Health insurance refused because of unknown pre-existing condition

A friend of mine visited me from Brazil and while she was here she suffered from an unexpected lung infection which put her in intensive care for several days. I had helped her get temporary health insurance to cover her stay here and help her get a visa. Now the insurance company says that the infection was caused by a problem she had already but which went unnoticed until the infection occured. She had no idea that she had any condition and answered the question truthfully to the best of her knowledge when applying. Now the insurance company won't pay the hospital costs (more than CHF 10,000) and she doesn't have the money. I find the whole thing unfair. Can the insurance company do this?

Hi there,

Supplementary health insurance policies generally do not provide coverage for pre-existing conditions. This is also the case when the policyholder is not aware of existing conditions when they take out the policy. It is up to the insurer to decide how lenient they want to be in this regard.

As a general rule, getting a thorough medical examination just ahead of taking out supplementary health insurance is a good move. This provides you with clear proof of pre-existing conditions or their absence, and can be useful in proving your health at the time of signing.

Insurance companies may not require strict medical examinations, but getting these works in you favor because doctors may incorrectly trace the source of an illness to a problem which they falsely believewas present at the time of signing. A thorough medical examination can help to debunk such myths and help you claim the insurance benefits you deserve.

Best regards from Moneyguru

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