Most people purchase travel insurance to cover unforeseen circ*mstances, from flight delays and cancellations to medical issues. In the event you need them, such policies can help you get money back for prepaid and nonrefundable expenses, inconveniences, and even health care costs. It’s as simple as choosing a policy and paying the premium – or is it?
According to the United States Travel Insurance Association (UStiA), approximately 16% of people with travel insurance file a claim, and less than 10% of those claims are denied. While a denial is fairly unlikely, it doesn’t mean you should ignore the possibility or skip travel insurance altogether. Even if your travel insurance company rejects your claim, you can file an appeal.
Let’s look at why claims are denied, how to file an appeal, and tips to make a winning case.
Travel Insurance Claim Denial Types
A travel insurance claim can be denied for several reasons. There are two main types of rejections: “soft” and “hard” denials.
Soft Denial
These denials result from insufficient information, documentation, or other minor issues with your claim. Providing the resources that your travel insurance company requests could help it get approved during the appeal.
Documentation that is commonly requested by insurance providers includes:
- Itemized receipts
- Repair estimates
- Bills
- Claim forms
- Medical bills
- Medical diagnosis paperwork
- International medical reports
- Rental agreements
- Police reports
Tip: A soft denial can also result from clerical errors or miscommunication. Carefully read your policy or contact your travel insurance provider’s customer service team if you have a question about your claim.
Hard Denial
These denials occur when your travel insurance provider determines that your policy does not cover the claim. If your policy clearly doesn’t cover the event for which you filed a claim, your claim could be denied permanently. However, if your circ*mstance warrants a second look, you can file an appeal once a hard denial is received.
How to File a Travel Insurance Appeal
Filing an insurance appeal can be easier than submitting a claim. When a travel insurance company denies your claim, they will often provide the reason(s) the claim was not approved.
To file an appeal, you must gather additional information and documents that support your case. First, you must understand exactly why your claim was denied. Consider reviewing the terms of the policy and be careful not to simply rehash your original claim.
To submit the insurance claim appeal, follow the directions provided in the claim denial. You can also search the travel insurance company’s website or contact their customer service team.
Sometimes, your understanding of the travel insurance policy and the adjuster’s understanding of the policy will be different. Fortunately, most travel insurance policies have extensive fine print that details what is covered and what is not.
An appeal that includes new supporting information will be reviewed by the insurance company’s claims team. If you can submit the appeal online, it may speed up the process.
If you receive a claim denial that doesn’t address the reason, it can be frustrating to figure out why it was rejected. However, you shouldn’t give up. Instead, try to contact the insurance company to get clarification on your denied claim.
If you hit a dead end with the insurance company, there are additional avenues you can take to get refunded, including contacting:
- State insurance commissioners: Search the National Association of Insurance Commissioners‘ website to find your state’s contact. Travel insurance companies may prioritize your claim if you take your appeal to a governmental or regulatory agency.
- Better Business Bureau (BBB): If you are having trouble communicating with your insurer, contacting the BBB might promote a response. The BBB helps everyday consumers settle disputes. Disputes can be related to contracts, customer service, billings, refunds, and warranties. It will accept your complaint even if the company isn’t listed in their directory.
However, you must be willing to provide your personal contact information and details about your travel insurance company so that BBB can forward the complaint to the company on your behalf.
- Consumer advocate: Consider reaching out to a legal or industry expert in travel insurance. They may be able help you contact someone more senior at the insurance company. Remember to be kind and practice your patience. If your claim is approved, it will be worth it.
- Small claims court: Suing an insurance company for denying claim should be your last resort. Although you don’t need a lawyer for small claims court, once your case is decided, you can no longer appeal. Plus, there is a limit to the claim amount, so this route is not recommended if your trip reimbursem*nt claim is in the thousands.
What Does the Appeals Process Look Like?
Once you submit an appeal by writing a letter about your claim and providing supporting documentation, you have done all you can. You must now wait for the travel insurance company to review your appeal and make a decision.
Travel insurance companies will often provide an estimated timeline for the review process. If they do not, however, feel free to contact the company’s customer service team or claims department to ask. You can also follow up if the business fails to meet its deadline.
Most travel insurance companies will assign an appeal to a senior adjuster. A senior adjuster checks to ensure the initial adjuster handled the original claim properly and then reviews your updated claim. Generally, an appeal can take as much time to process as the initial claim.
3 Tips for Filing an Appeal
1. Keep Documentation During Your Trip
Even if you do not intend to file a claim on your trip, keep all of your receipts until you are safely back home. If you are worried about losing paper receipts along the way, take a photo of each receipt with your camera or smartphone. Travel insurance companies accept photos of receipts if you need to file a claim.
If organization isn’t your thing, ask your travel insurance company if they provide a no-receipts claim option. This policy option will give you a fixed payment per insured person per day (up to the policy’s limit). In addition, you may have to prove that your trip or baggage was delayed.
If you find yourself in an accident or in need of medical assistance during your trip, be sure to ask for copies of all the resulting paperwork. This may include police reports, repair estimates, medical bills, and hospital records.
Tip: Remember that a no-receipt claim option often has a lower reimbursem*nt than if you provide receipts. The higher the trip cost, the less it makes sense to use this option.
2. Be Polite
An appeal is sent to a senior agent, often someone higher in the travel insurance company than the agent that reviewed your initial claim. While it shouldn’t take longer to review than the initial claim (unless you are waiting on supporting documentation), it’s important to remember that appeals can take time.
Try to be as patient as possible when waiting for a decision. It may be stressful and frustrating, but losing your cool will not make the process go any faster.
3. Learn from the Experience
If your appeal is denied, instead of vowing never to travel again, take a step back and think about what you learned from the experience. If you failed to keep all your documents or didn’t purchase the appropriate travel insurance, you will be more informed and prepared the next time you travel. Plus, you can share your experience with fellow travelers, so they can avoid making the same mistakes.
