In December 2008, a law was passed in the UK to protect women from being treated less favourably based on their pregnancy or maternity status in terms of goods and services provision. For insurance, this means that it is illegal for women to be treated differently due to costs incurred from pregnancy or maternity.

However, the law includes an exemption whereby service providers are allowed to withhold an individual’s ability to obtain said goods, facilities or services if they reasonably think that it could create a risk to the woman’s health or safety. An equivalent policy is in place for people with other physical conditions.

Policymaking for pregnant travellers can raise complex questions for insurers. We ask experts for their take on combatting discrimination towards pregnant women, considering how insurers can provide adequate and comprehensive cover during this time.

The gap between insurers and airlines 

The American Association of Obstetricians and Gynecologists advises that “occasional air travel during pregnancy is generally safe”, with most US airlines willing to accept pregnant passengers at up to 36 weeks’ gestation. 

However, Dr Lee Collier, Neonatologist at the Specialist  Transport Organisation for Research, Knowledge and Support (STORKS), pointed out that “most insurance products do not provide cover after 32 weeks’ gestation, leaving a four-week gap in cover”. 

During this gap in cover, pregnant women are forced to make difficult decisions. We asked insurers whether airlines and insurers have a responsibility to work to the same timeframe as each other.

According to Dr Collier, insurance products should be readily available that cover up to 36 weeks in line with medical advice and airline policies.

Adele Saunders, Head of Travel Product, Europe for Allianz Partners, noted: “While airlines focus primarily on the health risks associated with the duration of the flight, travel insurers are responsible for assessing and covering the entire duration of a trip.

“Insurers must consider additional factors such as the overall length of a trip and the medical facilities available at the destination, in case of unexpected medical emergencies, including potential pregnancy complications,” she explained.

While pregnancy is not a medical condition, there is a fundamentally higher risk of a medical issue while travelling

Vered Lobel, CEO of OneBefore, said that her company holds the perspective that the choice to travel should lie with the pregnant customer and/or their doctor. She pointed out that while pregnancy is not a medical condition, there is a fundamentally higher risk of a medical issue while travelling.
 

“It is still important to note that there will always be a cut-off point, which for us falls at 32 weeks. There is a consensus that the risk of going into labour is much higher after this point. For that reason, [in Europe] airlines will not accept pregnant travellers after that point, and customers would be hard pressed to find an insurer that would cover that.”

As part of its 32-week pregnancy cover, OneBefore offers a cancellation benefit for more flexibility – allowing a pregnant woman the opportunity to cancel their trip for the following reasons:

• Their midwife or doctor does not think it is safe for them to travel
• The airline will not transport them
• They will be more than 28 weeks pregnant during their trip (roughly the end of the second trimester, which is 27 weeks).

Should cover offer more flexibility?

In UK law, pregnancy is categorised as a protected characteristic, meaning you can’t be discriminated against by an insurer for being pregnant (as, technically, it’s not a medical condition). However, for insurers, this means they can’t risk-assess a pregnant person, or change their premium based on increased risk. 

How does the industry ensure that there isn’t a one-size-fits-all approach to pregnancy travel cover?

Saunders pointed out that coverage policies can vary greatly between insurers, countries, insurance products, modes of transport and other variables. 

“Different countries and regions have different industry standards and legal requirements that all insurers need to factor into their cover when designing products for a specific market,” she explained.

Travel insurance typically does not cover trip cancellations or other travel losses resulting from normal pregnancy. Therefore: “Customers are still required to comply with their doctor’s advice regarding travel to their destination and need to adhere to their travel provider’s conditions of carriage.”

Saunders said that through carefully reviewing their policy terms and conditions to ensure they have the necessary coverage, regardless of their location or travel destination, the customer can ensure that they are adequately protected throughout their travels. 

Lobel noted: “Most insurers need to limit the point at which they will offer medical expenses cover while abroad. This is because of the significantly higher chance of going into labour after 32 weeks of pregnancy, and to exclude cover for people actively pursuing a birth outside of the UK. Travel insurance policies – like all insurance – is there to cover losses from unexpected events.”

Dr Collier pointed out that the wording of policies available in the UK is frequently vague about what would be covered in the event of premature labour, and it is usually unclear whether repatriation of the newborn baby is included. 

Upon reflection, he said: “I think most pregnant travellers would expect full cover including repatriation in the event of preterm labour, but my experience over many years helping families in this situation is that they’re often left for many days or even weeks with a baby in hospital but no clear indication of what their policy will cover, and face the worry that the hospital and repatriation bills may end up being their responsibility.

My experience over many years helping families in this situation is that they’re often left for many days or even weeks with a baby in hospital but no clear indication of what their policy will cover

“Because of this, I think insurance companies already discriminate against pregnant travellers by creating the 32-to-36-week gap and using vague policy wording that leaves the limits of medical care and repatriation for the infant up to the underwriter or assistance provider to decide on a case-by-case basis.”

Underwriting pregnancy as a medical condition

We asked insurers if pregnancy could be underwritten as a medical condition and whether it would still abide by UK gender discrimination laws whereby insurers are not allowed to use gender as a factor in the calculation of premiums and benefits.

Lobel said: “There is very little exact science behind when a woman goes into labour – we therefore do not think this is something that can be underwritten. We only know that there is a much higher probability of going into labour after 32 weeks – and that most airlines will not transport a pregnant woman after this point. This is why insurers limit cover. Most pregnancies are straightforward and do not encounter major complications. We understand why cover is restricted at the advanced stages of pregnancy, and do not provide medical expenses cover abroad after 32 weeks,” she added. 

In the UK a web search would suggest that such policies already exist, but a layperson’s reading of the policy wordings suggests little or no additional cover for pregnant travellers

Saunders went on to say that Allianz would not consider pregnancy to be a medical condition in and of itself, only any known complications around it. 

“It is essential that customers are treated fairly and without discrimination, under any gender discrimination laws. As pregnancy is not classified as a medical condition, it cannot be underwritten as one under any circumstances.

“Customers should adhere to travel advice provided by  healthcare professionals. Should a healthcare professional advise a customer against taking a pre-booked trip for medical reasons, Allianz Partners are committed to assisting them in recovering any unused costs.”

On the other hand, Dr Collier perceives there to be a gap in the market for policies that are designed for pregnant travellers. He recommended that such a policy include cover up until 36 weeks’ completed gestation, i.e. 36 weeks and six days.  

“In the case of premature labour, which is defined as delivery before 36 completed weeks’ gestation, this should include all medical care and repatriation for both the birth parent and the infant.”

Dr Collier explained that offering such a policy for purchase avoids asking the discriminatory question and allows the traveller to choose the policy if they wish. 

“The wording should be clear and emphasise that the 36+6 rule includes the flight home, highlighting the potential for flight delays and cancellations. In the UK a web search would suggest that such policies already exist, but a layperson’s reading of the policy wordings suggests little or no additional cover for pregnant travellers.” 

Dr Collier concluded that the industry could do more to tailor its policies to meet the needs of pregnant travellers. “It’s hard to escape the impression that some insurers or brokers are using web search terms such as ‘pregnancy’ and ‘miscarriage’ but directing to a page selling a standard travel product. It’s long overdue to have some true specialist policies available.”

To sum up, while it could be argued that the travel insurance industry does not take a one-size-fits-all approach to travel cover during pregnancy, there could still be scope to improve the accessibility and visibility of more flexible policies tailored for pregnant travellers.