Rhythm and blues – heart block and travel insurance
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The cardiologist was emphatic. “You have third degree heart block. You need a pacemaker”. “But I have absolutely no symptoms”, I whined. “I’ve been out running several times this week, don’t get breathless”. He was unmoved. I could black out at any moment. While driving, to cite a worst case. In fact if I wasn’t fit enough to run he would get me admitted to the hospital there and then.
As it was, I had about three weeks to get used to the idea of a foreign body under the skin and wires to the heart. Heart block, for those fortunate enough to avoid this process, is a breakdown in electrical signals between the upper and lower chambers – the atria and ventricles. The heart’s rhythm is disrupted and it beats too slowly. I was aware I had an incipient problem. A 24-hour ECG (electrocardiogram) had revealed I had the heart rate of a snoozing snake – down to a mere 20 beats a minute in the first hour or so of sleep. But I had no idea it had progressed to danger level.
Fitting a pacemaker is usually a straight forward procedure. It’s a day job under local anaesthetic and painless, except briefly in my case when the surgeon ran the leads a little close to my collar bone. He and I had a conversation about walking safaris in Zambia, which we had both enjoyed, while the stitches went in. They warned me not to stretch my arm above my head for six weeks, lest the leads became displaced. But after a few weeks I was jogging gently with no ill effects.
There is, however, one serious (non-medical) side effect. Your travel insurance goes up. Significantly. In some cases stratospherically. I had assumed that, because the pacemaker made me less of a risk, it would go down. No such luck. It is, in the dread words of insurers, a “pre-existing medical condition”. Getting lumbered with one or more of these means every time you renew you need to answer a tedious string of health questions, either online, or on the phone from some youth who thinks phlebitis is a hazard of sleeping in third world hotel rooms.
With one exception, I’m not going to name names here. It seems to me the logic of all travel insurers is flawed in some way or other. They tell you premiums are based solely on past experience and arithmetical risk assessment, but too often leave you wondering how the sums added up. I was once refused cover for heli-skiing. Was it ok to ski off piste, I asked? Yes it was. And would I be covered to fly to the off piste ski area in a helicopter? Yes I would. As Bart Simpson might have said: “Doh”.
The insurance company I was using before the operation said it would more than double the premium my wife and I paid for annual worldwide cover. A company specialising in pre-existing conditions responded to an online request with a list of policies available from various providers, the cheapest of which was similarly more than double our current premium, the most expensive around five times as much; i.e. some £1,600 for its annual, all countries, multi-trip worldwide cover. I looked at a couple of market comparison sites. This proved more encouraging. They listed cheaper policies with lower cover. I began to ask myself questions about how much protection I needed. Had anyone actually needed £10 millions’ worth of medical cover? If so, I’d never heard of it. Would £5 millions’ worth be enough? Surely it would. Did I really need delay or possessions insurance or could I simply stump up if things went pear shaped? I wound up with a policy from Staysure. It wasn’t the cheapest I’d found but at around £520 it represented a solid compromise between the cover I really wanted, and that which wasn’t crucial. Besides it also included skiing. Except it didn’t. Staysure wouldn’t insure skiers older than 70. Black mark. I fractured a hip skiing at 70 (read my article) and I’ve been back to the slopes after recovering. At a time when silver travellers are staying healthy longer, seventy is absurdly young. An insurance broker friend will now insure clients to ski in their nineties.
I’d already decided to accept the Staysure quote, so I thought I’d just get single trip cover if I wanted to hit the snow again this winter. That led to more musings. If EHIC (the European Health Insurance Card) survives Brexit, will I really need travel insurance in the EU? After all, the card covers most hospital costs and maybe I’ll be able to top up with winter sports specific protection such as the French Carré Neige, which can be bought in resort for a very modest outlay.
Some readers will have met and negotiated these
problems. I hope they may post any tips or observations on this website’s
forum. For those who haven’t encountered them yet, two piece of advice: don’t
assume there’s any medical issue you don’t need to declare. Even if it’s cleared
up and totally unrelated to an illness or injury suffered while travelling, it
could render your entire policy void. And if at first the premiums you’re
offered leave you in a cold sweat, don’t (no pun intended) lose heart. Conduct
a ruthless inventory of the cover you can’t do without and the bills you can
afford to pay if the worst happens. Then shop around, shop around – and shop
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