Travel insurance claims

  Essentials

• Steps before you leave home — Prepare for the possibility of claims before you leave home, including safe storage of records of your possessions.
• Call your insurer’s 24/7 global contact number — On any major problem, especially medical or medical evacuation, contact your insurer as soon as possible. You may need approvals in order to get paid.
• Consult your policy carefully before you start your claim — You have to comply with all the conditions of the policy.
• Fulfill documentation requirements completely & exactly — If you miss one little thing, your claim may be denied.
• Appeal a rejection or reduction — Do not surrender if your insurer denies or reduces your claim. Engage them firmly and politely. A surprising number of claims are granted after appeal. If they don’t respond fairly, escalate.

the Big Picture

Note: views expressed below are our own opinions and your needs may differ. How to Travel is not responsible for your travel insurance decisions.

So, something bad happened and you have to make a claim. Bureaucracy beckons. Maybe your trip is delayed or even cancelled. It can be a stressful time, but the claims adjusters at your insurance company don’t care about that. Be prepared to jump through the hoops and wait a while to get the results you want.

The key is to think like a lawyer when you’re buying your policy and when you’re preparing your claim.

• What’s covered and what’s not? — You can’t claim for what is not covered, so you must understand exactly what’s covered by the policy and what is not. Examples? Prescription drugs yes, non-prescription drugs no. Treatment for illness yes, check-ups no. Surgery yes, physiotherapy usually no. Hit by a car yes, hit by a car because you were drunk in the street no.
• Complete and honest policy application? — Way back when you bought your policy, your application had to be complete and verifiable. Any omission or inaccuracy — you forgot to mention that little condition you had five years ago — can be grounds for refusing your claim.
• Original documentation for every penny of your claim? — Your claim must include original documentation to support every amount. It might be hard to chase down that doctor for a signature. The clinic might be bad a issuing receipts. But if you can’t back up a claim, your insurer won’t pay.

You may have noticed plenty of rage from insurance company customers. While the company may be inefficient, it’s not necessarily evil. An outraged customer is usually at fault for not getting one of these points right. Don’t be that customer!

Prepare for a travel insurance claim

Do these simple things before you go and both your claim process and chances of success will be much easier:

• Keep your policy confirmation printout accessible — When you buy your policy, your insurer will send you a policy confirmation either as an email or as a letter. Keep the printout in your travel wallet. Scan a copy into your digital device and into your cloud storage.
• Program the 24/7 emergency contact number into your phone — Assuming you have calling on your phone (and enough calling credit), you can make that emergency call immediately from wherever you are.
• Copy your full policy for reference — Keep a digital copy of your policy on your digital device and in cloud storage. You will need to refer to it if you need to make a claim.
• Scan receipts for all your gear — Make copies, either scans or legible photos, of the receipts for anything you’re taking with you, especially the more costly items. It also makes sense to photograph the items themselves to prove you have them. Leave the original receipts at home with a friend, relative or trusted agent who can send them to the insurer upon request. 
• Record serial numbers — Record the serial number of any item that has one. For most independent travelers that’s only your digital device(s). Keep the serial numbers in your digital device and in cloud storage.

Surviving the Big One: emergency claims

To get the claims process rolling for a medical or medical evacuation emergency:

• Get out of trouble — To the extent you are able, get yourself out of trouble. That might be getting immediate medical treatment, escaping a danger zone, going to the police… whatever it takes to reduce or eliminate your personal risk. Don’t lie bleeding trying to call your insurer. Get out of trouble first. Then call.
• Contact your insurer’s 24/7 emergency service — As soon as you can, call the emergency number you have as hard copy in your travel wallet and stored on your digital device and in the cloud. That’s a big ask if you’re flat on your back sick, in pain, sedated or unconscious. Maybe your traveling companion or other person can call on your behalf.
• Get the name of anyone you speak to — When you make emergency contact, it will be a voice communication. Your insurer will record it, but you should know who you are talking to in case there is any confusion later. Don’t rely on memory. Write down the name and the time.
• Ensure that your insurer and the local service provider are linked — Get confirmation that your insurer and the local service provider are in contact. From that point on, you know that any procedures are approved by your insurer. While your insurer won’t begrudge emergency treatment, don’t assume they will cover everything once you’re stabilized or out of harm’s way. If you get a procedure without their approval, they may not pay or may cover only the cost of a less-expensive option.
• Follow their instructions or referrals — The emergency services rep may refer you to a quality medical facility or hand you over to a local representative of the company.

How good is the 24/7 emergency contact?

