7 Ways to Avoid a Denied Travel Insurance Claim

TuGo’s goal is to ensure that our customers, like you, make informed decisions when it comes to buying travel insurance; you need to know what product(s) you’re buying, understand your policy before travelling, and what happens if you have to file a claim. That’s why this blog post will address 7 of the most common reasons for denied travel insurance claims, so you can avoid any surprises, come claim time. 

The difference between partially and fully denied claims 

It’s important you know what the difference is between a partially or fully denied claim, so you can avoid possible disappointment. A partially denied claim is when the cause of the claim is covered, but some of the expenses you submitted aren’t covered by the policy (i.e., it’s not in your policy “benefits”). A fully denied claim is when the policy doesn’t cover the cause of the claim at all. If the cause of the claim isn’t covered, or falls under one of the policy exclusions, your claim won’t be paid. 

3 reasons for partially denied travel insurance claims

1. Ensure you’re providing itemized medical receipts 

For any claim expenses, you’ll have to submit itemized receipts; a credit card statement or till receipt won’t work. This might be the reason a claim isn’t reimbursed in full, but an easy one to fix; keep all bills and receipts you receive and ensure they’re all itemized Read more about “How to make your travel insurance claim go smoother”. 

2. Avoid mistakes on the Medical Questionnaire

If you’re a senior traveller, aged 60+, you’ll be required to fill out a Medical Questionnaire (MQ) to determine your rate, not your eligibility at time of purchase. Ask your doctor for help if you’re unsure how to answer the MQ, because if any information is incorrect or missing from it, your insurer can fully deny your claim; but Claims at TuGo isn’t like every other provider. We recognize that as humans, we sometimes make mistakes. That’s why, depending on the policy you’ve purchased, if you made an honest mistake or omission on your MQ, TuGo will apply a $15,000 USD deductible instead of denying the full claim. That could save you quite a bit of money, especially if you’re seeking medical treatment in the US! 

3. Remember that your policy is meant for medical emergencies

Emergency Medical Insurance isn’t a health plan—it’s a medical emergency policy. Knowing what is or isn’t a travel medical emergency is the first step. Next, know when the ‘emergency phase’ of your emergency is over, as defined in your policy terms. 

For instance, TuGo’s Traveller policy defines “Emergency” as:  

“An unforeseen medical condition, which requires immediate treatment to alleviate existing danger to life or health. An emergency no longer exists, when the medical evidence indicates that you are able to continue the trip or return to your province/territory of residence. Once such emergency ends, no further benefits are payable in respect of the medical condition which caused the emergency, unless otherwise specified in a benefit.” 

Travel medical coverage applies for acute medical care only, and limited follow-up. Tests have to be done at the initial emergency stage. Sometimes it’s best to go home for more tests (if more tests are needed). Call your insurance provider before proceeding with any more tests, procedures or continuing treatment. If you can travel home or wait to have the tests done, and you don’t need additional acute medical attention, the additional expenses won’t be covered.  

4 reasons travel insurance claims are fully denied

1. Take the time to understand the travel insurance you bought 

Over the years, we’ve experienced some travellers who don’t understand what they’ve purchased, assuming that insurance covers the travel gambit, when they’ve only purchased one type of coverage. There are different types of travel insurance plans and policy benefits; not all policies are alike. For example, if you bought emergency medical insurance coverage, it doesn’t offer trip cancellation or trip interruption benefits.  

While it’s necessary to read your policy, we know that there may be questions that just need a human touch. If you’re unsure about the coverage you’re looking into, or have already purchased, your local insurance professional, as well as TuGo’s Customer Service team, are there to help. 

Want all the “bells and whistles”? Consider an All Inclusive Holiday Package, which bundles a number of insurance plans into one affordable option. 

2. Ensure coverage is available, if you have a pre-existing medical condition 

If you have a pre-existing medical condition, it doesn’t mean that you can’t get coverage; but it does mean you’ll need to talk to your insurance professional about stability for pre-existing conditions, and how to get the right coverage for your needs. Read more on how unstable pre-existing conditions impact claims. 

3. Avoid accidents caused by intoxication

Simply put: travel insurance and alcohol don’t mix. If you’ve submitted a claim related to alcohol-related illness or injury, your travel insurance claim will be denied. Claims also won’t be covered if they result from a history of alcoholism or withdrawal, or even a past alcohol-related illness before your trip (like cirrhosis). 

Not a drinker but a cannabis user? Read “What you need to know about cannabis and travel insurance” to find out how travel insurance coverage responds. 

4. Make sure to consult a doctor before cancelling due to a medical issue 

There are many valid reasons to cancel or interrupt a trip, but don’t do it without consultation. Say you need to cancel a trip due to a medical reason before you leave, or interrupt your trip while you’re away. And let’s say you have Trip Cancellation & Trip Interruption or Trip Interruption Only Insurance. To make a travel insurance claim on a Trip Cancellation & Trip Interruption Insurance policy, you must have seen a doctor before you cancel or interrupt your trip, and the doctor has to have advised you to cancel/interrupt the trip, before you do so. Plus, you’ll need that proof in writing from the doctor. 

Remember, reading and understanding your travel insurance policy is essential. If there’s anything you don’t understand, don’t be afraid to reach out to your trusted insurance professional with your questions. Know what you’re buying and what you’re covered for! 

Have any other travel insurance claim-related questions? Leave a comment below!  

Editor’s Note: This post was originally published in September 2015 and has been updated for freshness and/or accuracy.