It seems like every month there’s a news story about Canadians who’ve had their travel insurance claims denied. If you’re one of these unfortunate folks, here are a few pointers for what to do if a company has denied your travel insurance claim.
Clarify the Reason
First, make sure the company tells you exactly why your claim was denied.You should have a clear, well defined and documented reason for the denial. If you don’t, press back and demand a thorough, clear answer for your claim’s denial. Make sure that you get the clarification in writing.
Read Your Policy
Look at the fine print of your policy to see if the insurance company is justified in denying your claim. Remember that your travel insurance policy is a legal agreement between you and the insurer. Many times, travel insurance companies are justified in denying the claim, based on the wording of the travel insurance policy.
Appeal The Denial
Travel insurance companies have an in-house appeal process. Contact the travel insurance company and ask for your claim to be appealed. It’s certainly easier and cheaper than going to a lawyer, and it forces the company to take a hard second look at your claim and the reason it was denied.
If you’re in Ontario, the Financial Services Commission of Ontario (FSCO) has a helpful list of all company complaint officers and their contact information for insurance companies here.
Get an Ombudsman Involved
Very few people know this, but there’s an ombudsman service for consumers who’ve had their travel insurance claim denied. The service is called the Canadian Life and Health Insurance Ombudservice. There’s also a General Insurance Ombudservice which may be able to help.
Ask the Hospital to Reduce your Medical Bills
Again, this is something that’s not widely known, but many hospitals (especially those in the United States), offer programs to reduce their fees for those who can’t pay. You’ll need to contact the hospital directly, and you’ll probably have to produce a mountain of paperwork, but it could potentially save you thousands of dollars.
Get Legal Help
Taking a company to court should be the last option, as it’s potentially an expensive and time-consuming process. That said, once you’ve exhausted all other options, you may need to get a lawyer involved. At the very least, having a lawyer on your side may convince the company that you’re not a problem that’s just going to go away quietly, and it may spur them to action.
- The Canadian Life and Health Insurance Ombudservice has a helpful Complaint Guide guide that can help walk you through dealing with your travel insurance company.
- Check out our article on How To Keep Your Travel Insurance Claim From Being Denied.
Photo by 401(K) 2012 on Flickr.
*As always, the information on this page is from one Canadian traveller to another. We have spent years abroad and have gotten to know the ins and outs of the industry however we are not travel insurance agents. If you have any travel insurance questions, please talk to a qualified travel insurance agent or broker. Finally, policies and plans can and do change all the time, without warning, so always consult your insurance policy since that is the legal document to which you are agreeing to.
*This article is only intended as general advice. Please check your own policy carefully.