) providing You: 

a) were diagnosed over 12 months ago; and 

b) have no eye, kidney, nerve or vascular complications;  and 

c) do not suffer from a known cardiovascular disease, hypertension, or hypercholesterolemia; 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 12 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. Hypercholesterolemia (High Cholesterol) providing You do not also suffer from a known cardiovascular disease and/or Diabetes 

24. Hyperlipidemia (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.

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 we cover automatically. This means you run the risk of a claim being declined if you choose to not declare your Medical Conditions. 

Conditions which the Insurer canot cover

Under no circumstances is cover or the purchase of a policy available for:

• travel booked or undertaken against the advice of any medical practitioner 
• conditions (or related conditions) for which you are travelling to seek medical treatment or review 
• conditions involving drug or alcohol dependency
  
  

Under no circumstances is cover available for:

• any condition or illness for which You are currently awaiting surgery, treatment, investigation or procedures
• any Medical Condition of a Relative, Travelling Companion, or any other person not listed on the Certificate of Insurance.
   

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 only provided:

• for unexpected complications before the 26th week; or
• childbirth before the 26th week which was accelerated by accidental injury. We cover single non-complicated pregnancies automatically.
   

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 Our policy provides the coverage they need.