What are Material facts?

Photo By: Hui Quan Yang

Material facts

Material facts or representations are factual information that is relevant to determine your premium and extent of coverage.

GOOD TO KNOW

Travel health insurers rely on the principle of good faith in return for coverage since they do not closely review all applications or medical questionnaires at the time of purchase. To receive the coverage you paid for, you must disclose all facts relating to your health status. The factual statements are not warranties – if the information you provide is false, you are not liable, but your coverage will be voided.

IMPORTANT

If facts are omitted or the information provided is false or inaccurate (even by mistake), the contract between you and the insurer automatically changes – it becomes void or coverage for your medical expenses are reduced.

ASK BEFORE YOU BUY

Contact the insurance provider if you are unsure about what is being asked or what information you need to provide on the application form or medical questionnaire. If you are not getting clear answers, ask to speak to a manager. If you are still unsatisfied, look for coverage elsewhere.

Learn more in IAMAT’s Guide to Travel Health Insurance
  • Did you know?

    You are not covered if you need medical care or hospitalization as a result of drinking alcohol.

    The majority of travel health insurance plans exclude injuries resulting from alcohol consumption. Some plans do cover injuries related to alcohol use but you cannot exceed the maximum allowable blood alcohol levels.

  • Did you know?

    Your travel health insurance plan is a legal contract. When you purchase a policy, you have to adhere to the terms set out within that specific policy for the insurer to fulfill their obligation to provide coverage.

    Remember that insurance only covers you for unforeseen and unexpected events – an unstable pre-existing condition or participating in activities that can increase your risk for personal harm or injury put your coverage at risk.

  • Did you know?

    Medical questionnaires are required to be completed at the time of purchase if you are over a certain age (typically over 60) or have a pre-existing condition. These forms can be complex and include medical jargon. If you need help, ask the insurance provider for clarification. Many insurers also want your doctor to sign off on the medical questionnaire.

    If you file a claim, insurers will look closely at the answers on your medical questionnaire to see if they match your medical file before accepting your claim.

  • Did you know?

    Mental health coverage is excluded from most standard travel health plans.

    If you have a first time mental health event or need care for a pre-existing psychiatric condition, you will have to pay out-of-pocket for medical services and prescription medication you need abroad.

  • Did you know?

    If your existing insurance benefits plan or credit card (primary coverage) doesn’t fully or adequately cover you for your health condition, you will need to get supplemental or secondary coverage (also known as excess insurance).

    This additional plan pays for medical expenses after your existing or primary coverage has reached the payout limits. The secondary insurer pays the balance of your medical costs.

Photo By: Sharif Hossain Sourav