Do not Let Your Insurance Company Deny Your Claim

16 Apr

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Everybody has heard the horror stories: An evil travel insurance firm denies the claim of another decent individual. Here is a latest example: An 80 year old man went on a cruise and accumulated $107,000 in medical bills immediately after he fell sick with pneumonia which led to complications. The insurance company denied his claim. (As you most likely guessed, lawyers ultimately got involved). Many stories like this have numerous folks believing that insurance firms Never pay claims. So the question is: Is travel insurance just a huge scam? The short answer is no, but there are undoubtedly factors you need to know to support steer clear of becoming an additional tragic story.

Very first off, travel insurance is usually a great kind of insurance to purchase. “Excellent insurance” signifies paying a reasonable upfront premium to transfer a significant financial threat from oneself to an insurance company. By contrast, extended warranty on your iPod can be regarded “bad insurance” simply because the premiums are expensive and a broken iPod, although annoying, will almost certainly not ruin you financially. Since healthcare charges are really high-priced (i.e. the average hospital keep in Canada expenses $7000 a day) travel insurance is a wise way to protect yourself from the possibly crippling fees of a healthcare emergency.

Of program that all depends on the insurance business in fact paying a claim when the time comes. Claim payout rates in the insurance market are extremely guarded, but there is some anecdotal info obtainable. In a latest write-up by the Chicago Tribune, the US Travel Insurance Association indicated that roughly one in six policyholders file a claim, and fewer than 10 % of these claims are denied.1 According to Canadian insurance broker Travel Insurance Workplace Inc, around 9% of travellers have a claim, and significantly less than 7% of those claims are denied.2

So it looks like there is at least some evidence of insurance businesses paying out claims. But how can you make positive an insurance firm will spend YOUR claim, without having acquiring expensive lawyers involved?

1 way to guard yourself is to really feel like a attorney when purchasing travel insurance. No, you don’t need a law degree from Harvard, but you do have to understand that an insurance policy is a legal contract. If there is a claim, the insurance business is going to go back that contract, which includes your insurance policy and any applications or questionnaires you completed.

In the insurance planet, claims are really black or white, yes or no, covered or not covered. With that in thoughts, here are some ideas to support keep that dreaded “denied” stamp in the insurance company’s holster:

Read the policy: Contrary to well-known belief, not everyone who functions for an insurance company is evil. When a claim is denied, some insurance insiders sincerely wonder: “Didn’t they read the policy?” A lot of claims are denied simply because the policy specifically excludes the item in a section appropriately called “Exclusions.” Other denials are due to claims that are simply not covered by the policy, or the amount claimed is much less than the policy’s deductible. The lesson? Read and recognize the policy before you buy.

Answer the medical concerns truthfully and fully: Sadly, a lot of medical questionnaires are often lengthy and confusing. To fill out the questionnaire completely and accurately, you might want to seek the advice of your medical professional, pharmacist, or a relative who knows a lot more about your healthcare history. Don’t leave your travel insurance to the final minute. The majority of claim denials are a outcome of men and women rushing via the questionnaire, or not inquiring about items they were unsure of. A single insurance agent remembers asking his client, “Do you have higher blood pressure?” The client’s answer, “No. The 3 medications I take hold it normal.” Don’t forget, how you define terms is irrelevant, it is the language in your insurance contract that counts.

Pre-existing situations: A lot of plans cover pre-existing situations that are stable and controlled. However, you need to have to read how “stable and controlled” is defined in your policy contract. For example, a condition will not be regarded as “stable” if you modified your medication in any way recently. Speak to the insurance organization directly if you have questions. Non-disclosure of healthcare info can void your coverage even if the non-disclosed circumstances or symptoms have nothing to do with the circumstances causing your claim. In the example above involving the man on the cruise, the insurance company denied the claim because he failed to disclose a prior heart condition in his application.

Advise the insurer of any healthcare modifications prior to leaving: If you have currently bought your travel coverage and your wellness alterations in any way just before the date the policy goes into impact, you ought to notify your insurer. A wellness adjust in the interim may well invalidate your coverage.

If you do get denied, fight it: There are no guarantees in life, and even the most carefully completed policy application can outcome in a claim denial. Regardless of the purpose, never accept the denial without a fight. The insurance organization owes you a clear explanation, and make positive to get it in writing. Particularly ask for the a comprehensive explanation of why the claim was denied, which components of the contract had been supposedly contravened, and how you can launch an appeal. If all else fails, a attorney may possibly have to get involved to argue your situation.

Travel insurance is definitely worth getting, and the evidence appears to show that insurance firms do pay out in time of require. However, applying for travel insurance does take some work. Following these tips will at least lessen the probabilities of obtaining a dreaded claim denial.

Sources: (1) “Travel insurance claims can hinge on the tiniest specifics” Christopher Elliott. chicagotribune dot com. Could 22, 2012. (2) Winter/Spring 2012 Newsletter. travelinsuranceoffice dot com.

14 Responses to “Do not Let Your Insurance Company Deny Your Claim”

  1. Nan January 17, 2013 at 4:35 pm #

    Allows say both insurance providers deny other driver’s claims so both sides sue the insurance providers.

