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What happens when your travel insurer doesn’t pay back your claim? Things you must know!

Claims are refused in the travel insurance sector based on the conditions of the agreement specified in the insurance plan paperwork. A claim denial might be disheartening for a traveler hoping to get their money back, but here's something you might not know: only because one's claim was denied doesn't mean that's the end of the story.

A claim may be initially refused for various reasons, including clerical errors, miscommunications, and so on. When a travel insurance claim is denied, the traveler can accept the loss or pursue an appeal. For every professional travel insurance carrier, the appeals procedure is necessary for the claims management process. When a traveler wants the insurance provider to re-examine a claim, it's critical to move swiftly and convey your genuine grounds for filing an appeal.

When an insurance claim is refused, you will get a written communication stating the reason for the refusal. When you read the cause, you usually realize what is required to be done to remedy the problem. When claims are refused due to a lack of proof, you can get the necessary documents and submit them with your appeal. Unfortunately, the insurance company has difficulty obtaining the necessary paperwork from a foreign medical practitioner in rare circumstances. Therefore, it is critical to collect high-quality copies of any documentation required to file a claim while in the hospital or doctor's office.

If you provided all of the needed proof and your claim was refused, you will need to evaluate the details of your travel insurance plan. These are the terms of the agreement between you and your insurance provider. For example, if the paperwork states that already existing conditions have not been covered, including the claim that was the consequence of an acute onset of a pre-existing medical condition, then the claim denial that you have received is correct under the terms of your contract.

Further, we have come along with some tips and tricks that might help you claim your insurance: 

  • When travelling, have your emergency contact phone number and the travel insurance policy number handy.
  • If something goes wrong while you're gone, collect receipts for all you need to purchase to back up your claim.
  • Obtain your insurer's approval for medical treatment before it is carried out, if feasible.
  • Before purchasing insurance, always inform your insurer if you have a pre-existing medical condition; otherwise, you may be denied coverage.
  • Report missing or stolen items to the local police department within 24 hours of their disappearance. If this is not feasible, notify the person in charge of their disappearance.

You can file a complaint if you believe you are protected and your insurer is just acting unjustly. First, write out your complaint and inform the insurer regarding how you want it fixed. If you are dissatisfied with their reaction, you can file a formal complaint with the help of the company's internal complaints system.

All insurers are subject to the Financial Conduct Authority's (FCA) laws and must handle complaints in a certain manner. The service is entirely free to use. You should wait up to 8 weeks for the insurer to respond to your complaint. If they don't respond or if you disagree with their response, you might request a letter of deadlock. A standstill letter shows that you and your insurer have not been able to agree. After that, you can file a complaint with the Financial Ombudsman Service (FOS). The service is entirely accessible to use.

Your complaint will be investigated and resolved by the Financial Ombudsman Service. The insurer must follow their decision, but you are not required to. If you disagree and wish to pursue your issue further, you may file a lawsuit against your insurance.

When you reach home, you might feel the need to file a claim on your travel insurance coverage. Remember to check the following items before you send them in:

  • You are still within the time constraints for filing a claim.
  • You have coverage for what you're asserting.
  • The excess is the amount of money deducted from your claim by your insurance. If the sum you're claiming is less than this, this might not be worth filing a claim.
  • Check the terms and conditions to ensure there is nothing in them that stops you from claiming.
  • Considering the policy is new or old. If it isn't, the amount you receive for the products you're claiming would be lesser than the replacement cost. This is due to the insurance deducting money for wear and tear.

Contact your insurance as quickly as possible to a claim form. They might be able to email this to you to expedite matters. Then, fill out the claim form completely and preserve a copy for yourself. You must provide copies of any information to assist your claims, such as receipts or medical certifications. You should also preserve duplicates in case your claim is challenged or denied.

Your insurer may inquire whether you have any additional insurance that may cover the claim. Therefore, you must notify them if you have any other insurance that may provide coverage, such as house contents insurance.