7 tips for winning your travel insurance appeal

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.

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“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.”