4 Commonly Denied Travel Insurance Claims (2024)

If you’re submitting a travel insurance claim, it’s because something went wrong during your trip. The last thing you want, to add salt to the wound, is a denied claim. The best way to avoid a denial is to understand what your insurance covers before you even start your trip. If there’s something you want covered but you don’t see it in your plan document, review plan options carefully before making a selection — Seven Corners plans often have a Basic as well as a Choice option, for example — that provide varying levels of protection for you and your trip.

What can cause a claim to be denied? Here are some of the most common reasons and how to avoid them.

Most Commonly Denied Travel Insurance Claims

1. Your claim occurs before your effective date.

There are two main types of travel insurance: trip protection and travel medical insurance. Trip protection, because it provides trip cancellation benefits to assist you before you leave on your trip, can start before your departure date. Travel medical insurance, because it’s focused primarily on medical benefits, covers illness and injury that occur during your trip, not before.

With this in mind, it’s important to know when your effective date is. You’ll find this information in your plan document. Claims for events that happen before your effective date will be denied because that event took place before your plan started.

How do you avoid this denied claim? One way is to purchase travel insurance as soon as possible. Seven Corners Trip Protection plan and the optional add-on Cancellation for Any Reason (CFAR) begin the day after we receive the required premium to cover your trip. Other benefits, such as Trip Delay or optional Rental Car Damage, can have different effective dates, so please review your plan document for a full explanation.

If you purchase travel medical insurance, make sure to buy it ahead of time. The earliest your coverage can begin is 12:01 a.m. the day after you buy it but not until you depart from your home country. While your travel medical coverage doesn’t begin until you have left your home country, starting coverage on your departure date means that if you get hurt or sick during a layover in a foreign country, for example, you’ll be protected.

For example, let’s say I leave the United States on August 1 for a vacation to South Africa. I have a connecting flight in Amsterdam and don’t arrive in Cape Town until August 2. I would want my coverage to begin August 1 even though I don’t reach my destination until the following day. This way, I’m protected in case I get sick or hurt during my layover in Amsterdam.

2. The care you received was routine or preventive.

This applies to Seven Corners Travel Medical Insurance plans.

Most travel medical insurance plans are meant for short-term coverage and cover sudden illnesses or injuries only during your travels. It’s expected that your domestic primary health insurance will cover routine checkups and preventive care you receive in your home country.

To avoid having this type of claim denied, check your plan document before you leave. If it says that routine or preventive care services are not covered, get your routine checkup before you leave (usually a good idea anyway, especially if you’ll be traveling for an extended period) or wait until you get home when you can use your primary health coverage.

3. It wasn’t a covered reason.

This reason applies to Seven Corners Trip Protection plans.

Trip protection plans can reimburse your prepaid, nonrefundable trip expenses if you need to cancel or interrupt your trip for covered reasons. If you decide to cancel or interrupt for a reason not listed, such as being nervous about the safety at your destination, your claim will be denied.

One way to avoid having this type of claim denied is to purchase Cancel for Any Reason coverage. This optional add-on benefit allows you to cancel your trip for any reason you wish, not just those reasons covered in your trip protection plan, and still be reimbursed for 75% of your prepaid nonrefundable trip costs.

Interruption for Any Reason (IFAR) coverage works the same way. If you decide to end your trip and come home early, the optional IFAR coverage that you added can reimburse you for 75% of those unused, prepaid, nonrefundable expenses, regardless of why you chose to interrupt your trip.

Another way to avoid this claim is, again, to read the plan document and understand the covered reasons. This way, you’ll know you’re covered before you decide to alter your trip plans. You might even be able to adjust your coverage or choose a different plan before you find out too late that the protection you wanted wasn’t provided.

4. The timely filing limit expired.

This is basically another way of saying you missed the deadline. Most insurance companies have a timely filing limit. If you don’t provide the required documents within the stated time frame, your claim could be denied.

The simple answer to avoiding this type of denied claim: file your claim as soon as possible after an incident. We also recommend you check your plan document, which will tell you how long the filing limit is. Most plans have a 90-day limit.

Support So You Can Travel Smarter

If you review your plan document and start to feel overwhelmed, never fear. Check out our blog with tips for how to read a travel insurance policy or contact our licensed travel insurance agents for more information and an explanation of our plans.

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4 Commonly Denied Travel Insurance Claims (2024)

FAQs

Why are travel insurance claims denied? ›

The most common reasons for a denied claim include: There's insufficient documentation or evidence to support a claim. These include a lack of receipts, proof of payments or proof of the incident that you're making the claim for, such as a cancellation, necessary medical care or anything else that cost you money.

What is the most common reason for claims being denied? ›

The claim has missing or incorrect information.

Whether by accident or intentionally, medical billing and coding errors are common reasons that claims are rejected or denied. Information may be incorrect, incomplete or missing.

