Ask Sindie: A traveller with a heart problem - the insurance odyssey

Can those with a medical condition be sure they can claim for treatment?

Q: I have a heart condition called atrial fibrillation (AF). This is not serious but has not been brought under control. While it does mean I have an increased risk of stroke, this risk is mitigated by medication.

When I last bought travel insurance, I told the sales assistant about the condition and she took down the details. But when I asked her how this would affect the claim, she wasn't able to tell me.

I have plans to travel to Greece next year, but I'm now wondering whether, if I'm taken ill while I'm there, I should refuse private treatment on the grounds that my insurance may not cover me.

I'm confused as to when an illness might be traced back to a pre-existing condition, and I hate the idea that I could be wheeled down a hospital corridor, not being able to answer whether I'm properly insured.

CB, by email

A: Pre-existing medical conditions, ranging from diabetes or asthma to a heart attack or cancer, cause frequent problems with travel insurers. Some automatically refuse cover if you have one of these conditions, while those that do offer cover often levy a higher premium or an increased excess charge on a claim.

That said, you must tell insurers about any medical problem before you travel. Those prepared to give you cover will usually ask questions about your condition. This will allow them to establish the risk being undertaken - and to tailor the premium accordingly.

"We, like many other providers, will ask you to disclose any existing medical conditions," says Hugh Stacey, head of travel services at the Post Office. "This is very important to avoid exactly the situation you describe - where you are unsure if you are covered for treatment."

He says that as AF is a recognised heart condition, you would need to go through a medical screening with the Post Office. "This allows the provider to judge the severity of your condition and advise the best type of policy for you." He adds that depending on the outcome, some customers may have to pay an extra premium. "We will provide written confirmation of the cover supplied."

Insurer Churchill assesses people on a case-by- case basis. "When a customer declares they suffer from AF, we carry out a medical screening," says spokeswoman Emilie Lien. "Whether we can cover it depends on factors such as other cardio-vascular conditions and whether the customer is a smoker."

If these are not an issue, Churchill will provide full cover for all emergency treatment overseas, for no additional premium.

Vicky Emmott at Halifax Travel Insurance says people with pre-existing conditions are assessed via a tailored medical screening - the result of which is used to determine the level of cover offered. This, she adds, will fall into one of three categories.

The insurer will either take on the risk in full - including claims relating to that condition; accept the risk but exclude cancellation cover if the customer falls ill and can't travel; or accept the risk but exclude claims relating to the declared condition.

Another problem area is buying over the internet. "If you apply for travel insurance online, and say 'yes' when you are asked if you have any pre-existing conditions, then often you won't be given a quote," says Stuart Glendinning at the price-comparison website insuresupermarket.com.

If you are met with refusals, you could enlist a broker, who will scour the whole market for you. Or you could turn to one of a number of firms that specialise in cover for those with pre-existing medical conditions, like Free Spirit ( www.free-spirit.com) or AllClear ( www.allcleartravel.co.uk).

If you need help from our consumer champion, write to Sindie at The Independent on Sunday, Independent House, 191 Marsh Wall, London E14 9RS or email sindie@independent.co.uk. We cannot return documents, give personal replies or guarantee to answer letters. We accept no legal responsibility for advice given.