If your travel insurance claim has been denied, don’t worry. There’s hope.
But don’t take it from me. As I noted in a recent story, most appeals are successful, according to experts. And one expert, John Cook of the Quotewright blog, has told me how it’s done.
“You should understand the claim process when things don’t go your way,” he explained. “A majority of claims are paid without a problem. But but what happens if the claim is denied?”
Here’s how to win your travel insurance appeal:
1. Make sure you get the reason for the denial in writing. Don’t accept a verbal declination. If you feel you have a valid claim, then you have the right to file a claim. Once the claim has been filed, companies must than review it and have a responsibility to give you the reason why they have denied your claim. That reason should refer to the specific provision of the policy that supports the company’s position.
2. Ask for a claims appeal. Most companies will have procedures in place to review claims that are being contested. If they don’t, then ask for the supervisor or manager of the claims area to review the claim. Submit information that you think is pertinent to the claim and which will help them understand why it should be paid.
3. Read the fine print. Review the policy provision that they used to deny the claim. Is it a misunderstanding? Is the policy language ambiguous? Remember that if the policy language is vague and you could reasonably believe that you have coverage, then the company should rule in your favor.
4. Remember, talk isn’t cheap. Did someone at the insurance company advise you to do something and following their advice you lost money that they now they claim isn’t covered? If so, you should explain that in detail and ask for their review. Most companies record their calls and they can review what was told to you. Ask that they do that. If you were given wrong information they
have a responsibility for the consequences.
5. Give them more. Does the insurance company have enough information the claim? This is the time to get your travel agent to help. If you’ve purchased the insurance through a travel insurance expert, they should be able to assist you.
6. Take it to the next level. If the claim is still denied and you feel that it should be covered then file a complaint with your state insurance department. Insurance is regulated by the individual states and each state has complaint procedures if you feel a
claim has been denied incorrectly or if a company has treated you unfairly.
7. Go to small claims court. File a suit against the insurance company or insurance administrator. The state insurance department will have the service of process name and address. Make sure you follow court procedures and that you provide supporting documentation and all pertinent information. Most courts will provide you with the benefit of the doubt.
“Usually the claims appeal will settle most misunderstandings,” says Cook. “Especially if you have someone that can walk you through the process and help you with the policy provisions, like your professional agent.”
✓ Get the latest travel news, tips and commentary from Elliott’s E-Mail, the subversive newsletter from industry gadfly Christopher Elliott. You’ll travel like a pro. Sign up here. It’s free.
Sign up for my 
{ 6 comments… read them below or add one }
I use TravelGuard and I’ve had two claims with the company. I had to appeal one of them because there was some wishy-washiness over whether a flight was canceled because of weather or a mechanical problem. But a polite, detailed letter with a copy of some documentation from the airline did the trick.
In California under the Insurance Code an insurance company has a “good faith and fair dealing” obligation to handle and investigate your claim. If the company does not do so, it can be “bad faith” which is a seperate legal claim for damges. I suggest you write a return receipt letter to the ins. co. CEO-President first and set forth your “bad faith” claim handling. Often this gets results. Many other states have “good faith” statutes.
As a disclaimer, my name is Steve Dasseos. I’m the President of http://www.TripInsuranceStore.com and we are in the travel insurance business.
In my opinion, there’s no reason to buy a travel insurance plan if you aren’t sure if the claim will be paid. As a travel insurance seller, I believe we have an ethical responsibility to help people gets their claims settled.
For example, we send all our customers tips in case they need to make a claim on their travel insurance: (here are three of them)
Tip #1:
If you get sick or injured prior to or on your trip, it’s important you go to a doctor. If you don’t go to a doctor, the insurance company won’t believe you were sick or injured. Here’s how the policies typically read
“For Trip Cancellation benefits, an actual examination by a licensed Physician must take place before the cancellation is made. For Trip Interruption benefits, this examination must take place during Your Trip.”
Tip #2:
A lot of information is required when making a claim, even a small one. Keep a log of people spoken to. Don’t forget to keep receipts issued for services including items purchased if you have a travel or baggage delays.
Tip #3:
If you ever need to file a claim, write a cover letter with a synopsis of your claim to send with the claim form.
I hope this helps any one who reads this.
I “bought” a return ticket on line to Cyprus with a uk Company called “On the beach holidays” on June 26. That evening I was speaking with one of the party I’m meeting in Larnaca – to be told that I’d been booked to the wrong airport!!
On Friday 27th June 2008 I frantically tried to contact the company by e-mail (4) and telephone (4 hours at one stage!!! I had paid the full asking price for the flights. To date (july 10th) I have not heard from them.
The charming agents working for Onthebeach holidays slammed the phone down on me TWICE. Since then, the flight has gone and I’m at a loss of £287.50. During the conversation with a male agent (trying to sort this mess out) I said I was happy to upgrade to include a hotel in Larnaca, he then screamed at me, and slammed the phone down. A lovely way to treat customers. I have no option but to take them to the small claims court. Beware of this company, they are using sharp business practices. They are/were prepaired to leave a disabled person stranded, in the middle of the night , in a foreign Country with no transfer to the proper destination.
Yours,
Siobhan O’Neill.
If anyone can help me with who to contact about PRIME TRAVEL PROTECTION who has just gone under…please contact me on this forum. We were denied insurance and should not had been. Now to see others had the same problems with this company … who do we contact for further help?
Please, we need some help. we purchased a Basic Travel Insurance plan for our daughter for a High school trip. We had to cancel it due to her foot problem taking a turn for the worse. Now they say, due to it being a pre-existing condition, our claim has been denied. We had NO idea her foot condition would get bad. She is having surgery on this foot this weekend and we need this money to help pay for it. We really need some help. Please.
Travelex is the company that is not willing to help us. We filed all paper work, doctor supported paperwork and they have been giving us a hard time since October, maybe even sooner….. We were under the impression that we had coverage for any type of problem that came up, causing her not to be able to go. We are NOT rich and need some help! We are out $755.