With the move to Chubb, Amex cover removed the ability to cover pre existing conditions for an extra fee.
I’ve been activating and relying on my CBA cover (has no spend requirement) which still offers cover for an additional premium after answering a few short questions. They even cover over 80 year olds for an extra premium which isn’t available on the Amex cover.
I usually activate my cover as soon as I’ve booked my flights so I have immediate cover should I have a change in circumstances before my trip. This is particularly important If traveling to/through an area that may have volcanic ash activity. If you activate after the event, they’ll likely exclude it.
As with everything insurance, make sure you read the PDS and decide if it’s roght for your situation before proceeding.
Haven’t needed to make a claim yet