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If you’ve traveled outside of Canada, you may have purchased out of country or travel insurance to protect your finances in the event of a medical emergency on your trip. No one wants to think about needing to use this insurance, but unfortunately, medical emergencies do happen, and you want to be able to rely on the insurance you bought so you can get the medical attention you need.
If you have travel insurance, healthcare providers in other countries will usually provide services to you on the basis that you have such coverage available, but in some cases, insurance companies deny the insurance claims after large medical bills have already been incurred after an accident or injury. This can be true for travel medical insurance claims, or other types of insurance claims being denied.
Having a travel insurance claim denied for you or a loved one causes great anxiety and can lead to receiving collection notices from the hospital, labs, doctors, and any other healthcare providers that may have become involved in providing medical coverage after an accident or injury.
Why was my travel medical insurance claim denied?
The main reason travel medical insurance claims are denied is related to how the insurance was purchased in the first place (with importance placed on pre-existing medical conditions). If you purchase an individual or family travel insurance policies through a broker or directly from the insurance company, the medical questions that you must answer to get travel medical insurance coverage will be heavily scrutinized if a claim is made. Any inaccuracies in the answers given will be used to deny the claim on the basis that no insurance would have been offered if the insurance company had all of the information about any pre existing medical condition.
For example, questions regarding whether your condition is stable or whether there has been a recent change in medication can result in a claim being denied if inaccurate information is provided. These denials can be challenged as the decisions may be a question of interpretation. It may be possible to still recover all or part of the funds owed and reach a resolution with the health care providers so that you are not out-of-pocket. Contact our team of travel medical insurance lawyers to see how we can help.
When buying travel medical insurance, make sure you provide accurate answers to any questions about your prior health to ensure that you won’t experience a claim denial when a claim has to be made.
Tips to streamline the travel medical insurance claims process
Before you file:
When you file:
If you’re denied:
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insurance claim, we encourage you to consult further with one of our travel medical insurance lawyers to determine whether we can assist you in recovering all or part of what rightly belongs to you or your family.
How our travel medical insurance lawyers help
After being denied your travel insurance coverage, you might not know where to turn next. You may feel hopeless at this moment, but rest assured you are not alone. When you call Share Lawyers, you will speak with someone who knows what you are going through and can offer you the best possible advice at no cost to you. Whether our clients are dealing with travel insurance after a trip, life insurance, accidental death and dismemberment insurance, or denied disability claims, we are here to help.
Why you should contact us:
It’s free to talk to us
There are no fees unless you win
We specialize in travel medical insurance claims for Canadians and we can discuss your options
We make arrangements for a free consultation with one of our travel medical insurance lawyers to see how we can get you what you’re entitled to
We're there to answer all of your questions
Share Lawyers explains travel medical insurance denials
David Share, President of Share Lawyers, on what travel medical insurance is, why travel medical insurance claims are turned down by the insurance company, and what Share Lawyers can do to help.
Travel medical insurance is relatively easy to purchase by those who plan to travel outside of Canada. The insurance exists to support travelers with medical coverage if they become sick (or have an accident) and need medical attention.
These claims can be denied based on the medical questionnaire that you fill out upon purchase. Problems arise if there are any questions or suspicions around whether or not any pre-existing conditions are stable upon travel.
How much time do I have?
There are time limits to all disability claims and any delay in proceeding may be subject to a deadline so you should not delay in proceeding with your disability claim or obtaining legal advice to clarify these deadlines. We understand how important these timelines are and will respond to any call or email as soon as we can.
No fees unless you win your case
lawyer feels out of reach. We’re here to help, no matter where you are in the claims process. That’s why we offer a free consultation, with no upfront costs, and no fees unless you win your case. You’re not alone. We believe in your case, which is why we only get paid when you do. Call us—it’s free!
Disability Lawyers in Toronto, proudly serving clients in Ontario and across Canada
A travel medical insurance denial example
A 75-year-old Ontario woman took out travel medical insurance for her winter trip to Florida prior to leaving in October. She traveled to Florida and in February of the following year she became ill, requiring urgent medical attention. Unfortunately, as a result of her illness, she passed away a few weeks later in Florida. She incurred extensive medical expenses and the insurer refused to pay any of the amounts owing which exceeded $600,000 USD.
The insurer alleged that she misrepresented her health when applying for the insurance. They said she should have disclosed that she had a heart condition and was being treated for hypertension prior to her application and that she has also been treated for shortness of breath and had been prescribed a number of medications.
She had provided answers based on her understanding and knowledge of her health and had never been told by any doctors that she had a heart condition. The prescription information mentioned by the insurer was inaccurate.
With the discrepancies between her answers about her medical history on the original application and the information that was in her medical records, the question of the validity of her claim was open to interpretation and this gave rise to the possibility of pursuing the claim so that her medical bills could be settled at no cost to the family. Her family submitted the claim in a timely manner and looked into the denial quickly as well.
By taking legal action decisively and without delay, her family was able to recover funds from the insurance company that were used to settle the outstanding accounts with the medical providers on a compromised basis. No further bills were left owing, the settlement covered this as well as the legal expense of pursuing action. The family all knew the outcome and made sure to get all the disability insurance, travel medical insurance and travel insurance for themselves in the future.
It is important to read the fine print carefully so you understand what coverage you have in the event of a medical emergency and treatment.
These cases are focused both on the policy wording and the specific facts of each case, but an initial denial by insurance companies should not be taken at face value, without being further reviewed, as decisions to pay the claim are based on the proper interpretation of the coverage, insurers err on the side of denying the claim rather than admitting the claim.