Top Reasons for Travel Insurance Medical Claim Rejection

Manish had an international travel insurance policy. He was travelling to Thailand with his friends having the same travel policies. While travelling, all three of them tested positive for Covid-19. A Thai hospital instructed them to isolate themselves in a hotel (which was converted into a COVID Care Centre). As they had to follow the rules of Thailand, they were isolated in the centre and received the same treatment. They recovered within a week. All of them paid the bills out of their pockets and sought reimbursement from their insurance company.

His friends received the reimbursement money. However, Manish’s reimbursement claim was rejected. 

Manish tried everything. He had an email trail with the insurance company but was unable to get his claim amount. Then he approached Insurance Samadhan for guidance. We investigated his case and came to the conclusion that his claim was rejected due to poor documentation. We explained this to him and guided him through the claim process. His case was resolved within a month.

Travel Insurance covers many risks like loss of baggage or passport but this blog is referring to claims of medical treatment. This is one of the cases where a medical claim for travel insurance was rejected. There are many cases where claims were rejected as policyholders were unaware of certain important things which lead to claim rejection.

6 Common Reasons for Medical Treatment Claim Rejection in Travel Insurance

1. Poor documentation

When a policyholder fails to submit the proofs like medical bills, tickets, etc., then the claim might get rejected. Always ensure to keep all the documents safe with you as they act as evidence at the time of claim.

2. Timely intimation 

Did you inform the insurance company about the hospitalization in a foreign land? You need to inform your insurance company within 24 hours of hospitalization so that they guide you with procedures.

3. Procedures 

All Travel plans give guidelines on all permissible medical procedures as per terms and conditions.

4. Non-disclosure of pre-existing disease

An insurance contract is a contract which follows the principle of utmost good faith. It means that both insurer and insured need to be transparent with each other and both parties must disclose all the material facts before and after the policy is issued. When a policyholder conceals a pre-existing disease from his insurance company, the company can reject the claim on the grounds of non-disclosure of material facts.

5. New rules

Insurers revise their terms and conditions every year. You must read them even when you purchase a policy from the insurer you always do.

6. Exclusions

Claims for damages that are excluded from the insurance policy will never be approved. You must read the inclusions and exclusions of the policy before buying an insurance policy.

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If you face any problem related to insurance, you can contact Insurance Samadhan. We have helped resolve 14,500+ complaints of policyholders. We’ll be happy to help you.

Click on the below links to read some cases resolved by Insurance Samadhan:

Health Claim Rejection amid Covid-19

Insurance Mis-selling