Travel Insurance Claim Denials

Travel insurance can offer peace of mind for those on international trips. Many people buy travel insurance with the understanding that it can save them thousands of dollars in the event that an unexpected medical situation arises. But what happens if your travel insurance claim is denied, leaving you on the hook for expensive treatment and other emergency costs?

Working with an experienced lawyer can give you the support you need when faced with this overwhelming situation. The seasoned legal team at Warnett Hallen LLP has years of experience helping travelers appeal their insurance claim denials, and we are ready to fight for the compensation you deserve. Contact us today for a free consultation to learn more about how we can help you.

Travel Insurance: What Does It Cover?

When many Canadians travel, they assume their provincial health care plan will cover any medical costs they incur during their trip. However, the protection your home coverage can offer is typically minimal.

Purchasing travel medical insurance in advance of your journey can cover a broader range of eventualities. In addition, some countries require you to hold travel insurance before they let you go past border control. While policies can vary, typical travel insurance should cover:

• Medical Expenses – Your insurance should cover any medical expenses you incur up to the policy limit. In many cases, you will have to pay for treatment upfront and receive a reimbursement from the insurer later.
• Emergency Medical Care – Your policy should cover treatment for sudden conditions like appendicitis or heart attack.
• Medical Evacuation – Travel insurance should cover the costs if you require a medical evacuation back to Canada (or the nearest country that can offer you the care you need).
• Pre-Existing Conditions – While your policy should cover any pre-existing conditions, ensure you understand whether any pre-travel stability periods might apply.
• Repatriation – If you die during the course of your trip, your travel insurance will cover the cost of returning your body home.

For peace of mind, be sure to read your policy closely to determine what is covered and what is excluded.

Common Reasons for Travel Insurance Denials

Travel insurance claims can be denied for several reasons. Being aware of these common causes of denial can help you take steps to prevent issues proactively.

• Pre-Existing Medical Conditions That Were Not Declared or Were Not Covered Under the Policy – The insurer will investigate your medical history when you file a claim. If you failed to disclose health conditions you already had prior to the trip, especially serious ones like heart disease or cancer, they may deny coverage. They may even argue that some minor conditions that later caused medical issues abroad should have been declared.
• Injuries from High-Risk Activities That Took Place During the Trip – Adventurous pursuits like skydiving, bungee jumping, scuba diving, mountain climbing, or automobile racing often invalidate travel medical insurance. Review policy documents to understand which activities might be excluded before you travel.
• Medical Problems Caused by Drug or Alcohol Use – Excessive alcohol consumption leading to injury or illness abroad will likely void your medical coverage. The same often applies to recreational drug use. Insurers can require toxicology reports to confirm if substance use caused or contributed to medical issues.
• Missing Paperwork – Insurers require significant documentation like original receipts, medical reports, proof of payment, and claim forms to process a claim. Errors or omissions can give the insurer a reason for denial and delays. Keep immaculate records throughout your trip, and be sure to file your claim on time.
• Travel Outside Your Policy Dates – When you purchase travel insurance, you must list your travel dates. Your policy will not be valid beyond those pre-agreed dates. If you suffer an injury after you decide to extend your trip (and fail to extend your coverage), your insurer will not cover your medical expenses.
• Travel to Dangerous Locations Expressly Excluded in the Policy – Travel advisories clearly highlight global hotspots that carry heightened risk. Medical coverage may be void or limited if your destination is deemed high risk or in civil unrest. Browse travel advisories before you buy insurance.

To avoid denials, carefully review insurance policy documents before your trip. Make sure pre-existing conditions and planned activities will not present problems. Also, keep thorough medical records during your journey. File your claim promptly and work cooperatively with your insurer. 

What to Do If Your Travel Insurance Claim is Denied

Receiving notice that your travel insurance claim is denied can be incredibly stressful. But taking quick action improves your chances of successfully appealing the decision. We recommend following these key steps:

• Carefully review the denial letter to understand the insurer’s exact reasons for rejecting your claim.
• Gather documentation and evidence to challenge the denial, like medical records, doctor statements, and receipts.
• Consult with a personal injury lawyer to have an experienced professional review your case and advocate on your behalf.
• Be prepared to take legal action and build a strong case if the insurer will not overturn its decision without litigation.

Having skilled legal representation makes it easier to navigate the appeals process successfully and secure the compensation you’re entitled to. A knowledgeable lawyer can help you by crafting persuasive arguments and taking appropriate legal action if needed.

Getting Legal Help from Warnett Hallen LLP

A travel insurance claim denial can cause you immense anxiety and confusion. If you have had a claim denied, you might be fearful about what this sudden financial loss means for your future. But this does not have to be the end of the road. A knowledgeable personal injury lawyer can help you understand your options for appealing the decision and receiving the compensation you deserve.

The experienced legal team at Warnett Hallen LLP understands the challenges you are facing, and we want to help put things right. Our lawyers are committed to developing effective strategies to handle travel insurance claim denials, and we are ready to fight for you. Contact us today for a free consultation to learn more about how we can help you.