All companies selling travel insurance have toll-free or collect call telephone numbers. You never know when an emergency will arise, so you must keep those numbers on your phone and in hard copy in your travel wallet at all times. If you have a traveling companion, make sure that he or she knows where to call in the event that you are incapacitated and unable to call yourself. You should be informed about your companion’s insurance contacts, too.

Especially if you’re going to countries or regions off the usual tourist trail, you may wonder whether your insurer can provide services where you are. While you may be able to talk to the emergency contact, actual services are provided by local suppliers: doctors, hospitals, translators, air evacuation services and more. We can’t really know how well our insurer is connected, but big international companies are more likely to have services figured out in Lubumbashi, Shillong or Cochabamba. If you’re traveling well worn routes, especially in rich countries, almost any insurance company will have good support infrastructure.

As with all else in travel insurance, the quality (and cost) of your policy is reflected in what the emergency contact can do for you. While all of them will help with a medical emergency, cheaper policies offer fewer other services.

• Referral to an English-speaking doctor or a good quality hospital.
• Translation services for both medical and other situations.
• Arrange emergency transportation to that facility or medical evacuation.
• Approval of medical procedures.
• Communication with people back home that you have specified as emergency contacts.
• Replace lost prescriptions.
• Arrange return of mortal remains.
• Assistance to replace lost or stolen passports, debit cards and credit cards.
• Cash advances.

Note that these are all emergency services. The insurer is not responsible for your regular travel logistics. There are business and concierge services offered by premium insurance plans, but you’re hardly an independent traveler if you have to rely on them.

Non-emergency travel insurance claims

Except for coverage that your insurer manages directly, such as costly medical or medical evacuation, you will have to gather documents and file a claim yourself. Keep in mind that you have a time limit to submit your claim, commonly 90 days. (Check your policy!)

• Claim requirements for the type of loss — You will have the full policy saved on your digital device and in the cloud. Since requirements vary by type of coverage, consult your policy to find out what you need to do to file a claim for the specific type of loss. 
• Submit online claim form — Most insurance companies now have online claim processing. You can begin the process, but completion usually requires submission of original documents.
• Scan and send documents — The online process may not accept scanned documents as sufficient, but you should try to send them anyway to ask whether the originals (to follow) are complete. That’s much preferred to sending the originals, only to be told weeks or months later that they’re not enough to support your claim. Besides, you need backup copies in case the originals go missing. You may not have access to a scanner, in which case, take the very best photos of documents you can, using your phone or camera.
• Send original documents — Most claims require original documents. Note that some postal systems are slow, unreliable or both. If you have to submit your claim from a country with a doubtful postal system, eat the cost of an international courier. 

Support your claim with complete documents

Pay close attention to the documentation required for your claim. Your insurer will not compensate you for any loss you can’t justify. That means proof of payment, third party support documents, valuation of goods and more. 

The list that follows shows examples only, to illustrate the range of documents you need to gather. Putting your claim together can be quite a task, especially if you’re in physical difficulty, suffering emotional strain or are scheduled to move on with your trip. Take a deep breath and do it. Oh yes, it’s tedious, but it’s really worth getting right.

Your insurer will have a specific list for each type of claim. Do your best to comply with it exactly.

• Insurer’s forms — Your insurer may have forms you can download, especially for medical claims. Go over the form and find out where the doctor or hospital administrator has to sign (and stamp, if possible). Minimize that person’s work, especially if he or she does not understand English.
• Health related claims — For medical, medical evacuation, most trip cancellation or trip interruption claims, you will need a doctor’s letter (sometimes called a “physician’s statement”). For complex treatment or expensive claims, a full diagnosis, with procedures and prescribed drugs is much better than a simple doctor’s letter. If you were hospitalized due to an accident, your insurer will want to see a police report about the accident.
• Drugs — For all drugs, a prescription and receipt are required.
• Baggage & personal effects — This type of loss if fairly common and also a widespread type of insurance fraud. Hence the documentation required.
  • Police report — You will need a police report for any loss or theft. This usually has to be done within 24 hours of the incident. Don’t get into details with the police: a simple statement of the facts will do (preferably without making you look negligent in any way). 
  • Airline letter — If your baggage is lost by an airline, you need a letter from them admitting as much. It should include any amount paid by the airline.
  • Receipts for lost items — You should have these prepared in advance (as above). 
  • Homeowner’s or renter’s insurance — Your travel insurance is secondary coverage. Any cover provided by homeowner’s or renter’s insurance comes off the travel insurance settlement.
• Loss of cash — Never toss your ATM withdrawal slips until after the cash is spent. If your policy covers loss of cash, you need ATM withdrawal slips or bank / foreign exchange bureau receipts.
• Pre-trip cancellation — You need backup for all parts of the claim:
  • Receipts for all pre-paid expenses.
  • Proof that the amount you are claiming is after any refunds.
  • Your policy lists acceptable reasons to cancel. You must provide third party proof of the reason for cancellation. Examples: a doctor’s letter stating that you cannot travel or an employer’s letter confirming that you are needed at work.  
• Trip interruption — Same as for pre-trip cancellation… you need to provide third party proof of your need to go home.
  • You also need to show any return or onward air ticket that could be applied to your travel home.
  • Proof of payment for claimed expenses.
• Trip delay — Retain all receipts for ground transportation, lodging, meals and incidentals.
• Baggage delay — Loads of paperwork for a minor claim.
  • Your travel itinerary.
  • Incident report from the airline.
  • Receipts for all claimed clothing, toiletries and other personal effects.
  • Report of any other compensation received.
• Motor vehicle accidents — Requirements here are the same as at home.
  • Your rental agreement and invoice.
  • Police report.
  • Damage estimate or invoice.
  • Record of any coverage by the rental company.
  • Photos of the damage (not usually mandatory).
• Most types of claim — Your insurer will want to see your bank or credit card statements to prove that you have paid for a service. For goods a receipt will do.
• Contacts for the document provider — Whether it’s a doctor, a hospital administrator or a police officer, you should try to get a name and contact information. This not just for your insurer: you may have to contact this person if your insurer says that your documentation is not good enough.

