Travel Claims Denied Make More Headlines

Another story out of British Columbia about seniors being denied large claims for medical services in the U.S. are hitting the headlines. Apparently the seniors referred to in the story failed to accurately complete their medical applications.

I haven’t seen the applications and I haven’t spoken to the clients and I have no direct knowledge of the information they provided to the insurer.  So I won’t make any judgements, but such stories only emphasize the fact that travel insurance is a contract, and it weighs equally on two parties.  It is not to be made lightly and should never be entered into because one plan is cheaper than the next, or is “quick and easy” to complete.  Accurate answers are important.  Try misstating your income or credit history on a mortgage agreement and see what happens.

This is why we repeatedly urge you to deal with travel insurance specialists who know the policies and the questionnaires. Take your time completing the applications and answering what you are asked, exactly as the questions are asked.  For example, if asked if you have ever had a colon or bowel problem and you answer No because that colitis you had a few years ago hasn’t given you a problem for a while, you aren’t answering the question correctly. The question asked for facts, not personal opinions.  And to an underwriter looking to assess your health history, that’s not a small technical issue.

On the other hand if a question is so unclear or ambiguous that you really can’t answer it honestly or accurately, go to the insurer and demand they clarify any question you don’t understand and answer appropriately, with the help of your physician, if necessary.  Travel insurers still have a way to go in formulating clear, plain language applications. Don’t be afraid to prod them.

Also, make it clear to your physician that anything he or she has entered in your medical record is made known to you, in language you understand.  All too often, doctors don’t tell their patients the details of tests or specialists’ opinions, but they record them nonetheless.  And when insurers go back to verify your records (as they must do) they find you didn’t tell them everything.  There is nothing more frustrating to an insurer or an impartial ombudsman than hearing a patient complain:  “my doctor never told me I had a heart murmur.” And it happens a lot.

It is heartbreaking to hear of clients—no matter what age—being burdened by claims of $100,000 or $200,000, because they didn’t complete an application fully.  But the information provided on that application is all the insurer has to go by in determining whether or not to cover that client. And if insurers paid out every $200,000 claim that was based on inaccurate or incomplete information, who do you think would end up paying for that? You.

Provincial governments long ago abrogated their responsibility to provide you with comprehensive coverage when you leave the country for your winter holidays. They have left that responsibility to you and to travel insurers. With medical costs what they are, buying travel insurance is no small thing.  Don’t treat it as a mere formality.

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