Common Reasons Insurance Claims are Denied

Unfortunately, many travelers find themselves in financial difficulties because they did not purchase travel insurance. There is great wisdom in purchasing travel insurance, but sometimes, even though they did buy insurance, travelers unwittingly negate their insurance benefits or misunderstand what is covered. Below are some common reasons travel insurance claims are denied.

Be aware that it typically takes 30 days from reporting a claim for a final decision to be rendered by the claims adjuster.

Are you sure your policy covered you for this kind of claim?

We’re all aware of the importance of reading the fine print of contracts. But, too often, travelers don’t read their insurance plan completely. Only after a claim is denied or delayed do they realize they haven’t followed the agreement they purchased.

Travel insurance can certainly be confusing. And every policy is worded differently. Travel Insurance Claims 101 says, “check your terms and conditions.” There’s a reason behind the insurance rules, and you have to follow them.

For example, too many policyholders believe even the slightest flight delay qualifies them for a claim, when typically, a delay needs to be for three hours or more.

Another common misconception is trip cancellation due to a storm. During last year’s terrible hurricane season, insurance companies saw a large spike in claims for canceled or delayed vacations. What many vacationers found out was they weren’t covered because they waited too long to purchase their policy, or the storm’s impact wasn’t sufficient enough for a trip to be canceled.

Additionally, a cruise company or airline has to cease service due to weather for most basic coverage to be activated. The flight has to have been grounded, or your resort badly damaged. Simply being afraid to visit a destination hit by a storm, when your travel suppliers haven’t been damaged, could delay or deny your claim.

If you are really worried about hurricanes, ask for the most hurricane related coverage your provider offers, which might be ‘cancel for any reason’ coverage.

Travelers should review their policy with a licensed travel insurance expert prior to purchase and make certain they know everything about their covered perils and exclusions.

What was diagnosed by a professional, and when did you report that to the insurance company?

You may feel sick, and know you have to fly, but you don’t go to the doctor. So now you don’t have proof of your physical condition, but you’re asking an insurance company to believe you. Insurance companies need proof. Without notes from your doctor, you’re probably going to have a problem getting your claim approved.

If you are feeling sick, feeling concerned not to go on trip, call in advance to get some guidance before making a decision and starting a claim process.

Do you have all of your paperwork, and did you file the right claim form?

It’s easy to lose receipts and printouts from doctors, hospitals and others that might have been involved in an event. But the more you follow your travel insurance company’s process, the less likely you will experience a delay, or be denied.

It’s also critical that you follow your insurer’s documentation requirements for things like lost and delayed luggage.

When did you seek medical treatment?

Just because you got sick while traveling, doesn’t mean you have documentation to prove it. Seeking treatment prior to returning home and saving all medical documentation is critical to proving both your expense, and the fact that an event occurred.

Definitely get documentation during the trip, and if you forget, seek additional treatment upon return. Anything you do to get an independent, qualified party to document your case will be of assistance to you during your claim.

Was your condition pre-existing?

Pre-existing conditions are a common tripwire for claim delays and denials. Travelers should request a plan that includes a pre-existing medical conditions waiver if this could be an issue. Often purchasing a policy within a certain amount of time (usually 14-21 days) after the first payment of the trip provides coverage for pre-existing conditions. (NOTE: the traveler should verify the accuracy of this information as it relates to the specific policy they are considering.)

Important steps to take:

*Gather all paperwork and documentation in advance and obtain any claims-related medical documents and/or police reports prior to returning home.

*Understand your travel insurance policy language prior to departure.

*Buy travel insurance as early as possible to increase your eligibility for time-sensitive benefits and to ensure your trip cost is accurate.

*Expect claim processing delays following major travel events, like hurricanes.

If you need insurance for your next trip, click here for a variety of coverage options.

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