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What would happen if you had a month's trip to America booked - departing in six months time - and were unexpectedly diagnosed with lung cancer? Suppose you had to cancel your holiday and go in for immediate surgery. If you had been smart and taken out travel insurance - effective from the date you booked the trip - you should be able to recover costs associated with the cancellation of the trip (after any excess payable). However, if you had waited until the day before departure to purchase travel insurance your cancellation costs would not be covered. Some people try to squeeze extra mileage out of their annual travel insurance policy by making the start date of the policy the date of the first departure. This is a risky thing to do because there will be no cover for cancellation costs if anything should go wrong prior to the departure date.

Just suppose you'd been having tests and investigations within the last year for lung-related problems but failed to declare this fact when purchasing travel insurance. During your scuba diving holiday in California, you start coughing up blood all over the dive boat. You have to seek emergency medical care and a diagnosis of lung cancer is confirmed. Would you be covered for the high emergency medical costs or curtailment of your trip? Probably not.

Anyone with a serious pre-existing medical condition will already know that obtaining travel insurance can be tricky, but not impossible. Some travel insurance companies exclude all claims related to pre-existing medical conditions. Some insurers will cover for pre-existing conditions without any additional premium. Other travel insurance companies may have a medical screening system, usually carried out over the telephone or online. A series of questions is asked to assess the risk and determine whether insurance can be issued. If approved, there may be a choice to either pay an additional premium to cover the pre-existing condition - or elect not to pay the extra premium and exclude claims relating to the risk.

Common conditions such as hypertension (high blood pressure), diabetes and asthma can all cause problems when trying to obtain travel insurance - especially if combined with other conditions, so never neglect to disclose something as common as high cholesterol thinking that it is insignificant! All questions must be answered fully and honestly.

As with any type of insurance, there are always exclusions. Some insurers will refuse to insure those with pre-existing conditions involving cancer, serious kidney problems (requiring dialysis), serious heart conditions, strokes and HIV, AIDS, or any AIDS-related problems. They also do not cover for suicide or suicide attempts - in case you're thinking of jumping off the Golden Gate Bridge!

Most travel insurance policies will carry similar wording and it is wise to read and understand the terms and conditions. For instance, there might be clauses stating that you should never travel against the advice of a medical practitioner, or to obtain medical treatment abroad (unless already disclosed and pre-approved). The same goes for those on waiting lists for surgery or procedures, or awaiting the results of medical tests. There are specialist travel insurers who will often cover terminal illnesses.

During the medical screening, you may be asked specific questions, such as: have you been a hospital inpatient or had any medical condition that requires ongoing medication, or referral to a specialist within the past twelve months? Have you ever suffered from, been diagnosed with, or treated for cancer (or other malignant disease), a heart or lung condition (excluding well-controlled asthma), high blood pressure or any psychiatric disorder?

Any claims you make which relate directly or indirectly to the types of conditions listed above will normally be excluded - unless you declared the condition and it was accepted by the underwriter, subject to any conditions or additional premiums imposed. Whether or not a particular travel insurance company is willing to offer insurance will depend upon different factors, depending on the underwriter, so it is wise to shop around and obtain quotes.

The biggest mistake is taking the risk of failing to disclose a condition to obtain the insurance. You might get away with it if there are no problems and you have no reason to make a claim. However, if the worst should happen, the insurance company has ways to find out - and they will find out - about any pre-existing conditions! You could find yourself with huge medical bills and your insurance claims denied. With the high cost of medical treatment in some countries (the USA especially) it simply is not worth it. Always be completely honest so that you can have peace of mind and enjoy your holiday without worrying about every twinge!

Jean Andrews is a freelance writer living in the UK. She regularly contributes articles for TIA Ltd who offer travel insurance at great prices online.