Main reasons travel insurance claims get denied - Wyld Family Travel (2024)

Travel insurance is a vital tool that protects you from a wide range of unfortunate incidents that can occur during your travels. Although the vast majority of travel insurance claims will be accepted, there is a small percentage which will be denied.

Thankfully travel insurance claim denials can easily be avoided by making yourself fully aware of the terms of your policy. Many reasons that can deny a travel insurance claim can simply be avoided by being a responsible traveller, while others may involve you doing a bit of research and speaking with your insurer to choose the right policy for your travels.

Let’s explore the most common reasons your travel insurance claim may get denied.

Alcoholor drugconsumption

Main reasons travel insurance claims get denied - Wyld Family Travel (1)

If it’s found that you were under the influence of alcohol or a drug during a travel event you are trying to make a claim for, your travel insurance claim will most often be denied. Being intoxicated or impaired by a drug may mean your claim could have been avoided if you hadn’t been under the influence.

Although you may decide to have a drink during your travels, be sure to drink responsibly, make wise decisions, and realise that it could impact any claims that arise if you were deemed to be impaired.

Only drugs prescribed by your doctor should be taken during your travels as these will generally not impact any insurance claims so long as your insurer was aware of the condition you were taking medication for.

Pre-existing medical conditions

Failure to disclose to your insurance company anypre-existing medical conditions which you have received treatment for could result in any claim arising from such condition to be denied. Examples of pre-existing conditions include things like asthma, diabetes, high blood pressure,and allergies.

It is wise to disclose everything even if you believe it may be insignificant.Your insurer will be more than happy to at least consider any pre-existing condition and you may only need to pay a slightly higher premium or it may be covered free of charge.

Be sure to disclose any recent surgeries, planned operations, or medications you are taking that could impact your policy. You may be required to undergo a medical examination to discover any conditions you may not be aware of.

Adventurous sports or activities

Engaging is sports or extreme activities during your travels could impact your policy. Many policies may include conventional sports and activities like snorkelling, mountain biking, and jetskiing. You will find that high-risk activities such as skydiving, shark diving, and hang-gliding will generally not be covered by your policy.

Winter sports such as skiing canmany times be included but may involve purchasing an additional supplement to your policy. Professional sports and competitions are also usually not covered during your travels.

Reckless behaviour

Making a travel insurance claim for an event where you were deemed to be reckless could result in a denial. This can include things like failure to have a valid license or not wearing a helmet when riding a motorbike. It can also include trespassing or entering areas known to be dangerous.

Any activity which you don’tguard against injury and illnessor take unnecessary risks can result in an unsuccessful claim. This means no swimming after hours or balancing on balconies.

Illegal activity

Engaging in any illegal activity, whether the intent was malicious or not, could impact your claim. Common illegal behaviour includes fighting, association with drugs, or vandalism. Countries, of course, havedifferent laws to be aware of which may be vastly different to your home country, so it pays toresearchwhat may be deemed illegal wherever you are travelling.

Failure to obtain the correct visas for the countries you are travelling to can also fit into this category as an illegal employment.Generally, if you are planning to work overseas, you should discuss this with your insurer as you may need to select a policy which covers this type of travel.

Unattended belongings

Your luggage and personal property will generally be covered under your policy so long as you are responsible for it. This means retaining or securing your belongings at all times. You should also disclose any high-value items to your insurers such as cameras and laptops to make sure they are included.

It is wise to have receipts or documentation thatproves you possessed the items. This will make handling your claim for lost or damaged belongings much quicker and easier.

Failure to report incidents or meet deadlines

For an event to be claimed such as lost bags or theft, you must report the incident to the appropriate authorities in a timely manner, most times within 24 hours. Be sure to keep any written statements or reports to show as proof of the incident.

Reporting incidents in a timely manner and keeping documentation are just some of the easyways tomake sure you are eligible for a travel insurance claim.

You must also make any claims to your insurer within a set amount of time. Thiswindow could be as short as30 days. Have documentation ready and lodge your claim as soon as possible in case more documentation or information is needed.

Lack of documentation

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Failure to have enough supporting evidence that an event occurred could mean your claim gets denied. Keep all police reports or written airline statements as well as any receipts showing costs incurred from travel delays or lost baggage.

Document everything you are taking on your travels and keep all receipts for lodging and activities.

Government warnings or actions

Travelling to anyvolatile destinationsor countries where travel is not advised, may not be covered under your policy. It is wise to keep yourself up to date with the latest travel warnings with websites likeSmartraveller.

Travelling to a destination where an act of war, rebellion,or military coup takes place will generally void any claims arising from such events.You will also not be covered for any property of yours which isseized,withheld, or destroyed by agovernment authority.

