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What to Do if Your Travel Insurance Claim Gets Denied When Abroad

  • September 21, 2017
  • Staff
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Safe Travels USA

Safe Travels USA

Best for Visitors
Economical Plan
COVID19 included
Covers Medical
Pre-Existing Conditions
First Health Network

Buy Online

Atlas America

Atlas America

Rated “A – Excellent”
COVID19 included
Covers Medical
Covers Dental
Trip Cancellation
Full Refund on Cancel

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Last Updated on June 9, 2022 by Mani Karthik

Driven by the assurance of reimbursement of the cost incurred in a foreign land, including the expenses related to deposits and cancellation fees, more and more people are opting for travel insurance. According to Technavio’s research analyst, the global travel insurance market is predicted to grow steadily at a CAGR of 12% from 2016 to 2020.

But what if you have taken the insurance, fallen ill but been denied the claim while abroad?

Incorrect form filling, missing payments, new rules and claims generated for exclusions are some of the reasons why a claim could be rejected. Many of us are not really convinced with the reasons insurance companies give us for rejecting a claim. So, what to do in such a case?

Well, you can complain to the company. However, before you file a complaint, it is required that you do your due diligence to verify certain facts beforehand. Trying to take action against an insurance company without preparation will not only cost you, given that these companies are always armed with the best lawyers who are experts in defending against such lawsuits.

Request for Full Disclosure of Claim Denial

You need written proof from the insurance company, giving you the reasons why your claim was denied. There might be situations where you are asking for coverage for a medical emergency but the company finds your medical condition to be a result of a pre-existing disease for which you were not covered. Knowing the exact reason will help you make your appeal.

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Go Through the Policy Documents

Firstly, you should check the policy for all your information, which should be correct. In most insurance policies, the wording is poor and ambiguous, which might keep certain things unclear regarding what is covered and what is not. Such lack of clarity is not acceptable, as the insurance company is bound to give its client clear information. Pen down the exact wording that states that you are covered for the expenses incurred. Gather any other document that is proof of correspondence between you and the insurance company.

File a Complaint with the Insurance Company

Every insurance company has a complaint handing department and complaints do go through a process to rectify any recoverable mistake made at their end. Contact the insurance company either through the phone or by writing a formal letter of complaint to the relevant authorities. In the letter, clearly mention your name, policy number, reason why your claim should not have been rejected (include supporting documents) and what you would like the company to do to put things right.

Opt for Independent Assessment

When you get into an argument with the insurance company in order to get the claim approved, it is not easy to get to a conclusion, since both you and the insurance company will give every possible evidence to prove your point. So, what can be done? Go for an independent assessment. There are loss assessors who can look into the cause of the damage or theft and according to their investigation, they will send a report to the insurance company, which is considered evidence.

Lastly, if even after going through the insurance company’s complaints process, the result is not satisfactory; you can take your complaint to the Financial Ombudsman Service, which is an independent service that investigates complaints from individuals about financial companies.

Once you have exhausted all your options, and still haven’t received any kind of compensation from the insurance company, as a last resort, you can sue them.

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