Owen Park
I have recently filed two travel insurance claims and my colleagues have recently filed several more. I am now in a position to comment on what helped speed up payment and what are the common avoidable delays.
File the claim within the policy window
Most travel insurance claims have to be filed within the policy period of 21 to 30 days after an incident. There are many travelers who have lost their claims because they were late filing their claim. The clock for medical claims starts on the date of the incident and not on the date of the discharge from the hospital or the return date to the home country. To avoid denied claims due to late filing, travelers should file their claims within the 14th day of the policy period. It only takes a minute to set a calendar reminder and it could save you a lot of time and effort in the long run. This is a fundamental part of traveling with travel insurance that most guidebooks neglect to inform their readers.
Documentation that the insurer actually wants
What the insurer wants to see
Firstly, the insurer wants to see specific document types. Itemized bills as opposed to summary bills, original medical reports that describe the diagnosis and treatment in full, and receipts for all individual costs claimed. Lost items: a police report filed within 24 hours, proof of ownership (e.g. receipts for purchase of lost item, photos of item in use, credit card statements etc.), and a statement of value with supporting documentation. Trip cancellations: documentation of covered reason for cancellation (e.g. medical certificate, hospital records, employer’s letter), original booking confirmations, and subsequent cancellation confirmations outlining what has been refunded to traveler. Each type of claim has its own unique set of required documentation and the traveler must ensure that they have gathered sufficient documentation to support their claim prior to submission.
Use the claims portal or app, not email
Most travel insurance companies have a portal for filing a claim, where you upload all necessary documents. Filing a claim by email to customer service usually leads to delays of weeks, because such emails are first forwarded by the email system to the department internally where they might get lost in a large queue of emails of other customers. In contrast, uploading all required documents into the portal of a claim immediately puts them into the claims system and you usually get an instant acknowledgment that your claim has been submitted. Phone calls can be used for clarification, but submitting a claim by phone is not efficient, because then the content of the phone call is added to your claim case, but the documents for the claim still have to be uploaded to the portal.
Follow up on a schedule
While going through the claim process for my two cases and for the cases of my fellow travelers, I came up with a set of general rules which – I believe – can speed up the payment process and prevent many unnecessary delays. These are: (1) follow up on a schedule, (2) be polite but insistent. First, claims which are being processed are generally being processed faster than claims that no one is following up on. Hence, the rule: check in on your claim on a regular basis, i.e. approximately every 14 days (i.e. around the time when the adjuster processing your claim would normally update the claims system in any case). However, do not follow up too often, as adjusters need time to process the claims submitted to them. Second, when you do follow up on a claim, always use a message that works. This means that you should be sending a message which (a) is clear and to the point, (b) is polite and courteous and (c) refers to the specific claim submitted by you (i.e. include the claim number and the date of submission). For example: “Hello, I am following up on claim X submitted by me on date Y. Could you please confirm receipt of my claim and also let me know when I can approximately expect to receive a update on the processing of my claim?”. Such a message will be processed much faster than a phone call or mail which does not contain this information. Finally, as I mentioned already above, if a claim is denied or if the processing of a claim is being delayed for reasons which you consider to be excessive or unfair, then make sure to use the provider’s internal complaint process. Most such processes will deal with your case much faster than the initial claims processing process.
What gets claims denied
Common denial reasons. While reading through all the different traveler’s insurance policies there are a few aspects that occur quite often that result in claims being denied. While reading through all the different traveler’s insurance policies there are a few aspects that occur quite often that result in claims being denied. First of all, the majority of denial reasons are caused by lack of sufficient documentation for a claim. Even when a claim is filed perfectly and all conditions for the claim are fulfilled, claims can still be denied if relevant documentation is missing. Secondly, claims are often denied due to alcohol or drug use being involved in the incident that leads to the claim. This is denied by all providers. Thirdly, claims are also denied when there are any pre-existing conditions that are related to any kind of medical treatment received during the trip. Most providers have a lookback period of 60 to 180 days before the start date of the policy during which time any kind of symptoms related to pre-existing conditions would result in the whole policy being denied. Lastly, claims are also denied when policy holders did not read the exclusions and assume that certain activities would be covered. These are the typical reasons for denial of claims and should therefore be avoided.
What does it look like when applied to a trip that you are planning in advance?!
Build a contingency fund while you’re planning your trip. Take into account one extra day of travel every week, reserve a portion of your budget for unexpected expenses and arrange for part of your trip to be refundable should you need to cancel. In general, planning ahead for contingencies is much cheaper than trying to sort out a last-minute fix. Plan your trip starting from a fixed date and with a set budget, rather than designing your dream trip. The most limiting aspects of your travel options will dictate your itinerary and the more you incorporate these restrictions into your initial plans, the better your trip will turn out. Book the fixed costs first, i.e. the flight, the main accommodation and any booking that is a prerequisite to your travel. After that, it really doesn’t matter too much and the rest of the trip is likely to unfold serendipitously.