What is the most common travel insurance claim? ›

Medical expenses

Falling sick due to the local food or weather is a common scenario for travellers. In certain countries, medical expenses can cost a lot more than in your home country where you may have subsidies from the government.

What is a frequent reason for an insurance claim to be rejected? ›

Insurance companies deny claims for many reasons, such as insufficient evidence, missed deadlines, or policy exclusions. If your insurance company denied your claim, you can file an appeal, agree to mediation or arbitration, or take the insurance company to court for bad faith.

What reasons are not covered by travelers insurance? ›

What Does Travel Insurance NOT cover?
  • Reasonably foreseeable events.
  • Known storms, epidemics, acts of war.
  • Travel restrictions imposed by government authorities.
  • Pre-existing conditions, unless the Premium plan is bought within the window for coverage.
  • Dangerous activities.

How to successfully appeal an insurance denial? ›

Steps to Appeal a Health Insurance Claim Denial
  1. Step 1: Find Out Why Your Claim Was Denied. ...
  2. Step 2: Call Your Insurance Provider. ...
  3. Step 3: Call Your Doctor's Office. ...
  4. Step 4: Collect the Right Paperwork. ...
  5. Step 5: Submit an Internal Appeal. ...
  6. Step 6: Wait For An Answer. ...
  7. Step 7: Submit an External Review. ...
  8. Review Your Plan Coverage.

What is a dirty claim? ›

Dirty Claim: The term dirty claim refers to the “claim submitted with errors or one that requires manual processing to resolve problems or is rejected for payment”.

How do I resolve a denied claim? ›

How to Resolve a Claim Denial
  1. Review the reason for the denial.
  2. Gather supporting documentation.
  3. Appeal the denial.
  4. Negotiate with the insurance company.

What to do after a claim is denied? ›

If you review the explanation and still believe your claim was unfairly denied, try these steps.
  1. Contact the Insurance Company. Claims are often denied due to insufficient information. ...
  2. Keep Detailed Records. ...
  3. File an Appeal. ...
  4. Contact Your State Department of Insurance. ...
  5. Hire a Public Adjuster. ...
  6. Hire an Attorney.
Oct 24, 2023

Which travel insurance is best at paying claims? ›

We named Nationwide travel insurance as our pick for the most coverage reimbursed. It offers 100% trip cancellation coverage and up to 200% trip interruption protection, depending on your plan choice. Nationwide also provides some of the best policies for cruise ship passengers, based on our review.

Is it worth claiming on travel insurance? ›

Travel insurance can give you extra protection if your holiday doesn't go as planned. This is very important if you are travelling independently because you may find yourself stranded with no way to get home and no rep to help sort out your holiday problem.

What is the most expensive travel insurance claim? ›

Most expensive claims
  • Hot tub fall - $187,604. ...
  • Complications in Germany - $155,000. ...
  • Fiji fracture - $147,148. ...
  • Cancer complications - $140,148. ...
  • Pneumonia issues - $102,060. ...
  • Wrist fracture - $87,000. ...
  • Emergency treatment in Vietnam - $86,500. ...
  • Bile duct problem in Greece - $84,000.
Dec 19, 2023

What are 5 reasons why a claim may be denied or rejected? ›

9 top reasons your claim is denied
  • Incomplete information. Claims often get denied due to incomplete information. ...
  • Service not covered. ...
  • Claim filed too late. ...
  • Coding or billing error. ...
  • Insurer believes the procedure wasn't necessary. ...
  • Duplicate claim filed. ...
  • Pre-existing condition not covered. ...
  • Lack of pre-authorization.
Dec 12, 2023

Which of the following may result in a denied claim? ›

Information that is erroneous or incomplete, a lack of supporting documents, or a failure to adhere to proper procedures are some additional justifications for denial.

How often do claims get denied? ›

According to the Medical Billing Advocates of America, across the healthcare industry 1 in 7 claims is denied, often for a variety of reasons ranging from technical errors to simple administrative mistakes.

How often are insurance claims denied? ›

According to the Medical Billing Advocates of America, across the healthcare industry 1 in 7 claims is denied, often for a variety of reasons ranging from technical errors to simple administrative mistakes.

Can travel insurance deny pre existing conditions? ›

While most travel insurance policies exclude pre-existing conditions from medical expenses and evacuation coverage, you may be able to obtain coverage with a pre-existing conditions waiver.

Why am I getting denied insurance? ›

You could be denied coverage because of the car you drive, the state where you live, your driving history or your credit score. Each insurance company considers these factors differently. So one company may offer you coverage even if you were denied by another.

How long can you wait to make a travel insurance claim? ›

All claims, however you make them, should be submitted within 60 days of returning from your trip. The exception is when you need 24-hour emergency medical assistance.

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