DAN insurance and pre-existing medical conditions

[OctopusLover]

I have asthma. DAN (in europe, not sure elsewhere) says pre-existing conditions aren't covered even when declared. Does anyone know how this relates to accidents where a pre-existing condition is a known predisposing factor but the causal chain cannot be proved?

A PFO increases your risk of DCI. If you known you have a PFO, how likely is it that DAN would deny any claims related to DCI? Similarly, asthma increases your risk of pulmonary barotrauma. Should I assume no matter how well controlled my asthma or whether I have medical clearance, DAN insurance won't cover me if I suffer a pulmonary barotrauma?

Any information on the matter would be greatly appreciated

 

[undefined]

I would recommend that you check with DAN, but a quick search on their site brought up this coverage guide:

https://world.dan.org/wp-content/uploads/2022/05/aig_pds_2021.pdf

Under the section "Exclusions applying to all Benefits No coverage is provided under these Terms and Group Policy"

2. for treatment of known Chronic, Pre-Existing or Predisposing Medical Conditions, unless such condition was previously disclosed to DAN and the Insured Person received a written waiver for coverage of that condition;
17. for care, treatment, services or supplies:
c. resulting from a known Predisposing Medical Condition that was not declared in writing to DAN at the time of application for cover or communicated to DAN in writing if the condition arose during the period of cover;

I would take that to mean that they will not cover treatment of your asthma, and would not cover treatment of other ailments that could be caused by your asthma unless your asthma was declared to them in writing at the time you got your policy.

Once again, you should check with DAN and ask them your questions (preferably via email so you have a written response). This post is neither legal advice nor medical advice.

 

[OctopusLover]

I have contacted them with a similar email to this post but the response is still vague. "Accidents related to" could be taken to mean anything, My partner suffered from anxiety and got prescribed some really "light" pills due to work stress last year which she no longer takes as she changed jobs. Is this a pre-existing medical condition? What if she runs out of air, panics, makes an emergency ascent and gets bent? You could argue her pre-existing anxiety made it more likely that she would panic and not remember to look for her buddy's air. You can take this to extreme and argue that anything is related to anything right?

For the sake of clarity and good order, please note that any accidents/injuries related to a preexisting medical condition are not covered under the insurance policies, not even after disclosure. So, should one require medical care because of a preexisting problem, it would still remain not coverable under the policy.

For specific medical questions, I kindly ask you to contact our medical division at the following email address: medical@daneurope.org

Kind Regards,
On behalf of

​ Medicalreferrals medicalreferrals@daneurope.org

 

[undefined]

I have contacted them with a similar email to this post but the response is still vague. "Accidents related to" could be taken to mean anything, My partner suffered from anxiety and got prescribed some really "light" pills due to work stress last year which she no longer takes as she changed jobs. Is this a pre-existing medical condition? What if she runs out of air, panics, makes an emergency ascent and gets bent? You could argue her pre-existing anxiety made it more likely that she would panic and not remember to look for her buddy's air. You can take this to extreme and argue that anything is related to anything right?

From what I have heard about DAN over the years, I think that they are very likely to solve the problem first and then sort out the legal details. I highly doubt that if you called up DAN from a dive shop at the edge of nowhere and said you thought you got a DCS hit that they would pull up your file and say "Sorry, mate, but we won't help you because it says here you have asthma."

Now, when the dust settles and the bean counters and lawyers start looking at the claim, who knows how that shakes out.

 

[OctopusLover]

That doesn't solve anything for me then. I can pull out the credit card and put whatever money is required on the table on the spot myself too, hell DAN would probably even advise me on the free line on what's required for free, so what's the point of the insurance?

 

[undefined]

That doesn't solve anything for me then. I can pull out the credit card and put whatever money is required on the table on the spot myself too, hell DAN would probably even advise me on the free line on what's required for free, so what's the point of the insurance?

If I'm bent, I'd prefer to have experts on my side arranging for medical care and transport. Whether they pay for it or I pay for it is pretty much a secondary concern. I may be able to pull out the credit card, but coordinating care may be challenging depending on my condition.

 

[scubaozy]

Question is whether a doc specialized in dive medicine is clearing you for diving with your condition. If yes, I doubt dan will make trouble. If you dive without doc clearance, this is imho gross negligence, so expect problems.

 

[OctopusLover]

Question is whether a doc specialized in dive medicine is clearing you for diving with your condition. If yes, I doubt dan will make trouble. If you dive without doc clearance, this is imho gross negligence, so expect problems.

I've had a dive doctor (UKDMC referee) examine me and clear me after a full pulmonary function test. The DAN insurance terms don't care whether I'm cleared or not. The email I sent them mentioned I had medical clearance and you can see their response above

 

[scubaozy]

I've had a dive doctor (UKDMC referee) examine me and clear me after a full pulmonary function test. The DAN insurance terms don't care whether I'm cleared or not. The email I sent them mentioned I had medical clearance and you can see their response above

It is a bit contradictory to (their) video, I shared. In that case I recommend you take a look at AquaMed -> Medical questions.
In your shoes, I would repeat health check every year and document that the doc also evaluated you for your asthma condition as well.