Cover for existing medical conditions

At COTA, we believe that having an existing medical condition shouldn’t get in the way of exploring what the world has to offer. That’s why we consider and assess existing medical conditions to determine whether we can offer cover. 

 

What is an existing medical condition?

An existing medical condition is one for which, in the three years prior to policy purchase, you have:

  • had symptoms or been diagnosed;

  • been prescribed medication;

  • received (or are waiting for) medical treatment;

  • received (or are waiting for) tests, investigations or specialist consultation;

  • received or been advised to attend a follow-up consultation; or

  • had surgery or attended a hospital or clinic (as an outpatient or inpatient).

It also includes any chronic or ongoing medical condition or terminal illness.

 

This definition applies to you, your travelling companion, a close relative, someone at home and any other person.

 

Getting cover for existing medical conditions

The good news is that a number of the most common medical conditions are automatically covered as part of our standard cover. These can be found on our list of Automatically accepted conditions. Customers whose existing medical condition appears on this list, and who meet the criteria for that condition, are covered for events arising from that condition as part of our standard cover.

Even if your existing medical condition isn’t automatically covered, in many cases you’ll still be able to get optional cover by applying to add them as a specified medical condition when you buy a policy.

 

Adding a specified medical condition (optional cover)

If you want to apply for cover for existing medical conditions that are not automatically covered, you’ll need to let us know at the time you buy your policy. We will ask you some questions about your health and determine if we can offer you cover, and if so, on what terms.

In many cases, we expect that we’ll be able to offer you cover for your existing medical condition for an additional premium. If you choose to pay the additional premium, the condition becomes a specified medical condition covered under your policy, and the premium and any additional excess will be shown on your Certificate of Insurance. You’ll then be covered under events that arise from that specified medical condition. 

In addition to offering medical screenings in-store and over the phone, COTA has an easy online self-assessment service. You simply add in your existing medical conditions and answer a few questions to find out straight away whether we can provide cover and on what terms.

 

Medical conditions that must always be screened

If you have ever had any of the following medical conditions, you must have a medical screening at the time the policy is purchased. We will then determine if the condition can be added to the policy and covered as a specified medical condition:

 

  • heart conditions - cardiovascular/coronary heart disease;

  • respiratory conditions (except asthma and/or sleep apnoea providing they meet the criteria to be automatically covered);

  • chronic kidney disease;

  • conditions involving the neck or back;

  • cancer which has metastasised (the process by which cancer spreads from the place at which it first arose as a primary tumour to distant locations in the body);

  • immune system deficiencies/reduced immunity; or

  • any terminal illness.

 

Missed your check-up?

If you received medical advice within the last three years that you should have had a review, follow-up consultation or treatment for a medical condition – and if you didn’t get the review, consultation or treatment – we‘ll classify it as an existing medical condition.

Want to discuss this further?

To arrange a quote over the phone, please call our friendly customer service centre on 1300 1300 50.