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8 Reasons Why Travel Insurance Claims May Be Denied

No one wants anything bad to happen while they’re on vacation but if it does travel insurance can help cover your expenses relating to a medical emergency a cancelled or interrupted trip or lost baggage… unless your claim is denied.

We’re reviewing 8 reasons why travel insurance claims are denied to help you avoid this situation and ensure you’ll be protected while you’re on vacation:

  • The incident wasn’t a sudden or unforeseen event.
  • The Government of Canada issued a travel advisory before you booked.
  • Omitted or lied about a pre-existing condition.Illegal activity.
  • Drug or alcohol consumption.
  • Not having the correct coverage for sports or certain activities.
  • Injuring yourself in a place that’s off-limits.
  • Lack of documentation.

We’ll walk you through each of these reasons why travel insurance claims are denied and how you can avoid them.

What is travel insurance?

Before we break down the reasons why travel insurance claims are denied it’s a good idea to define what we mean by travel insurance. Generally there are several different insurance products that fall under the umbrella of travel insurance including:

  • Travel Medical Coverage – covers emergency medical expenses while you’re abroad including transportation to medical facilities or home to continue treatment.
  • Trip Cancellation Coverage – if you need to cancel your trip unexpectedly before you leave this protection can help reimburse you.
  • Trip Interruption Coverage – if you need to go home early unexpectedly due to an issue back home or you’re prevented from continuing your vacation this coverage will help reimburse you and cover the costs to get you home.
  • Baggage Coverage – this covers the basic necessities or luggage replacement if your baggage is lost stolen or delayed.

1. Not a Sudden or Unforeseen Event

Insurance is always for emergencies – unexpected events or disasters. Here are some travel insurance scenarios that wouldn’t be covered:

  • You booked a vacation but don’t feel like going anymore.
  • A close relative was in poor health when you booked a trip.
  • You forgot your luggage at home.
  • You wanted to go for a routine doctor’s visit while abroad.

These are all situations that you can plan for or prevent – nothing here is unexpected.

2. The Government of Canada Issued a Travel Advisory Before You Booked

The Government of Canada maintains travel advice and advisories for all countries. Check this database before you travel – if a travel advisory is issued before the date of booking your trip (and the purchase of your travel insurance policy) you won’t be covered if you try to make a claim related to that advisory.

For example if you booked a trip to Mexico and a few weeks later you found out you’re expecting! But now you’re concerned about Zika and want to cancel your planned vacation. However the Government of Canada had posted a travel advisory about the Zika virus before you booked. In this scenario you wouldn’t have coverage.

However if a travel advisory is issued after you book your vacation and purchase your travel insurance you’d be eligible to make a successful claim.

Let’s say you booked a trip to Hawaii and there was no travel advisory about Zika. You book your trip and find out you’re expecting – and now Zika has spread to this beautiful island. In this case you would likely be covered because the Canadian government didn’t issue a warning until after you booked your trip.

Always check the Government of Canada’s website before you book. If there is a warning you likely won’t be covered by your travel insurance.

3. Omitted or Lied About a Pre-Existing Condition

A pre-existing condition doesn’t mean you can’t get travel insurance – but you do need to be honest about it. In some cases you may be covered for that condition although your travel insurance premiums may be higher. Alternatively you may be able to purchase travel insurance and just your pre-existing condition won’t be covered.

No matter what be honest on your insurance application as otherwise any claim you have can be denied due to misrepresentation.

4. Illegal Activity

Illegal activities aren’t covered because you’re breaking the rules of wherever you’re visiting. It’s on you to know the laws before you go.

5. Drug or Alcohol Consumption

Drugs and alcohol impair our ability to make good decisions and increase our risk for an injury or illness. It’s not that you can’t consume any alcohol or legal drugs while you’re on vacation – it’s making sure you aren’t putting yourself at risk by being over-intoxicated or participating in an activity where alcohol or drugs can put you at more risk.

6. Not Having the Correct Coverage for Sports or Adventure Activities

Vacation is for trying new things and participating in your favourite activity. But if you’re wanting to do an adventure activity or your favourite sport abroad make sure it’s covered by your travel insurance. If it isn’t you may be able to get special add-on protection to cover that activity. Many tours or activity operators will also offer insurance if yours doesn’t cover you.

Here are a few activities that may not be covered without add-on protection :

  • Backcountry skiing snowboarding snowshoeing and snowmobiling
  • Base jumping
  • Bobsledding luge and skeleton
  • Canyoning
  • Ice climbing
  • Mountain biking
  • Mountaineering (over a certain elevation)
  • Paragliding or parasailing or hang gliding
  • Scuba diving (below a certain depth or without certification)
  • Skydiving

Keep in mind that what’s covered will vary by the insurance company. Talk to your insurance broker and they can help find you the coverage that will include that activity.

7. Injuring Yourself in a Place That is Off-Limits or Out-of-Bounds

If an area is marked as out-of-bounds or off-limits it’s generally for good reason. If you injure yourself while adventuring in such an area your claim will likely not be covered as you’ve chosen to break the rules ignore warnings and put yourself at a high level of risk.

8. Lack of Documentation

You’ll need to provide documentation to your travel insurance company if you make a claim. If you can’t provide this evidence you may find your claim is denied.

Always keep copies of:

  • Written proof of cancellations
  • Doctor’s notes
  • Police reports
  • All receipts

Writing down what happened as soon as possible will also help you later on.

When You Buy Travel Insurance Can Impact Claims

It’s important to buy your travel insurance at the right time. If you want trip cancellation or interruption coverage you should purchase this coverage at the time of booking.

Travel medical insurance should be purchased before you leave. It can even be purchased while you’re travelling although there will be a waiting period before you’ll be able to use it (and the injury or illness must originate after that date).