Common reasons travel insurance claims are denied

Common reasons travel insurance claims are denied

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Purchasing travel insurance is key to financially protecting yourself against unforeseen accidents and illness while traveling outside your province or territory of residence. The situation we all dread is when your insurance claims are rejected by your insurance provider. When it comes to travel insurance, not only is it stressful but also a huge obstacle for your holiday. Fortunately, you can avoid this situation by preparing in advance for scenarios in which your claim for medical insurance for travel will likely get rejected.

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Common reasons for Claim Rejection

1.  Claim Exclusions:

Travel insurance provides coverage for sudden and unforeseen events. This means that at the time of purchase there was no known reason for cancellation/interruption; or there was no medical evidence to indicate that the insured would have a medical emergency on the covered trip.

Among the most common reasons for claims getting rejected is that your claim is not included in your policy document as a valid reason. Be sure to check the exclusions and inclusions in your travel insurance policy before buying it so that you are equipped to know when to file a claim.

2.  Missing Bills:

Any claim you choose to register has to be well substantiated with the necessary proof. Your evidence can be in the form of the associated paperwork, bills, tickets, and more. Ensure you keep medical bills for any international treatment you receive so that you can file a claim accordingly.

3. Undeclared Medical Conditions:

A pre-existing condition is a medical condition which existed prior to the effective date of coverage and includes medically recognized complications and recurrences of a medical condition.

It’s important to understand how pre-existing conditions and stability periods relate to your medical history and how they may affect your policy coverage.

If you file a claim for a medical condition that was not disclosed prior to buying your travel insurance policy, your claim is likely to be rejected by your insurer. Be careful while filling your application form to prevent this outcome from occurring.

4.  Engaging in Adventurous Activities:

Any claims for  medical insurance for travel when the policyholder was engaged in adventure-related activities are usually rejected by insurers. In cases where you have fallen sick as a result of partaking in an adventurous activity, your claim is still likely to be rejected.

5.  New Rules:

Any changes in policy rules that have come into effect can result in your claims being rejected if they violate those rules. These outcomes are quite rare but you should be up-to-date with your policy’s structure and updates.

6.  Incorrect form details:

Filling out form details that do not match your application form is likely to be another reason for claim rejection. This is why consistency across your paperwork is vital. Be sure to fill out your details as filled in your original documents to avoid claim rejection.

7.  Pre-approval by the insurer:

Pre-approval doesn’t guarantee that your insurer will cover that medical service. You still have to file a claim once the service is provided. There is an approval time period after which your insurer will let you know whether or not they can cover your medical service.

8. Policy Limitations

While travel insurance policies offer a variety of benefits and an overall limit of coverage, it is also important to know that many of the benefits may carry a sublimit which may be applied to the policy period, per occurrence, or the specific benefit. These policy limitations may limit the amount of coverage which may be paid for certain coverages.

9. Policy Exclusions

Policy exclusions are terms within the policy contract which may restrict or exclude coverage in certain and specific circumstances. Exclusions may apply to the whole policy or just specific coverages.

10. Not Eligible for Coverage

In many cases, when purchasing a policy, you must qualify for the policy either through the eligibility wording or applicable questionnaires. If the eligibility is not met or the questionnaire is answered untruthfully, the insured may only be entitled to the return of premium.

Conclusion

Travel insurance is a very handy financial tool, to keep your holiday stress-free. There are many circumstances in which this policy is applicable, but also select circumstances in which claims can be rejected. Being aware of these scenarios can prevent you from learning about your policy the hard way. Always be mindful of policy inclusions and exclusions beforehand so you can avoid or be equipped to deal with claim rejection.