Recurrence clause clarification

Summer 2014 CSANews Issue 91  |   Posted date : Aug 06, 2014.Back to list

Bird talk - Le Jaseur
Dear Bird Talk,

There appears a clause in medical travel insurance policies, including Medipac, which states the following:

EMERGENCY SERVICES EXCLUDED FROM COVERAGE

“ ...services relating to an illness or injury which caused the emergency, after such emergency ends.”

Does this mean that one should go home after having received emergency medical care? I had a urinary tract infection during my last trip, which was treated with antibiotics. What if the infection had returned a week or so after I had stopped the medication and/or the condition actually worsened. Would I have been covered or not? There are many minor emergencies such as colds and flu which can worsen even after initial treatment. Can you please clarify this matter for me?

Marion
Toronto, ON

Response:
Ed.: An excellent question, Marion. The insurer has the right, and usually exercises it, to decline subsequent claims that are related to a prior claim. These are called “Recurrence” clauses. If you purchase Medipac, this would not be an issue. Once you have a claim with Medipac, we will advise you if you will NOT be covered for a recurrence. If you so choose, we will pay your way home because your coverage has been impaired. In your specific situation, Medipac would provide coverage and pay any subsequent claim, even if the condition worsened. This is another major difference between Medipac and most other insurers.

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