The Daily Telegraph - Saturday - Travel
My cancer is gone, but I can’t get insurance
Even if doctors have given the all-clear, travel cover after receiving a cancer diagnosis can cost as much as the holiday itself, finds Juliet Rix
After treatment for cancer, the first thing many people want – indeed, need – is a holiday. Given that 40 per cent of us are now expected to get cancer at some time in our lives and more than 1,000 people a day receive a new diagnosis, there are a lot of people with cancer in need of a break.
And as sensible individuals, they – we – also need travel insurance. Ah, and there’s the rub.
As a travel writer, I have long had annual travel cover with one of the big insurers, Direct Line. I’ve been perfectly happy with it. Following a diagnosis of cancer, however, they refused to cover me.
The fact that the cancer was deemed cleared apparently didn’t make a difference. The fact that I have been insured with the company on and off for a couple of decades didn’t, either. They would cover me losing my luggage or breaking my leg, but not my “pre-existing medical conditions [PEMCs]” – and that’s pre-existing as in before booking the trip, not before taking out insurance with them. And they are not alone.
I tried a few other companies. None would give me annual cover. What about individual trips? A week in the Caribbean: more than £500. A week in Europe: north of £100. And that’s with significant excesses.
Given time, I might have been able to find cheaper options, but shopping around isn’t much fun in this context. Each time you want a quote, you are obliged to go through the details of your recent cancer – which is probably what you want the holiday to get away from.
The Financial Conduct Authority (FCA) knows that there is a problem with travel insurance and PEMCs.
The regulator introduced new rules in April 2021 requiring all insurers that refuse or limit cover, or raise premiums above a certain level due to a person’s PEMCs, to signpost affected customers to a suitable directory of specialist insurers.
The FCA approves two such online lists: one from the government-backed MoneyHelper, the other from the British Insurance Brokers’ Association. Direct Line did refer me to the specialist directory – but many people do not receive this meant-to-be-mandatory advice (something the regulator has acknowledged).
In its latest annual Financial Lives report, the FCA reported that in the year to May 2022, 1.9 million adults looked for travel insurance to cover them for a serious PEMC and nearly a quarter – 23 per cent, 437,000 people – did not find one.
A further 10 per cent were offered cover but did not buy it, presumably because of the cost, which the report acknowledged can be “very high”. In some cases, it is not far off paying for the holiday all over again.
A Which? survey published this summer came up with similar figures: 36 per cent of respondents with, or with a history of, a medical condition, had had difficulty with travel insurance – either a refusal, high prices or problems when claiming.
Which? also noted that travel insurance has a relatively poor record on paying out (75 per cent versus 99 per cent for car insurance), and the second most common reason for rejecting a claim (after general policy exclusions) was pre-existing medical conditions.
What exactly is the definition of a PEMC? The FCA does not have one. The Association of British Insurers (ABI) does and it’s something of a catch-all:
“Any health condition you have now or had in the past.” Really? Should we all be declaring the fluey bug we had one winter and a broken toe in our teens?
Insurers are, of course, entitled to assess risk and charge accordingly, but the assessment of PEMCs does not always reflect the actual risk.
The FCA seems to be aware of this, too, reminding insurers in 2021 that they are expected to “assess the risk from medical conditions and calculate medical-condition premiums using reliable information that is relevant to assessing this risk [to] help make sure that consumers are quoted a fair premium which properly covers their circumstances”.
If I had had a stroke or a heart attack, I would understand an insurer seeing me as a higher-risk traveller. Any repetition of those would be an immediate emergency – with all the attendant costs abroad.
Successfully treated cancer is very different, with any risk a relatively slowburn one. Even urgent cancer referrals take a fortnight. If I found another lump in my breast while on a one- or twoweek holiday (which is unlikely, anyway, given that I am screened twice a year), would I be heading to A&E on a Caribbean island? Or knocking on an Italian doctor’s door? Of course not. I’d be contacting my medical team in the UK to make an urgent appointment for when I got home.
I even have my consultants’ testimony – in writing – for my fitness to travel. And the one who has been treating me most recently helpfully added: “Her recent treatment does not make her more likely than any other person to have health problems when she is abroad.”
But in the tick-box world of online forms (and the forms that call handlers have to fill out if you phone the company), there does not seem to be a place for such assurances or assessment of individual risk.
If I am not at increased risk, you might ask, why not stop worrying and travel without insurance cover for my so-called PEMCs? This is, in fact, what a helpful supervisor at one of the specialist insurers suggested when I balked at the price of full cover. Many people are doing exactly that. But if they do then have to claim, it can become difficult.
I was warned by a cancer specialist nurse: “They can get you. If you have something like a blood clot, they will say it is because of the cancer, even if it isn’t. It’s hard to prove the cause.” A relative of hers with a PEMC had just paid more than £1,000 for their travel insurance.
The FCA is currently reviewing the functioning (or not) of its 2021 rule change and intends to publish its results towards the end of the year. In the meantime, I shall be using specialist insurers (which do tend to offer better value than the big brands for PEMCs) when I can afford to and going without full cover when I cannot.
In such cases, I shall be relying, should I have to claim for anything health-related, on the testimony of my consultants and the hoped-for fairness of my insurer.