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

This article was last updated and fact checked on August 1, 2024 by Mani Karthik.

So, you’re vacationing. Say, in the USA, having a blast exploring everything from the Grand Canyon to Broadway shows, when—bam!—you hit a snag. Maybe it’s a medical emergency, a lost bag, or a canceled flight, and you’re relying on your travel insurance to save the day.

But then, the dreaded happens: your claim gets denied. What now?

First off, take a deep breath. It’s frustrating, but there are steps you can take to address this issue. Here’s a straightforward guide on what to do if your travel insurance claim gets denied while you’re abroad.

1. Understand Why Your Claim Was Denied

Before you panic, review the denial letter or email carefully. Insurance companies are required to provide a reason for the denial. Common reasons include:

• Coverage Exclusions: Some situations might not be covered by your policy.
• Incomplete Documentation: Missing or incorrect documents can lead to a denial.
• Policy Limits: You might have exceeded the coverage limits.

If the reason isn’t clear, don’t hesitate to ask your insurance provider for a detailed explanation.

2. Review Your Policy Documents

Dig out your travel insurance policy documents and read through them thoroughly. Look for sections on coverage limits, exclusions, and the claims process. Compare these details with the reason provided for your claim denial. This will help you understand if the denial was justified or if there’s been a mistake.

3. Gather and Review Your Documentation

Ensure you have all the necessary documents to support your claim. This might include:

• Medical Reports: Detailed records from healthcare providers.
• Receipts and Bills: Proof of expenses incurred.
• Police Reports: For theft or loss of property.
• Travel Itineraries: Documentation of canceled flights or accommodations.

Make sure all documents are complete, accurate, and properly organized.

4. Contact Your Insurance Provider

Reach out to your insurance provider to discuss the denial. Ask for a reconsideration of your claim and provide any additional information or documentation they might need. It’s important to keep records of all communications with your insurer, including emails, phone calls, and letters.

5. File an Appeal

If your insurance provider is firm on the denial, you can file a formal appeal. This usually involves:

• Writing a Detailed Appeal Letter: Explain why you believe the claim should be approved, citing your policy terms and supporting documents.
• Submitting Additional Evidence: Include any new or supplementary documentation that could strengthen your case.

Follow your insurer’s guidelines for submitting an appeal and keep copies of everything you send.

6. Seek Assistance from Consumer Protection Agencies

If your appeal is still denied or if you’re facing delays, consider contacting consumer protection agencies. In the USA, you can reach out to:

• The Insurance Commissioner’s Office: They oversee insurance practices and can provide assistance.
• Consumer Financial Protection Bureau (CFPB): They handle complaints about financial products and services, including insurance.

7. Consult a Legal Professional

For persistent issues, consulting with a legal professional who specializes in insurance claims might be necessary. They can offer advice on your legal rights and may help you escalate the matter.

8. Consider Alternative Dispute Resolution

Some travel insurance policies include arbitration or mediation clauses for disputes. Check your policy to see if this option is available. These processes can be less formal and quicker than court proceedings.

9. Learn from the Experience

Once the issue is resolved, review what happened and how you can prevent similar situations in the future. Make sure to understand your policy better and keep comprehensive records for any future claims.

10. Stay Calm and Persistent

Dealing with a denied claim can be stressful, but staying calm and persistent is key. Keep detailed records, communicate clearly with your insurer, and follow through with appeals and complaints as needed.

By taking these steps, you’ll improve your chances of getting a favorable resolution to your denied claim. Safe travels, and may your adventures be smooth and claim-free!