Under FCA rules effective January 2023, travel insurers cannot simply decline a customer with a pre-existing medical condition. They must either offer cover or signpost the customer to the Money and Pensions Service (MaPS) directory of specialist insurers. (Source: FCA PS20/5)
| Key fact | Detail |
|---|---|
| FCA signposting rule | Insurers who cannot cover a condition must direct customers to the MaPS directory (Source: FCA PS20/5, January 2023) |
| MaPS directory | Free at moneyhelper.org.uk -- FCA-authorised specialist medical travel insurers |
| Non-disclosure risk | Failing to declare a condition can void the entire policy, not just the medical claim (Source: Insurance Act 2015) |
| FOS complaint route | Free, binding on insurer up to 415,000 pounds (Source: FOS 2026) |
| GHIC | Covers EU state healthcare only -- not a substitute for travel insurance |
What the FCA Signposting Rule Means
FCA Policy Statement PS20/5 (effective January 2023) requires any travel insurer who declines to cover a pre-existing condition to tell the customer about the MaPS travel insurance directory. This is a regulatory requirement. If an insurer declines without signposting you can report this to the FCA at fca.org.uk/consumers/report-a-concern. The MaPS directory at moneyhelper.org.uk/en/everyday-money/insurance/travel-insurance-directory lists regulated providers specialising in complex and high-risk medical conditions.
What Counts as a Pre-Existing Condition
Each insurer sets their own look-back period of typically 2 to 5 years. A condition is usually pre-existing if in that period you have received a diagnosis, taken prescribed medication, been referred to a specialist, had symptoms you are aware of even if undiagnosed, or been on a waiting list for investigation or treatment. Mental health conditions including anxiety and depression are covered by most specialist insurers. Stable, well-controlled conditions such as managed hypertension or type 2 diabetes are covered by many mainstream insurers at standard or lightly loaded premiums.
Non-Disclosure -- Why the Entire Policy Can Be Voided
If you fail to disclose a material condition, an insurer can void the entire policy under the Insurance Act 2015 -- not just the claim relating to that condition. This means a claim for stolen luggage could be rejected if undisclosed hypertension was discovered during a separate medical claim. The FCA expects insurers to distinguish deliberate misrepresentation from innocent error. The Financial Ombudsman Service regularly adjudicates these disputes -- in cases of innocent non-disclosure the FOS often rules in the customer's favour. (Source: FOS annual review 2024)
Conditions and How Insurers Treat Them
| Condition | Mainstream approach | Specialist route |
|---|---|---|
| Active cancer treatment | Usually declined | MaPS directory; Macmillan Cancer Support list |
| Heart conditions (stable post-MI) | Loading; may decline within 6 months of event | Specialist required within 6 months of cardiac event |
| Type 1 diabetes | Specialist insurers cover | Confirm insulin pump cover if applicable |
| COPD or severe asthma | Loading; some decline if on oxygen | Specialist covers if stable |
| Depression or anxiety | Often excluded by mainstream | Specialist providers cover |
| Pregnancy | Covered to 28 weeks by most | Check complications of pregnancy clause |
How to Find Specialist Cover
- MaPS directory -- moneyhelper.org.uk -- the FCA-endorsed first step
- BIBA -- biba.org.uk -- connects you with specialist brokers
- AllClear, Free Spirit, Staysure and InsureandGo are established specialist insurers on the FCA register
How to Complain If a Claim Is Rejected
- Request the insurer's full written reasoning citing the specific exclusion applied
- Gather evidence -- GP records showing the condition was stable or undiagnosed at purchase
- Submit a formal written complaint -- the insurer has 8 weeks to issue a final response (Source: FCA DISP 1.6)
- If unsatisfied, refer to the Financial Ombudsman Service within 6 months of the final response
This article is for information only and does not constitute financial or legal advice. Consult a qualified adviser for guidance tailored to your situation. Check the FCA register at register.fca.org.uk before dealing with any financial firm.
Frequently Asked Questions
Do I need to declare a condition that has fully resolved?
It depends on the insurer's look-back period and exact question wording. If a condition resolved more than 5 years ago and the question asks only about the past 5 years, you may not need to declare it. Read each question precisely and answer only what is asked.
Is GHIC a substitute for travel insurance?
No. The GHIC gives access to state healthcare in EU countries at local cost. It does not cover repatriation, private treatment, cancellation or lost luggage. Apply free at nhsbsa.nhs.uk/european-health-insurance-card.
Can an insurer charge any amount for a pre-existing condition?
There is no regulatory cap on premium loading. However the FCA Consumer Duty (effective July 2023) requires insurers to demonstrate fair value. If a loading seems disproportionate, the MaPS directory and BIBA specialist brokers often find better-priced alternatives.
Sources
- FCA PS20/5: fca.org.uk
- MaPS Travel Insurance Directory: moneyhelper.org.uk
- Insurance Act 2015: legislation.gov.uk
- Financial Ombudsman Service: financial-ombudsman.org.uk
