*Title:

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Pre-existing medical conditions

(i) Insurances with a Period of Insurance of 30 days duration or less

If at the time of effecting this Insurance you are receiving regular medical treatment, advice or consultation for one or more of the following conditions, this Insurance will not provide cover for such condition(s) unless medically screened and accepted in writing by Underwriters.

•  A heart or circulatory related condition, including but not limited to hypertension, angina, heart attack and stroke.

•  any condition of the lungs other than mild, well-controlled asthma suffered in isolation

•  any form of cancer

If you would like us to consider providing cover for any of the conditions listed above, you must contact SALT on 01342 843560. Our coordinators will confirm whether the condition can be covered and if so, on what basis and how much it will cost to do so.

If you do not contact SALT, any expenses arising from any of the above medical conditions may not be covered by this Insurance .

(ii) Insurances with a Period of Insurance in excess of 30 days duration

If at the time of effecting this Insurance or at the commencement of a Covered Trip you are receiving regular medical treatment, advice or consultation for an ongoing or recurring medical condition or set of symptoms, this Insurance will not provide cover for such condition(s) or set of symptoms unless medically screened and accepted in writing by Underwriters.

If you would like us to consider providing cover for your pre-existing medical condition, you must contact SALT on 01342 843560. Our coordinators will confirm whether the condition can be covered and if so, on what basis and how much it will cost to do so.

If you do not contact SALT, any expenses arising from your pre-existing medical condition(s) will not be covered by this Insurance.

* Do you have pre-existing medical condition(s) that you would like to declare? Yes    No

If yes please provide details:

Diagnosed Condition:

When Diagnosed:

How many medicines do you take for the condition?

Has your dose been increased or have you been prescribed a new tablet in the last six months?
Yes       No

Are you awaiting further investigation or treatment for this condition?
Yes       No

Have you had any unplanned hospital admissions for this condition?
Yes       No

Do you smoke? If no please answer next question.
Yes       No

Have you ever been a smoker?
Yes       No

If 'yes', when did you give up?

Please provide any other information you feel may be useful to us:

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