Why Travel Insurance Claims Are Denied

How denied travel insurance happens.

Most insurance policies end up being paid out to beneficiaries, largely because higher-risk applicants are either rejected up front, or at least assessed at a correspondingly higher rate. But for policies with a more limited shelf life, like travel insurance, there’s generally no investigation until a claim is submitted – and that’s where things can get complicated.

The problem is that applications that would have been declined in the first place aren’t discovered until it’s too late and the claim is denied – very bad news for those relying on their insurance coverage.

Also Read: How Much Travel Insurance Is Enough?>

Even Honest Mistakes Can Hurt

That’s what happened to North Bay senior Joanne Parr after she made what she maintains was ‘an honest mistake’ when answering a question on her application form about past treatments for other ailments.

Her insurance company found the discrepancy later, by combing through her medical records after the bills were submitted. She’s still trying to collect.

Generally speaking, where claims are denied it’s because travellers weren’t eligible for the coverage due to inaccurate or incomplete information on their medical questionnaire – even if the non-disclosed conditions had little to do with the ailment prompting the claim.

Full Disclosure Really Is Required

And the urge to fudge things a bit can be huge, since people occasionally do have something they’d prefer to hide, whether it’s potentially hazardous travel, existing health problems or problematic lifestyle choices like smoking or drug use.

According to a recent Travel Health Insurance Association of Canada survey, 14 per cent of respondents admitted to deliberately providing inaccurate health information when applying for travel insurance – and a further 18 per cent said they done so inadvertently.

Of course, someone can have a pre-existing medical condition and not know about it, or may not have had it properly diagnosed. But insurers don’t care and have a variety of tools to identify such omissions.

Answer Every Question Accurately

To ensure you’re protected, take the time to accurately answer every question on your application, noting any pre-existing issues or new medications you’ve been prescribed recently. One common omission is failing to recall whether you’ve been to the doctor in the last six months – even for a routine check up.

In Parr’s case, she was asked if she’d been treated for heart problems in the 12 months prior to applying for insurance. She answered no, forgetting that she’d been to hospital with chest pains several months earlier.

Be Sure To Check Medical Records

Don’t simply check all those boxes. If you can’t remember certain details, take the necessary steps to find out the correct answer, including checking your medical records – the first thing insurers look at.

Since it’s not possible for underwriters to review such records in advance, they have no qualms about combing through several years worth of documents once a significant claim is made.

One additional caution: If you’re organized and tend to make travel insurance arrangements well in advance, make sure your information is up to date.

If your health has changed in any way since you purchased the policy, you’re expected to inform your insurer or there could be coverage problems. In some cases, even unfilled or unused prescriptions can work against you.

 

Related Topics

Insurance / Travel Insurance 101

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