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WHEN IS FULLY COMPREHENSIVE SICKNESS INSURANCE FULLY COMPREHENSIVE?

Posted by: Gherson Immigration

WHEN IS FULLY COMPREHENSIVE SICKNESS INSURANCE FULLY COMPREHENSIVE?

A very recent appeal to the First-Tier Tribunal has raised an interesting point on the grey area that is the definition of fully comprehensive sickness insurance.

Under the Immigration (European Economic Area) Regulations 2006, EEA nationals who intend to reside in the UK by way of exercising their treaty rights as a Student or as a Self-Sufficient person, must have fully comprehensive sickness insurance for them and their family members.

The definition "fully comprehensive" however, is not elaborated upon in these Regulations, and one must instead look to the Home Office Guidance on the European Economic Area nationals qualified persons', amended on 7th April 2015 which offers the definition as "any form of insurance that will cover the costs of the majority of medical treatment they may receive in the UK".

In an interesting case that will affect EEA nationals and immigration practitioners advising those EEA nationals and their family members, the First Tier Tribunal has handed down a judgment that means greater care and attention has to be taken when dealing with health insurance policies that exclude pre-existing medical conditions.

In the case of Ms Shira Tzur v The Secretary of State for the Home Department, an Israeli extended family member of a Greek national was refused an EEA residence card on the grounds that the sponsor, the Greek national, and the family member did not have fully comprehensive medical insurance.

The problem with the BUPA insurance policies was that the cover specifically excluded cover for pre-existing medical conditions (diagnosed or undiagnosed) for the first two years of the membership.

The Sponsor, Greek national, had a Systolic heart murmur that was diagnosed as a child and was symptomless and required no treatment or medication. The Israeli family member was an ex-smoker.

The conclusion of the Tribunal, which upheld the refusal, appears to be that if the health insurance policy excludes pre-existing medical conditions, the EEA national and family member must prove that they do not have any pre-existing medical conditions. If they cannot prove this, or choose not to do so, their applications will be refused.

The case will be heard in Upper Tribunal on 1 September 2016.

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