If your insurer tells you you’re missing a document or a document isn’t completed correctly, it’s great if you’re still located where you can fix the problem. But that depends upon your insurance company being quick on the reply. The trouble is that travelers travel. By the time you find out that you need to get or fix a document, you’re in the next country. Your best defence is to make sure you supply every document required by the policy and that each one is complete and correct: all boxes filled, signatures, receipts on letter-head, contact numbers, even rubber stamps… the works.

You can often be challenged for missing a document, but you can never be faulted for supplying too much.

You filed: what happens next?

The true measure of an insurance company is whether they handle claims fairly and promptly.

• Response time — Processing a claim often takes 2 – 4 weeks, although complicated claims can take a month or more. If you don’t hear back within 6 weeks (8 at the outside), contact the company.
• Response quality — Inadequate information is a major source of policy holder frustration with insurance companies. Normally, you’ll just receive a form email with the result of your claim. If your entire claim is approved, then no problem. But if your claim is reduced or completely refused, there should be a clear and complete explanation.

How to appeal if your claim is rejected

An insurer may refuse your claim for valid or invalid reasons. First, their profit depends on not being generous, so they’ll use any technical problem with your claim to deny or reduce it. Second, they’re constantly bombarded by fraudulent claims, so if anything even remotely smells off about your claim, they’ll reject it. Third, they make mistakes just like any other business.

In any of these cases, their rejection of your claim is just an opening gambit. They expect you to respond with an appeal. But appeal how? 

First, be honest with yourself about your chances. Maybe they nailed you on a technicality. It sucks, but they’re right. Maybe the amount is not worth your effort.

If you believe your claim is legitimate and the amount involved is worth fighting for, don’t take “No” for an answer. Write a clear and polite appeal. It will go to a different (more senior) adjuster, who will also consider errors by the first adjuster. A surprising number of appeals are granted, at least in part, on the first appeal.

• If their reasons are unclear — This is not often the case, but if they don’t state clearly how you didn’t comply with the policy, ask for a detailed explanation. The more they explain, the greater your chance of isolating an error in their argument.
• If their reasons are clear, but you don’t agree — Ask yourself if your claim is clearly within the bounds defined by the policy or whether there’s some doubt. 
• If you can improve support for your claim — Did you not collect or forget to send a piece of documentation that is required by the policy? If you don’t have it, can you get it? While it’s hard to get documentation from overseas, you might be able to get a receipt copy for a lost item you bought at home.
• Copy regulatory bodies — If your first appeal is rejected, copy the insurance regulatory body or ombudsman in your jurisdiction on your second written communication. That often gets the insurer’s attention. 
• Continue to follow up — If the claim is worth the effort, work your say up the company hierarchy, with copies to the authorities (as above) until the insurer stops replying to you. 
• Give ‘em hell on social media — If you finally fail, but feel that you’ve been treated unfairly, give them notice that you will make their bad behavior known on social media. They’ll probably ignore you, so go ahead and launch your missile. Maybe you won’t make them budge, although some reply to respected forums. At least you’ll get a bit of satisfaction from venting.

Be patient and persistent. There’s a good chance you’ll be rewarded with a pay out, even if not for the full amount you hoped for.