Failure to get therecommended vaccinations for theregions you are travelling to could also result ina claim being denied.

This article is provided byInsureandGo Australia

Main reasons travel insurance claims get denied - Wyld Family Travel (2024)

FAQs

Why are travel insurance claims denied? ›

The most common reasons for a denied claim include: There's insufficient documentation or evidence to support a claim. These include a lack of receipts, proof of payments or proof of the incident that you're making the claim for, such as a cancellation, necessary medical care or anything else that cost you money.

Which is a common reason why insurance claims are rejected? ›

The claim has missing or incorrect information.

Whether by accident or intentionally, medical billing and coding errors are common reasons that claims are rejected or denied. Information may be incorrect, incomplete or missing.

Does travel insurance cover cancellation due to family illness? ›

Travel insurance will only cover you for the unexpected illness or death of a close family member. This means that if they had a medical condition when you took out your policy that was related to their death, you wouldn't be covered.

Why would an insurer reject a claim? ›

You failed to update your insurance details when your circ*mstances changed. You have missed some of the instalments of your premium. You have not followed the claims process correctly. You have not complied with a policy term.

What percentage of travel insurance claims are denied? ›

Legitimate claims

According to the United States Travel Insurance Association, one out of every six insureds ends up filing a claim, and less than 10 percent of those claims are denied. If your travel insurance claim is denied, you may be upset,. However, getting upset is not going to help you.

What is the most common travel insurance claim? ›

By far, the most common and often most significant travel insurance claim is for medical emergencies. A sudden illness or injury during your trip can not only ruin your plans but also cause a severe financial strain.

What are 5 reasons a claim may be denied? ›

Six common reasons for denied claims
  • Timely filing. Each payer defines its own time frame during which a claim must be submitted to be considered for payment. ...
  • Invalid subscriber identification. ...
  • Noncovered services. ...
  • Bundled services. ...
  • Incorrect use of modifiers. ...
  • Data discrepancies.

What are the three most common mistakes on a claim that will cause denials? ›

Here, we discuss the first five most common medical coding and billing mistakes that cause claim denials so you can avoid them in your business:
  • Claim is not specific enough. ...
  • Claim is missing information. ...
  • Claim not filed on time (aka: Timely Filing)

What are the most common claims rejections? ›

Most common rejections

Eligibility. Payer ID missing or invalid. Billing provider NPI missing or invalid. Diagnosis code invalid or not effective on service date.

What is not covered by travel insurance? ›

Reasonably foreseeable events. Known storms, epidemics, acts of war. Travel restrictions imposed by government authorities. Pre-existing conditions, unless the Premium plan is bought within the window for coverage.

What conditions are not covered by travel insurance? ›

Injuries or illnesses which occur during your trip are covered-unless they relate to a pre-existing injury or illness. However, some policies cover some pre-existing injuries or illnesses if you pay a higher premium. There may be exceptions to this such as terminal illnesses, mental disorders and heart conditions.

Does travel insurance cover family members? ›

That's why it's so important to have travel insurance that includes trip cancellation and trip interruption benefits. These benefits can reimburse you for nonrefundable trip expenses if you must cancel or interrupt your trip due to the covered serious illness or injury of a family member (among other covered reasons).

How to challenge insurance claim denial? ›

You can start the appeal process by calling your insurance provider. Ask for more details about the denial and review your appeal options. Your insurance agent can walk you through the appeals process to help get you started.

How can I stop my insurance claim being rejected? ›

Your right to appeal

Internal appeal: If your claim is denied or your health insurance coverage canceled, you have the right to an internal appeal. You may ask your insurance company to conduct a full and fair review of its decision. If the case is urgent, your insurance company must speed up this process.

What is the difference between insurance claim rejection and denial? ›

A claim rejection occurs before the claim is processed and most often results from incorrect data. Conversely, a claim denial applies to a claim that has been processed and found to be unpayable. This may be due to terms of the patient-payer contract or for other reasons that emerge during processing.

How easy is it to claim travel insurance? ›

Contact your insurer as soon as possible and ask them to send you a claim form. They may be able to email this to you to speed things up. Complete the claim form carefully and keep a copy for yourself. You'll need to include copies of all paperwork that will help your claim, including receipts or medical certificates.

How does travel insurance verify claims? ›

Provide documentation from the incident to help us verify your claim.
  1. Receipts.
  2. Official reports/news articles.
  3. Photos.
  4. Doctor's notes.
  5. Notices of travel delay or severe weather.

How long does a travel insurance company have to settle a claim? ›

In some states, it may take even longer. California is one of the most citizen-friendly states, so your insurance claims can be cleared and closed much quicker compared to several other states. Insurance companies must settle claims within 85 days of their filling date in California.

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