Insurance 6 min read

Travel insurance and pre-existing conditions, explained

The single most misunderstood part of any policy — and the one most likely to void a claim you were quietly counting on.

What actually counts

A pre-existing condition is broader than almost everyone assumes. It is not merely 'a serious illness you have now'. In most Portuguese and other EU policy wordings it covers any condition you've had symptoms of, sought advice about, been diagnosed with, or taken medication for — typically within the last 12 to 24 months, and sometimes ever.

That includes the blood-pressure tablets you've taken for a decade without incident. The knee you had scoped in 2023. The anxiety you mentioned once at the centro de saúde. The asthma you haven't needed an inhaler for since school. All of it is potentially in scope, and none of it feels like 'a condition' to the person filling in the form.

Why it matters more than the excess

People shop policies on price and excess. Insurers decline claims on disclosure. If you don't declare a condition and you subsequently claim for something an assessor decides was related to it — even loosely — the claim fails. In the worst cases the entire policy is voided, which means the unrelated stolen laptop isn't covered either.

The amounts involved are not small. An air ambulance repatriation from South-East Asia to Lisbon starts around €50,000 and goes up sharply from there. That's the number a policy exists to protect you from, and a non-disclosure is the most reliable way to lose it.

Nobody has ever been refused cover for declaring something. People are refused claims for not declaring it. The asymmetry is the whole lesson.

Inês Carvalho, Founder & Managing Director

How the assessment actually works

It's far less painful than people expect. Most insurers run an online medical assessment: a structured set of questions per condition, answered in ten minutes, with an immediate outcome. There are three possible results.

  • Automatically covered. A long list of stable, common conditions are included at no extra premium — controlled hypertension, many allergies, well-managed asthma. Most people are surprised how much sits here.
  • Covered for an additional premium. A loading, quoted up front. Usually modest, occasionally not.
  • Excluded. The rest of the policy stands; that specific condition and anything arising from it isn't covered. Sometimes that's an acceptable trade, and sometimes it means we should look at a different underwriter — they differ enormously.

Four things that catch people out

  • The European Health Insurance Card is not travel insurance. The Cartão Europeu de Seguro de Doença gets you state healthcare inside the EU and EEA on the same terms as a local — which is genuinely valuable and worth carrying. It does not cover repatriation, it does not cover private clinics, and it is worth nothing at all outside Europe. Every year somebody tells us they're covered for Thailand because they have one.
  • Cover starts when you pay, not when you fly. Cancellation cover is the reason to buy the policy the day you pay your deposit. If you buy it a week before departure, the four months of cancellation risk you were exposed to were uninsured.
  • The condition doesn't have to be yours. Cancelling because a non-travelling relative fell ill is a very common claim, and a pre-existing condition in their history can exclude it. Read that clause specifically.
  • Re-declare if anything changes. New diagnosis, new medication or a change in dose between purchase and departure? Tell the insurer. It usually costs nothing and it preserves the claim.

Inês Carvalho

Founder & Managing Director

Twenty-two years in the industry, the last nine building Meridian from a two-desk office off the Praça Luís de Camões. Speak to Inês directly on +351 912 744 819.

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This is the sort of thing we do all day.

If any of the above raised a question about a trip you're actually planning, that's a fifteen-minute phone call — and it's free.

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