How to Avoid a Denied Travel Insurance Claim | by TuGo Travel Insurance

TuGo Travel Insurance shares strategies to help you avoid a denied travel insurance claim, especially when it comes to medical or health services.

This is a guest/sponsored post by TuGo^® Travel Insurance for the Outpost Travel Health Center | Sept. 8/2022

(photo: anyaberkut/iStock)

TuGo Travel Insurance shares a few strategies to help you avoid a denied travel insurance claim, with the goal of ensuring ensure that Canadian travellers make informed decisions about the product(s) being purchased, helping them to understand the policy before travelling, and communicating what happens if there’s a claim.

If you’re already a TuGo customer or looking to learn more about TuGo^® Travel Insurance, avoid any surprises come claim time by reading the following information, provided by TuGo.

Partial versus fully denied claims.

A partially denied claim is when the cause of the claim is covered, but some of the expenses you submitted aren’t eligible for coverage (i.e., it’s not in your policy “benefits”).

A fully denied claim is when the policy doesn’t cover the cause of the claim at all. If the cause of the claim isn’t covered, or falls under one of the policy exclusions, your claim won’t be paid. Knowing the difference is between a partially or fully denied claim can help you avoid possible disappointment.

Why travel insurance claims get partially denied:

Forgetting to gather the required documentation.

For any claim expenses, you’ll need to submit itemized receipts. A credit card statement or a till receipt from a pharmacy won’t work. But there’s an easy fix: simply remember to keep all your bills and/or receipts.

Medical Questionnaire Mistakes.

If you’re a senior traveller aged 60+ purchasing emergency medical coverage, you’ll be required to fill out a Medical Questionnaire (MQ).

If you’re unsure how to answer the MQ, ask your doctor for help. If any information is incorrect or missing from it, your insurer can fully deny your claim; but Claims at TuGo isn’t like every other provider. We recognize that as humans, we sometimes make mistakes. That’s why, depending on the policy you’ve purchased, TuGo will apply a $15,000 USD deductible instead of denying the full claim. That could save you quite a bit of money, especially if you need medical treatment in the US!

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Not realizing that insurance is for unexpected medical expenses.

Emergency Medical Insurance isn’t a health plan—it’s specifically designed for medical emergencies. Knowing what is or isn’t a travel medical emergency is the first step. Next, know when the ‘emergency phase’ of your emergency is over, as defined in your policy terms.

Travel medical coverage applies for acute medical care only, and limited follow-up.

Tests must be done at the initial emergency stage. If more tests are needed beyond the ‘emergency phase’ of your medical event, sometimes it’s best to go home for them, rather than continuing your care abroad. It’s important to call your insurance provider before proceeding with any more tests, procedures, or continuing treatment.

If you are fit to travel home or able to wait to have additional tests done, and you don’t need additional acute medical attention, the additional expenses won’t be covered.

Why travel insurance claims get fully denied:

Not understanding what you’re covered for.

Over the years, we’ve experienced some travellers who don’t quite understand what they’ve purchased. There are several types of travel insurance plans and policy benefits; not all policies are alike. For example, if you bought Emergency Medical Insurance coverage, it doesn’t offer Trip Cancellation or Trip Interruption benefits.

While reading your policy is important to understanding your coverage, we know that some questions are better answered by a human. If you’re unsure about coverage, TuGo’s Customer Service team is available to help at 1-855-505-0869.

Not making sure that you have coverage available for your pre-existing medical condition.

If you have a pre-existing medical condition, it doesn’t mean that you can’t get coverage; but it does mean you’ll need to talk to your insurance provider about stability for pre-existing conditions, to get the right coverage for your needs.

Cancelling or interrupting your trip due to a medical issue without consulting a doctor.

There are many valid reasons to cancel or interrupt a trip, but don’t do it without a consultation. For example, say you need to cancel a trip due to having contracted COVID-19 before you leave, or interrupt your trip while you’re away.

To make a travel insurance claim on a Trip Cancellation & Trip Interruption Insurance policy, you must see a doctor before cancelling or interrupting your trip, and the positive COVID-19 test result must include a name and date, as well as the laboratory or medical clinic name.

For more information about COVID-19 testing, visit TuGo’s Travel Insurance FAQs.

Intoxication

Simply put: travel insurance and alcohol don’t mix. If you’ve submitted a claim related to alcohol-related illness or injury, your travel insurance claim will be denied. Claims also won’t be covered if they result from a history of alcoholism or withdrawal, or even a past alcohol-related illness before your trip (like cirrhosis).

Your travel insurance doesn’t cover high-risk sports and activities.

Not all providers offer coverage for sports and activities. But with TuGo, you can snorkel, bungee jump, hike or even parasail over water and still be protected under our standard Emergency Medical Insurance.

Plus, if you’re taking your adventures to the extreme—backcountry skiing and snowboarding, downhill freestyle skiing and snowboarding in organized competitions, high-risk snowmobiling (racing competitions, endurance events, high-marking and/or snowmobiling in unguided backcountry terrain), ice climbing and others—add Sports & Activities Coverage to your travel insurance policy and you’re good to go.

Remember, reading and understanding your travel insurance policy is essential. Don’t be afraid to reach out to TuGo with your question if there’s anything you don’t understand! ♦

• • This is a guest/sponsored post by TuGo® Travel Insurance, which is Canadian-owned and operated, and has been in business for 60 years. Outpost Travel Media does not assume liability for its content, and we encourage you to contact TuGo directly for more information on their products and services, to read their terms and conditions, and if you have any questions related to travel insurance.

• • The information provided in the Outpost Travel Health Center are guidelines only. Always (always!) get individual medical advice from your doctor, a travel health doctor, or at a travel health clinic before travelling. In fact, we always advise your first point of planning for any trip should be booking an appointment with your family doctor or at a travel health clinic (which specialize in destination health and safety info, and requirements). Be advised too, that some destination-specific vaccines or preventatives (such as for malaria or traveller’s diarrhea) may require multiple doses, and thus require days/weeks/months of spacing between. So, when it comes to travel and health, start your planning sooner than later.