AFCA Travel Insurance Decision Puts Pre-Existing Conditions Under the Microscope

The dispute involved a family holiday that was cancelled after a student suffered a panic attack before boarding a flight. The traveller’s mother argued the event was a new and specific fear of flying, not a continuation of the daughter’s earlier school-related anxiety. The insurer, HDI Global Specialty, rejected the claim on the basis that the policy excluded losses connected with pre-existing conditions treated in the relevant period before the cover was purchased.

AFCA accepted that the young traveller had previously flown without the condition affecting overseas travel. However, it still found the insurer was entitled to rely on the exclusion. The key issue was not whether anxiety had caused a travel problem before, but whether the medical condition existed and had been treated within the policy’s look-back period. Medical notes and school-related documentation recorded anxiety and panic attacks before the travel policy was taken out, which was enough for the exclusion to apply.

For consumers, the decision is a reminder that pre-existing condition wording can be much wider than many people expect. A condition does not always need to have previously disrupted travel to become relevant to a later cancellation claim. If the policy wording captures a diagnosed, treated or symptomatic condition, the insurer may examine whether the later event arose from, was connected with, or was aggravated by that condition.

Before buying travel cover, Australians should pay close attention to:

• how the policy defines a pre-existing medical condition;
• the look-back period for treatment, diagnosis, medication or symptoms;
• whether mental health conditions are covered, excluded or subject to assessment;
• whether a medical screening or written approval is needed before departure;
• what evidence may be required if a cancellation claim is later made.

The ruling also shows why price should not be the only factor when choosing insurance. Two policies may look similar at checkout, but their medical exclusions, cancellation benefits and claims requirements can produce very different outcomes. Travellers with recent medical history, ongoing treatment or family members with known conditions may benefit from asking more questions before they commit.

For households and small business owners who already find policy wording difficult to compare, a licensed insurance broker can help explain what different exclusions mean in practice. The aim is not just to buy a policy, but to understand when it is likely to respond, when it may not, and what steps are needed to reduce the risk of an unexpected claim denial.

This decision is another reminder that insurance certainty comes from reading the detail early, not after a disrupted trip. Anyone arranging cover should compare insurance options carefully, disclose relevant information accurately, and keep written records of any medical assessments or insurer confirmations before travelling.