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5 Common Reasons a Travel Insurance Claim May Be Denied

Common Reasons a Travel Insurance Claim May Be Denied

Purchasing travel insurance is key to financially protecting yourself against unforeseen accidents and illness while travelling outside your province or territory of residence. Understanding how your policy responds in the event of an unexpected accident or illness, along with the terms and conditions of your policy, may be even more important.

Below we will discuss some of the common reasons a claim may be limited or not payable.

Not a Sudden and Unforeseen Event
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.

A medical condition is not considered ‘sudden and unforeseen’ if there is medical evidence that shows the symptoms existed prior to the effective date of coverage and within the stability period as outlined in the insurance policy.

Stability periods vary from provider to provider.

Pre-Existing Medical Conditions
Pre-existing medical conditions are one of the most common reasons for a claim denial.

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.

Generally, for policies to consider coverage for a pre-existing condition, the medical condition must be stable and controlled for a specified period of time.

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.

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.

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.

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.

Remember that in the event of a claim your previous medical history will be confirmed.

When purchasing travel insurance be sure to provide an accurate and complete medical history to your licensed insurance broker.

Knowing and understanding your policy benefits will help you travel with better peace of mind. If you have any questions related to the policy you’ve purchased, be sure to ask your broker questions.

For questions about Travelance policies, speak with your Travelance licensed broker or call 1-855-566-8555.

*Note: Coverages, benefits, exclusions, limitations, and terms and conditions vary from provider to provider. Be sure to speak with your licensed insurance broker for clarification.

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