Preexisting Condition

I don't know if I'm just being dense or just too lazy to figure it out, but could someone explain preexisting conditions?

Our DIL was diagnosed with a rare type of cancer AFTER we scheduled a cruise for next Christmas. They said they got it all with surgery, but two weeks ago it showed up again. More surgery, another statement that they got it all. She is scheduled for her next PET scan in September and then another in early December. If more cancer is found then, the cruise is history.

I read about deadlines for purchasing insurance but for some reason I can't figure out if you must purchase insurance so many days before or after paying for the cruise.

Gooch,

A Pre Existing Condition (PEC) limitation in an insurance policy is for an illness that already exists at the time of purchase of the insurance and/or for a set number of days before, usually 60-180 depending on policy.

In your example, if you had purchased the insurance at the time of planning the cruise, your DIL's illness would not have been PEC. That is, it was unknown at the time of purchase. As of now, it IS pre-existing, and because her treatment is ongoing and changing more often than the 60-180 day limit, it likely would not be covered by most insurance policies for a December cruise. Even a doctor visit for that condition constitutes treatment in most instances.

Many third party policies will grant a waiver for PEC, but there are rules you must follow to get this waiver:

1. You must purchase the insurance within a specified time frame, usually 14-21 days of making your first payment on any aspect of the trip.

2. You must insure the full cost of the trip.

3. You must be medically able to travel at the time of purchase.

You may wish to speak with an Insurance broker on what options you might have for insuring this trip. There are a couple of policies where the specified time-frame (#1 above) is measured from before the final payment due date rather than the first payment. If you want to pursue this, I highly recommend calling the people at Trip Insurance Store. It's a toll free call and they know their stuff. If there is a policy for you, they will know. And they won't sell you a policy that doesn't meet your needs.

One other option you may wish to explore is Royals's Cruise Care. If you need to cancel, but this reason is not covered for a cash payment, you could get a 75% cruise credit. It could be better than nothing, especially if you purchase it 61 days after the last doctor appointment where she was told "they got it all".

Hope that helps, and that your DIL remains NED.

We did schedule the cruise and bought insurance before it was found.

Well, off-hand, it sounds as if you are covered. That said, what matters is not the date of diagnosis; rather, the date that treatment was first sought (or should have been sought) for symptoms.

For instance, if she went to the doctor for persistent severe headaches and was sent home with a migraine Rx, it didn't work, and is diagnosed with a tumor two months later, it's the first doctor visit that counts as the date for evaluating the pre-ex clause.

Your individual policy should have the details as to the length of the "look-back" period.

That might be a problem. This may be TMI, but she was having severe bleeding during her periods that was so bad she was anemic. They said she had fibroids and tried to control the problem with medication. That didn't work.

The cancer was found in one of the fibroids.

That doesn't seem fair. The insurance company could claim that any symptom you had was associated with the problem. An ingrown toenail? Dandruff?

This may be TMI, QUOTE]

 

:eek:

Well, you told us that much.

Might as well go ahead and tell us what day you made first deposit or payment towards the trip,, what day you purchased the travel insurance, and what insurance company you went with.

 

That information would help determine how we could be more helpful.

most pre-existing condition definitions say things like "should have known" or "symptoms that should have caused one to see a doctor. It is almost normal for insurance companies to try to reject a claim for lung cancer because you once had a sore throat...etc. Additionally, the whole pre-existing conditions section is not applicable where a medical problem is or should be anticipated at the time you purchased the insurance.

Put that together...you had some symptom that might have been a clue to a doctor that you might have had the condition (so they reject you) and once you knew of the medical issue, you should have anticipated a medical problem (so they reject you).

Not trying to rain on anyone's parade....but the insurance companies exist to keep your premiums so they try to find any reason to deny a claim.

All above is true, but since the DIL did seek medical care AND because she received a documented diagnosis different than what the final disease turned out to be, she actually stands a pretty good chance of being covered. Not saying it won't require some hoop jumping and perhaps an appeal, but far better than not seeking care for the original symptoms.

Knowing which policy and how long the lookback is would be of further help.

I was wrong, way wrong. I've messed up the dates so bad this whole conversation is irrelevant. I was confusing the reservation for our Christmas 2014 cruise with the one for our Christmas 2015 cruise. The reservation for 2015 was made in April, after her original surgery and diagnosis. So this is a pre-existing condition.

If it even matters, the original surgery was in November, the reservation was made in April with Royal Caribbean with their insurance.

At least I now understand it. Thank you all for your help.

I was wrong, way wrong. I've messed up the dates so bad this whole conversation is irrelevant. I was confusing the reservation for our Christmas 2014 cruise with the one for our Christmas 2015 cruise. The reservation for 2015 was made in April, after her original surgery and diagnosis. So this is a pre-existing condition.

 

If it even matters, the original surgery was in November, the reservation was made in April with Royal Caribbean with their insurance.

 

At least I now understand it. Thank you all for your help.

If nothing else, Royals insurance includes "Cancel For Any Reason".

It doesn't pay a refund but it does give you a 75% future cruise credit.

Make sure you cancel at least 48 hours before you were scheduled to leave your house.

Of course, confirm all this be reading your policy.

That might be a problem. This may be TMI, but she was having severe bleeding during her periods that was so bad she was anemic. They said she had fibroids and tried to control the problem with medication. That didn't work.

 

The cancer was found in one of the fibroids.

 

That doesn't seem fair. The insurance company could claim that any symptom you had was associated with the problem. An ingrown toenail? Dandruff?

The insurance company has to be reasonable; no insurance company that wants to retain their license to operate would try to claim that dandruff was a subtle symptom of, say, a stroke. Insurance regulators frown on such behavior.

This particular standard is pretty universal amongst various types of insurance; it's not a quirk of the trip insurance industry. Life, Health, Disability, etc.

As far as your SIL's condition goes: If she did not receive additional treatment or have a medication change for her condition during the pre-ex "lookback" period, since she was considered "recovered" then it is not generally considered pre-existing. The policies aren't heartless, if you genuinely thought something had gone away, (and it's been gone long enough), you are considered "cured", and if it re-occurs, it's a new condition. Chronic conditions controlled by stable amounts of medication (i.e. Blood Pressure) are also "cured".