Two cardiology experts are encouraging insurers to assess the risk of rehospitalization in travel insurance based on the applicant's actual health condition rather than relying solely on the stability of their medical status. They are proposing a software solution with algorithms that could enable coverage for individuals who would previously have been declined. 

The risk of a patient being rehospitalized is often poorly assessed by insurers, who base decisions primarily on the stability over time of a pre-existing condition, says Dr. Christian Lamarre, co-founder of Medtech Insurance. 

The idea to innovate came after his father, Dr. Claude Lamarre, was denied travel insurance for a cruise. He had received a pacemaker five and a half months earlier following an episode of bradyarrhythmia within that period. To be eligible for coverage, his condition needed to have been stable for at least six months. 

“Yet he had no other health issues—he was in perfect health,” says Dr. Christian Lamarre, who says this anecdote was the spark for the Medtech project, launched just over two years ago. 

An emergency physician and family doctor, Dr. Lamarre partnered with cardiologist David Ian Paterson—who has authored more than 200 publications on heart attacks—to establish Medtech Insurance. The startup has received financial backing from Amazon Web Services and the NVIDIA Inception Program. 

Age as a discriminatory factor 

Age should not be the only risk factor when insurers decide whether to cover older clients, the doctors contend. “These factors are not necessarily evaluated or made objective when determining a patient's stability,” says Dr. Lamarre. “Some policies require six months of stability instead of three, but there’s nothing magical about the time that has passed. And if age is chosen as a determining factor, it discriminates against older people who are otherwise healthy.” 

Generally, insurers require a stability period of three months prior to departure for travellers aged 0 to 54, and six months for travellers aged 55 and up, regardless of trip length. 

“When you look at cardiac issues, there are short-term risk factors that predict events within three to six months,” adds Dr. Paterson. “But there are other factors, like cholesterol, that predict risks over the long term—over ten years. It’s a completely different picture.” 

Yet such factors are not considered when determining travel insurance coverage, which leads Pierre Saddik, an actuary specializing in travel insurance and president of Saddik International, to believe that the current evaluation method is outdated. He also believes that a patient’s medical history does not necessarily reflect their current state of health. 

“Some insurers have little interest in changing their approach if it doesn’t increase profits,” he says. “But in doing so, they’re ignoring potential clients.” 

Saddik draws an analogy with auto insurance to illustrate his point. “It’s like saying a car isn’t insurable in the first month after its brakes are repaired,” he explains. “A body that has just undergone surgery is considered to be in poor condition during the first few months, even though it has just been treated.” 

Meanwhile, a patient who has taken care of their health—like Dr. Lamarre’s father—is penalized, whereas another individual who never consulted a doctor before buying travel insurance could be far more at risk and not even know it, Saddik adds. 

Tailored premiums 

Based on an in-depth literature review, Medtech’s founders analyzed numerous factors that can predict the risk of rehospitalization following a cardiac event. From this, they created a dynamic risk calculator to determine an individual’s actual insurability. 

After training the tool on major cardiac issues such as angina, arterial blockages, or pulmonary edema, the model was expanded to include other health concerns common among older patients, such as fall or fracture risk, pulmonary issues, and even traveller’s diarrhea. 

The sum of all these combined factors enables near-instant, dynamic calculation of a personalized insurance premium, reflecting the insured’s actual health condition. Clients complete a detailed questionnaire online. 

“We realized that many highly predictive questions are rarely or never asked,” notes Dr. Lamarre. “Even with years of data, without predictive data, our risk analysis cannot be sufficiently accurate.” 

“One reason why these questions aren’t always asked is that insurers fear losing a sale by asking too many,” Saddik explains. 

Adding more questions and allowing artificial intelligence to calculate risk also removes the subjectivity of the attending physician, who may be influenced by the patient’s desire to travel. 

Having clients complete the health declaration themselves also makes them more accountable in the process. 

‘Revolutionary’ 

Stéphan Bernatchez, chair of the board at brokerage Fort Assurances and also a Medtech board member, finds the initiative by Drs. Lamarre and Paterson “revolutionary.” 

“What’s fantastic is that it’s an underwriting tool,” says Bernatchez, a former property and casualty insurance expert. “It’s as if, beyond the age of a building, you also get the engineer’s sprinkler report and a roof condition report. You have all that at underwriting, which lets you see if the risk is better or worse based on the data.” 

“This means that even if a client had a heart attack five months ago, if all other indicators show low risk, they could still be insurable,” Bernatchez adds. 

Bernatchez explains that the result is more travellers will be insured, leading to additional revenue for insurers, and insureds will pay a fair price for their coverage. 

A model yet to be adopted 

Still relatively new, Medtech’s calculator has attracted interest from some insurers, but none have yet adopted it. 

“We have a complete digital solution that can be customized with the branding of any insurer who decides to adopt it. They would have their own portal, and our secure platform would operate in the background via an API [application programming interface],” explains Christian Lamarre. 

However, many insurers lack the technological infrastructure to integrate Medtech’s tool. 

“I’m not convinced that current platforms used by insurers are powerful enough to support additional questions or integrate our advanced calculators. The formulas may be a bit too sophisticated for what’s currently on the market,” says Dr. Lamarre, who, along with his partner, will publish an article on their project in the Travel Insurance Journal in fall 2025.