How to Avoid Travel Insurance Claim Rejection?

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Tips to Avoid Rejection on Travel Insurance Claim

There are several tips and tricks that an individual should follow to avoid rejection of insurance claims made against inevitable travelling mishaps. They are enlisted below –

Choosing the Right Travel Insurance Cover: It is essential to purchase an insurance policy that protects against every potential travel risk. Specifically, when visiting local lands, it is advisable to buy an insurance policy accepted by the local regulatory authorities. Further, when travelling internationally, it is wise to purchase a region-specific insurance plan that abides by the travel policies of the destination country.
Claim Exclusions: In the excitement of packing and planning a trip, it is easy to forget to check the list of exclusions of an insurance policy. People often find out the hard way that exclusion applies to their situation, sometimes when they are hundreds of miles away from home amid a medical emergency. The main reason that insurance companies deny travel insurance claims is misuse or abuse of coverage, including exclusions. You must understand your coverage and its limitations to avoid unpleasant surprises later.
Be Aware of the Coverage Details: To ensure that you get the most out of your travel insurance and your claim is not rejected, read the terms and conditions carefully and be aware of what is not covered. You must also understand the limits of your policy when filing certain claims.
Submit Paperwork on Time: To register a valid claim, you must provide substantiating paperwork related to your treatment and the contact information for the medical professional who provided your care. It may also be helpful to submit receipts for any services you received. You need to refer to the list of documents for respective claims as mentioned in your policy. There should be enough valid proof of paperwork associated with your claim for a hassle-free settlement.
Opacity in Medical Conditions: As part of the application process for travel insurance, some people may choose not to disclose any pre-existing medical conditions. This can prove disastrous if you face an emergency during your trip and your claim for health care is denied. Even if you are hurt or become ill and do not have a pre-existing condition, there is a chance your claim will be rejected. To avoid these situations, make sure to disclose all existing medical conditions when you apply for the policy.
Indulging in Adventurous Sports and Activities: Generally, travel insurance does not cover losses incurred from participation in adventure sports and activities. Further, the list of activities excluded from insurance differs with each company. With Digit, we cover adventure activities that last only for a duration of one day. Three-day long treks or hiking, etc. are not covered. So, it is advisable to engage in such sports with extra caution as it possesses a high risk of claim rejection.
Avoid Travelling to Places Blacklisted by the FCO and WHO: The FCO (Foreign and Commonwealth Offices) and WHO (World Health Organisation) have compiled a list of locations that may be unsafe for travel, such as war-torn areas. When considering vacation plans, make sure you avoid such blacklisted areas to avoid complications concerning insurance claims in case of accidents or loss during travel.
Visit Pre-approved Clinics: Travel insurance companies provide a list of pre-approved hospitals and clinics where their customers can insist on getting emergency care. Customers who have already visited these hospitals should contact the customer service department if they feel they were denied adequate care. Travellers who visit non-listed clinics may find that their trip insurance does not cover them.
Avoid Alcohol Abuse: Many insurance companies refuse to pay accidental death benefits for fatal accidents that occur while the deceased individual is intoxicated. So, avoiding intoxication through alcohol or any other harmful drug when travelling is highly suggested.
Take Good Care of Belongings: Leaving your valuables unattended is considered negligence, leading to rejection in the claim.
Report Theft or Loss of Property Immediately: It is crucial to report any accidents or thefts to the insurance company within 24 hours when one is insured. The individual should get a written medical report and make a police report in case of medical emergencies and non-medical emergencies, respectively. These are the reports that an individual needs when filing a claim with an insurance company to avoid rejection.
Provide accurate information: When purchasing your travel insurance policy, provide all the required information correctly. Over or understating information can lead to rejection of a claim. Insurance agencies scrutinize every document before processing a claim. So, if you want a quick, hassle-free paperwork process, you can start off by honestly stating all your information.

Filing a Claim with Digit Insurance

International travel insurance plans can get expensive, so a seamless claiming process is important. With Digit, we offer a 3-step simple, easy, and hassle-free process to file a claim. All you need to do is follow these 3 steps

Step 1

Give us a call at 1800-258-5956 (if in India) or drop a missed call & we’ll call back in 10 mins.

Step 2

Upload the required documents and your bank account details on the link sent.

Step 3

We’ll take care of the rest!

How to deal with travel insurance claim rejection?

You can ask your insurance company to reconsider a claim payment because the policy does not cover the treatment. If the company denies your request for a reconsideration, you can appeal its decision to an independent third party. You must follow your insurance plan’s appeal process.

Is the insurance company justified in rejecting the claim?

When an individual files a claim with an insurance company, the company investigates the claim to determine whether it is valid or not. The company doesn't want to turn down a claim unnecessarily, but sometimes the reasons for rejecting a claim are correct. Even though it may damage their public image, they will do it to protect their company rights.

Why do insurance claims get rejected?

Insurance claims can get rejected for many reasons. Inconsistency in the claim and documentary proof, exaggerated claims, claims filed for a policy exclusion, etc., are some of the reasons a claim can get rejected.

What are the 3 most common mistakes while filing a claim?

3 of the most common mistakes policyholders make while filing for a claim are the temptation to exaggerate losses, claiming beyond plan limits, and not providing complete or accurate documents as required to process the claim.

What usually happens if a claim is rejected?

If your claim is rejected despite producing the right documents, you can complain to the grievances officer of the policy branch. An effective grievance redressal mechanism will be in place to assist you and resolve the matter. If it is not resolved, or resolved to your satisfaction, you can escalate your complaint to IRDAI which will take it up with the insurance company and facilitate a re-examination of the complaint and resolution.

What steps should I take if my claim is rejected or denied?

The first thing you need to do when your claim is rejected is thoroughly examine the details of your policy. Next, you need to file an appeal. You will receive notifications or a letter of denial which includes an ‘Explanation of Benefits’ with a reason for each transaction and rejection of claim. You will be required to provide further documents and information to your insurance agency to rectify or understand the rejection of claim.

What is the difference between a rejected and denied claim?

Denied claims are claims that were received and processed by the payer and deemed unpayable. They may contain some sort of vital error that was only caught after processing. A rejected claim contains one or more errors found before the claim was processed. Errors will prevent the insurance company from paying the bill and the rejected claim is returned to the policyholder to be corrected. It may be the result of a clerical error or a mismatched procedure.