Travel Insurance: The Third Option Nobody Tells You About
Someone buying travel insurance with a heart condition from fifteen years ago faces what looks like a choice between two bad options. Declare it and watch the premium double. Or stay quiet and hope nothing happens.
There’s a third option almost nobody mentions, and it solves the problem entirely: you can declare a condition and ask for it not to be covered.
Why the third travel insurance option exists
Travel insurance underwriters separate two things that people assume are the same: knowing about a condition and covering it.
Declaring a condition tells the insurer the truth about your health. That’s what validates the policy. Whether they then charge you to cover that condition is a separate commercial decision — and one you can decline.
If you declare an old, stable condition and choose to exclude it, the insurer prices the rest of your cover normally. You’re not paying a medical premium. And crucially, the policy remains valid for everything else.
Break your leg on a ski slope? Covered. Food poisoning in Thailand? Covered. The excluded condition flares up? Not covered — but you knew that, and you chose it.
What happens when you don’t declare on travel insurance
This is the part people underestimate, and it’s worse than most expect.
Non-disclosure doesn’t just void claims connected to the hidden condition. It can void the entire policy.
Under the Consumer Insurance (Disclosure and Representations) Act 2012, you must take reasonable care not to misrepresent your health. If the insurer can show it would have offered different terms — or no cover at all — had it known, it can treat the policy as though it never existed.
The practical result: an undeclared heart condition can leave a broken leg unpaid. The two have nothing to do with each other. It doesn’t matter.
And the numbers involved aren’t small. Treatment for a heart attack has been quoted at around £45,000 in Spain, £75,000 in Thailand and £362,000 in the United States. Repatriation is separate and often costs more.
Why “I feel fine” is the wrong test
The most common reason people fail to declare isn’t dishonesty. It’s a genuine misunderstanding about what the question is asking.
The test isn’t whether you feel unwell today. It’s whether the insurer’s screening question covers your history — and that wording reaches back much further than people expect.
Typically you must declare anything that in the last five years involved: symptoms, treatment, investigations, surgery, or a medical appointment. Some insurers use two years for general conditions but apply “ever” to certain categories.
Always declare regardless of how long ago:
- Any cancer, even in long remission
- Any heart condition — arrhythmia, angina, a past heart attack, valve disease
- Any respiratory condition including COPD, severe asthma, or sleep apnoea on CPAP
- Mental health treatment, including depression or anxiety managed with medication
- Anything you’re currently awaiting tests, results or surgery for
- Any scheduled procedure at the time of buying
Pregnancy is usually declarable after 28 weeks, though some insurers set it at 24.
The rule that saves people money: when unsure, declare it and let the insurer decide it’s irrelevant. Many conditions cost nothing to add. You’re never penalised for declaring — only for hiding.
The FCA travel insurance rule that changed in January 2026
Worth knowing, because it works in your favour.
The Financial Conduct Authority operates a “signposting” system for travellers with medical conditions. If an insurer won’t offer cover at a reasonable price, it must direct you to a specialist provider rather than simply declining.
In January 2026 the threshold at which this applies rose from £100 to £200. That widens the band in which mainstream insurers must quote you a fair price before pushing you elsewhere.
Practically: if a quote for a declared condition comes back unexpectedly high, you’re entitled to be signposted to a specialist rather than left stuck. Ask for it.
How to use the declare-and-exclude route
The mechanism isn’t always offered upfront. You often have to ask.
- Complete the medical screening honestly. Every question, every condition, including the ones you think are irrelevant.
- See what the condition adds to the premium. Many add nothing. If so, take the cover.
- If the increase is significant, ask directly: “Can I declare this condition but exclude it from cover?”
- Get the exclusion in writing on the policy schedule before you pay.
- Check what else it excludes. This is the part to read carefully — see below.
The catch worth understanding
Excluding a condition doesn’t only exclude that condition. It usually excludes anything arising from or connected to it.
Exclude a heart condition and you’re likely excluding related cardiac events, complications, and possibly cancellation if the condition worsens before you travel. Exclude diabetes and you may be excluding circulation and wound-healing complications too.
That’s a real limitation, and for a serious or active condition it can make the exclusion unwise. The route suits old, stable, resolved conditions — the kind where the risk of a flare-up abroad is genuinely low.
For anything active or complex, a specialist medical travel policy is usually the better answer, even at a higher premium.
What the GHIC does and doesn’t replace
UK travellers heading to Europe often assume the Global Health Insurance Card removes the need for cover. It doesn’t.
The GHIC gives access to state healthcare in EU countries on the same basis as a local resident. That’s useful, and it’s free.
What it doesn’t cover: private treatment, repatriation, cancellation, lost baggage, or anything outside the EU. Repatriation alone can run into five figures, and there’s no route to it other than insurance.
Carry both. They do different jobs — as covered in our guide to what travel insurance actually covers.
If a travel insurance claim is refused
Refusal isn’t final. The Financial Ombudsman Service is free to consumers and regularly overturns insurer decisions on non-disclosure — particularly where the screening wording was ambiguous or the condition was genuinely unrelated.
Under the 2012 Act, the insurer’s response should be proportionate to the misrepresentation. An honest mistake is treated differently from deliberate concealment, and the burden is on the insurer to show it would have acted differently.
If you’re refused, ask the insurer for its reasoning in writing, then take it to the Ombudsman.
Frequently asked questions
Does declaring a condition always increase the premium?
No. Many common, well-controlled conditions add nothing. Others add a modest amount. Only serious or active conditions tend to move the price substantially.
Can insurers see my medical records?
Not without your consent. But at claim stage they will usually ask for it, and refusing consent generally means the claim isn’t paid.
What if my health changes after I buy the policy?
Most policies require you to notify the insurer of material changes before travelling. A new diagnosis between purchase and departure needs reporting.
Is declare-and-exclude available on every travel insurance policy?
It’s common in the UK market. Availability elsewhere varies — in the US and Canada, pre-existing condition waivers work differently and usually depend on buying within a set window of your first trip payment.
Book the cover the day you book the trip
Declaring costs you nothing. Hiding can cost you everything, including cover for things entirely unrelated to what you hid.
If the premium for a condition is unreasonable, ask to declare and exclude rather than staying silent. Get it in writing, understand what else the exclusion catches, and buy the policy the day you book — cancellation cover only works if it’s in place before you need it.
Sources & official guidelines
- Financial Conduct Authority — medical condition signposting and the 2026 threshold
- Consumer Insurance (Disclosure and Representations) Act 2012 — the law governing non-disclosure
- Financial Ombudsman Service — free escalation if a claim is refused
- NHS — what the GHIC covers and its limits
Treatment cost figures are indicative examples published by UK insurers and vary by country, hospital and treatment. Screening criteria and exclusion terms are set by individual insurers — your own policy wording is the authoritative source.
Last reviewed: 24 September 2026 — sources verified.
General information only, not personalised insurance advice. Policy terms, screening criteria and regulatory thresholds vary by insurer and country and change over time. Read your own policy documents and speak to a licensed broker about your circumstances.