    Will it be feasible for each side to win since it will likely be two seperate tests?

  2. Allen January 17, 2013 at 6:27 pm #

    I am talking about, what goes on should you let someone assist you with your bags towards the vehicle and when there they grab the important thing from you and drive away using the vehicle? Now first of all will the insurance provider really believe the storyline or simply think you left the secrets within the vehicle? Or maybe they are doing believe that it is your vehicle still fully insured because you virtually handed the important thing to an unfamiliar person?

  3. Cary February 18, 2013 at 6:40 am #

    My insurance company is with Statefarm. I’m the primary driver with full insurance coverage for the car. My brother just received his license but does not have any car insurance YET. Would it be legal for him to drive my car and if so, would my car be covered by the insurance company if he gets into an accident. I am from Canada, Ontario.
    Thanks for all the great answers.

  4. Kristeen April 10, 2013 at 7:10 am #

    How do I file a class action lawsuit against an insurance company that I believe has denied many people thier insurance claims for no good reason and got away with it because they didn’t have enough money for a high end or honest attorney to fight for there cause and therefore lost.

  5. Liliana May 15, 2013 at 1:20 pm #

    I looking to get as cheap as possible travel insurance to visit my entire family in Australia, can anyone help?

  6. Danial May 17, 2013 at 9:27 am #

    I have lied for years about my dogs breed to my homeowners insurance company and I know that there is some out there that will insure me with a Pitt-bull breed. If someone could please let me know what companys do, or have in the past.

  7. Verona May 18, 2013 at 10:50 pm #

    The new health care bill will, starting soon, prevent insurance companies from denying people due solely to per-existing conditions. This is a GREAT idea, becuase now, if you lose your job and insurance becuase of the economy, you can never get insured again.

    The problem is, people will wait until they get sick then buy insurance. Thus, the mandate. So, if the mandate goes, people will wait until they get sick, which will bankupt the insurance companies, then the government will take over, and maybe we will FINALLY have a decent health insurance program like England or France does.

    Your thoughts?

  8. Shanell June 8, 2013 at 7:04 am #

    I’ve often wondered if health care would become easily affordable if insurance companies didn’t have any influence over how much a service or a pill cost. But insurance companies use the money we give them for major investments in many goods and services. I see the total abolishment of health insurance as being similar to the abolishment of slavery back when our founding fathers were starting our country. It just wasn’t economically feasable at that time, they said. Would our economy collapse if health insurance was abolished and doctors, hospitals and drug companies had to compete for business by lowering prices?

  9. Ashanti June 14, 2013 at 1:58 am #

    I’m going to be out of the country for a while, and am putting my car in an auto storage place. But since I’m keeping it registered and leaving the plates on it, I have to maintain insurance. Do any insurance companies offer cheaper insurance or a special type of insurance that I can put on there, since I wont be driving the vehicle? This is because I’m deploying to Iraq, btw.

  10. Ayako July 26, 2013 at 3:05 pm #

    On a recent snowy day, my wife was stopped in the road because the traffic ahead of her was stopped. Another lady’s car hit her from the rear and caused $1-2K damage. At the scene, the lady said she would pay, to keep her insurance costs down. When she got the estimate, she changed her mind. We called her insurance, who said my wife was partly to blame (?), and that we would have to get our insurance to get the money from them (?!). Is it better to let my insurance company handle it, or should I sue the other driver in small claims court?

  11. Virgil August 15, 2013 at 2:06 am #

    I have to get my wisdom teeth extracted and need anesthetic. I pay a substantial amount for insurance every year and I am supposed to have 95 % dental coverage. Reading through all the paper work I have received from the insurance company and the hr department at work, it has lots of details on what exactly is covered. I found almost everything should be covered, apart for the preparation of the operation room fees. However, when I received my pre-approval form from the insurance, they are denying most of it, because they don’t cover this “specific code”. They aren’t disclosing these codes and you’re therefore stuck with this surprise denial. Are they allowed to deny me this information? Thanks for your help.

  12. Vera August 21, 2013 at 4:02 am #

    So here’s the deal. About ten days after I submitted my e-QIP I got a notice in the mail about an unpaid medical bill (lab work). It was under $100. I immediately paid it.

    I legitimately had no idea about the bill because I usually let my insurance company handle it. I’m thinking the insurance company denied the claim and the bill went straight to collections.

    I’m stressing out because I had put no to the question about being delinquent on loans and financial obligations.

  13. Garland August 23, 2013 at 1:02 pm #

    I’m curious if my vehicle will have to be considered a commercial vehicle because I’m advertising my website, teaching services, and phone number. Someone told me that my insurance company can deny my claim if I don’t notify them of the fact that my car is being used to advertise something. This is, of course, if I happen to get into an accident. Please let me know if I need to be more clear about my question. Thank you!

  14. Jermaine September 20, 2013 at 6:15 pm #

    I am looking into traveling to Australia this fall, and want to apply for my visa as soon as possible. When I was looking over the forms online, it asks if I currently have my return flight purchased and if I have travel insurance. It is still very early, so I was hoping on getting these afterward. I am just wondering if not having these are going to affect if my visa application is approved or not?

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