What About Those In Less Than Perfect Health?

Because the Canadian travel market is expanding so rapidly, travel health insurers have developed an astonishing array of products for those with diagnosed health conditions and the expanding population of elderly. No travel health insurer wants to be locked out of the buoyant snowbird market, for example, not with between 500,000 and 600,000 of them heading out of the country each winter and with at least 80 percent of them buying supplemental health insurance.

On the one hand insurers don’t want to take undue risks by underwriting clients who are likely to expire in the tropical sunset-although dead clients are often cheaper to underwrite than ones who linger too long in hospital. But neither do they want to miss out on their market share. And so they have become very creative in providing plans for clients with more complicated health profiles.

The means to this end is called “medical underwriting” and it refers to basing risk (and premium price) on your specific health characteristics. To qualify, you must complete a health questionnaire, and this can be a daunting experience. Some questionnaires are pages long and are studded with ambiguity, opacity, contradiction and medical and even legal jargon. But it’s the only way insurers have of digging out the information about an applicant’s health.

Believe it or not: some applicants lie. Others just forget. And some just don’t know everything that’s in their medical record-either because their doctor didn’t tell them (thinking it wouldn’t make a difference to their care) or they didn’t understand what their doctor told them, or they didn’t think it relevant to the question being asked. All of these situations can be problematic because insurers have to know an applicant’s medical history in order to asses the risk they are undertaking (and the premium they should charge). It’s not up to you to determine what is or is not relevant. It’s up to you to answer the questions factually.

Question: Have you ever had symptoms, been investigated, or had treatment for a heart murmur? If you answered No or left it blank because a few years ago your doctor said no treatment was necessary and you need not worry about it, you made a serious mistake. The answer was clearly Yes, but you thought that since no treatment was necessary it was irrelevant. That’s the kind of omission that could negate an expensive hospital claim. If the answer was “I’m not sure” then you should have asked your doctor.

Remember, when asked to complete a questionnaire, whether by phone, online or by hand, you’re not being asked to offer your opinions, but to provide facts. The underwriters will determine what is or is not relevant. Sometimes they too ask a lot of irrelevant or obscure questions, but you have to answer factually, however silly the question may sound to you.

There are also many instances, particularly among the elderly, where applicants truly don’t know or don’t remember everything that’s in their medical record. But where coverage depends on that knowledge, it’s best to ask the family physician for help. Even if you have to pay a fee for that help-which is only reasonable-having accurate information from your medical record will protect you in the end.

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