Rejection of a travel insurance claim can burn the savings of an individual on account of burgeoning medical costs in most foreign countries. Hassles in the claim settlement can lead to a panic situation when you are travelling to an unknown country thousands of miles away from your home. Most of us rightly opt for a travel insurance policy for our peace of mind while travelling abroad. It is highly advised to glance through the travel insurance policy documents coverage and exclusions and in case of any doubt contact your insurers to avoid the unwanted surprises while you are on a trip or while filing a claim after returning back. Keeping the contact numbers of assistance service provider handy should be very useful in case of a medical emergency or other travel related claim.
We discuss below a few important points you should note to avoid a travel insurance claim rejection.
- Any misrepresentation or concealment of facts while taking the policy online or filling up the proposal form physically can be the most prominent reason due to which your insurance claim can be rejected later. For example, most travel insurance policies exclude the coverage for any preexisting diseases which you had symptoms or was taking treatment at the time of travel. If you fail to properly declare any chronic condition or preexisting ailment your claim can be rejected later.
- Adherence to all the policy conditions is very important for a valid claim under the policy. To give an example many travel insurance policies excludes coverage for injury arising from an adventure sports activities while on a trip. Similarly, if travelling against the advice of a medical practitioner the travel insurance policy will not pay. Any incident or accident giving rise to a claim under the influence of alcohol is also not covered under the policy.
- Claim notification to the TPA of the insurer should be as soon as possible and within the timelines prescribed on your insurance policy documents. This is a condition which is to be strictly followed first by the claimant to insurer honor its liability under the insurance contract. Unnecessary delay and procrastination in intimation of claim should be avoided to avoid its rejection. Any delay in intimation and claim filing can be considered by the insured on the merits of the case.
- Any fraudulent activity on the part of insured to mint out money from the insurance company in the form of claim payment will lead to definite rejection of travel insurance claim. Incident for which the claim is filed with insurer must be properly proved by the insured to the satisfaction of the insurer with all valid supporting documents. The incident must be properly explained without any exaggeration for smooth claim processing.
- Claim form can be downloaded from the website of the insurance company. It should be completely filled and signed by the claimant and without any ambiguity for the reference of the insurer.
- There are specific set of documents listed in the travel insurance policy wording for filing a claim under different sections of travel insurance. Although most of the documents should be common for every section, some of them can be specific. For instance, Police report is mandatory for filing a loss of passport claim and property irregularity report issued by airline is mandatory for filing a loss of checked in baggage claim.
- Many times the claimant misplaces some necessary documents like airline tickets, boarding pass, medical reports etc. and thus becomes unable to produce the same in front of the insurer on demand while claiming. If you are planning to file a claim against your policy, it is advised not to prejudice the importance of any document and keep all the medical bills, reports and other travel related documents safely until claim settlement. Missing bills or important documents can lead to rejection of your travel insurance claim.
- It is essential to go through the exclusions mentioned in the policy, so that we do not get any surprises later. Exemplifying this, an insured should know that any medical treatment while you are abroad on a trip which is not absolutely necessary and can be deferred till you return back will not be covered under your travel insurance policy. Similarly maternity claims are excluded except medical treatment following a life threatening condition is not covered.
- It is important to keep in mind the deductibles under the policy which should be paid first by the insured from his pocket before the insurer pays any claim amount. For a majority of section this is a monetary amount but for sections like trip delay the deductible can be in form of time. In these the claim is paid if the flight is delayed more than the hours specified as deductible in your policy document.
- It is also important to know the policy limits called as sum insured as in case of a claim this will be maximum amount to be paid by the insurer beyond the applicable deductible. It is to be noted that there will be different sum insured applicable for different sections under the policy. For example, a loss of passport claim can be paid up to a few hundreds of dollars while medical claim policy limit can be up to millions of dollars.