To think my insurance should cover me nearly dying?!

You totally need to fight this.
totally different situation but one that they said I knew something was wrong before hand. We sent all the proof we could from doctors to bookings. They refused us until we went to the financial ombudsman for help. (You need to have a final response letter from the insurance company)
after 9 months we did get it settled I know you may not have that but if you can keep pushing for it. I knew I was being treated unfairly.

good luck and hope you feel better soon.

Well, I'm so sorry for OP but grateful to this thread, I've just added something I went to the GP about last year, no diagnosis made but when I went online to add it I was asked a few questions about if it related to any specific conditions (answer no) and it's now listed on my policy as having been declared for no extra charge. In future I will mention anything I spoke to the GP about in the previous year, no matter how tiny.

but why do you have to pay? I know someone who nearly died in Australia and all he had to pay for was the ambulance? Everything else was covered including heart surgery?

People are being weird on here. Insurance doesn’t ask you to declare everything you’ve ever been to the doctors for.

It asks you if you have any current health conditions.
and then anything currently being investigated but not diagnosed and lastly and any hospital visits over last 3 years.

I state my high blood pressure. I don’t state that 15 years ago I had a chest infection that I got antibiotics for. Because it’s not a health condition.

The op doesn’t have IBS. I don’t see how the ombudsman wouldn’t rule in her favour.

You don’t need to claim on your insurance as there is a reciprocal agreement between UK and Australia.

This ^

When buying travel insurance you have to answer the questions you are asked.

I always buy via the phone rather than online because I might want clarification of what the questions mean and that's easier with a human being than with some AI bot.

As I've posted earlier my insurer asks if I've ever had any heart problems and if I've sought any medical advice or treatment in the last 12 months. Simple. (That was Saga by the way. Whether they still ask the same questions I don't know, but that was what they asked last year)

If I was looking at buying travel insurance and I was asked about any other medical conditions more than 12 or 24 months ago, I wouldn't touch that insurer with a bargepole. Would I have to declare treatment for adolescent acne from 50 years ago? It's not worth the risk

I suppose it depends on what you consider to be an illness.

Searching online, the consensus seems to be that IBS is a “condition”.

The definition of a condition is given as

“A 'medical condition' refers to a specific health issue or illness that can be diagnosed by healthcare providers based on symptoms, medication use, or diagnostic testing. It includes a wide range of conditions that impact an individual's health and ability to function, such as chronic diseases or acute illnesses”

Based on that would have assumed that it would have to be declared, although never being formally diagnosed with it does muddy the waters somewhat.

There's got to be more to this.

OP simply wouldn't be charged for emergency care if a UK citizen.

There's something going on here with this story.

The hospital care was amazing but obviously, this is Australia, and the bills are absolutely eye-watering.

Are you sure you're in Australia? That sounds like America. None of this makes sense.

She's not been dishonest though.

The OP says she was never formally diagnosed. In any case, IBS is not an illness and is a diagnosis of exclusion.

The insurance companies just like to try to get out of paying.

It doesn’t matter whether the two issues are connected - you’re supposed to declare everything.

So many people get caught out with insurance claims unfortunately - you have to be so honest.

Are you not a British passport holder @octavio1996. If you are, there is a reciprocal agreement (others have already mentioned this).

Unfortunately, it sounds as if the insurance company are trying to find any excuse not to pay. They probably do this routinely. IBS has nothing to do with your appendicitis. It's a diagnosis of exclusion anyway.

On the back of this thread I’ve just rung my insurance company to declare a diagnosis of diverticula disease from years ago. They asked if I’d seen a dr about in the last 12 months, or taken any medication, and when I confirmed I hadn’t, they said it’s irrelevant, I don’t need to declare it and they are only Interested in conditions arising, being investigated or that I’m taking medication for, in the last 12 months. You obviously need to take this further, they are being ridiculous.

Everyone gets digestive issues. Having some bloating and a dicky stomach five years ago that was not diagnosed as anything should have no relevance on her insurance claim, in my opinion.

Insurers are total cunts. They will do anything in their power not to pay out.

@Badbadbunny But her mentioning a possible IBS (because she had some bloating) five years ago, that came to nothing, would surely not be logged on that form as currently under investigation? I recently went to the doctor worried about a mark on my skin. She told me it was nothing, am I supposed to mention that in five year’s time on an insurance form?

You will probably need to discuss this with the ombudsman once you are back home . It’s an awful position to be put in and I’m truly sorry 😔. We had similar ( not as bad as you ) a few years ago when one of the kids had chicken pox . They told me it was my fault a si knew she didn’t have it before . I off course didn’t let them get away with it but took a while for tem to pay back all expenses .
Hope you are feeling better soon

Exactly - why involve travel insurance

When a claim is made the travel insurer asks for a GP report. The IBS stuff was obviously showing on your GP records and any investigations you had or they wouldn't know about it. You didn't declare it. Whether it is relevant to appendicitis or not isn't the issue. EVERYTHING needs to be declared when you take out travel insurance within the time period asked eg 2 years 5 years etc, GP visits, any meds taken, any investigations etc.

Get a copy of your application form, see what the time period was. then get a copy of your GP report and see when IBS was last mentioned. You need specific details of dates etc to ahve a successful appeal.

Or if it is showing on your med records withing the last x years which the proposal form asked for then they are right to reject.

Ask for it to be reviewed by the insurance's firm's Chief Medical Officer / complaint adjudicator team as a matter of urgency due to your situation and state that you will be referring to the Financial Ombudsman Service. Ask them to also raise a complaint with their CEO. This normally brings more attention to your case.

Unless there is some Government help or the above process progresses at a very speedy rate, I think the likely scenario is that you will be asked to pay your medical bills before leaving Australia and you will have to fight the Insurance Company when back home to reclaim the cost (if successful on appeal).

I would also put in a Subject Access Request (SAR) to the Insurance Firm to see what exactly they are holding on file regarding your medical conditions, etc - this will help with your appeal to the Financial Ombudsman Service if needed.

How long is 'years ago' OP and in what context do the IBS symptoms appear in your medical notes?

A potent vindaloo can cause 'IBS symptoms', but if you've had multiple investigations/referrals over it, they may consider this 'ongoing' if it's fairly recent.

Exactly, 30 years in Australian health care and administration and I can’t understand how you are expected to pay (unless you went to a private hospital).

if you look at the policy, it should say somewhere that you need to declare all medical conditions, doctor visits etc. I did this the first time I used the travel insurance with my bank (Barclays) and I update it every time I book a holiday, or annually, whichever comes first. They then send me a copy of everything I’ve disclosed.

Id hand it over to the hospital & let them charge it through insurance

As for what to do next I don't know how you'd go about escalating it. Unfortunately

Reciprocal Health Care Agreement (RHCA):
Eligibility:
UK citizens visiting Australia are eligible for medically necessary treatment under Medicare.

What's Covered:
The RHCA covers essential and urgent medical care, including:
Medically necessary treatment outside of a hospital.

Medically necessary treatment as a public patient in a public hospital.

Certain prescription medicines under the Pharmaceutical Benefits Scheme (PBS).

What's Not Covered:
Pharmaceuticals (unless you're in hospital).

Ambulance services.

Medical evacuations.

Dental treatment.

Pre-existing medical conditions.

People who are not registered as visitors (e.g., those studying in Australia).

Routine medical treatment

1. Medicare Enrolment:

What to Bring: Bring your passport and a valid visa.