Getting Their Due

Clients who have purchased travel insurance don’t really expect anything to go wrong. No one does. But when it does happen, then what?

Putting in a claim is how clients get paid. So, how do you assure the claim isn’t denied?

Try to Assure Clients to Pick the Right Policy: “We have never had a denial,” says Sue Tindell, owner, Travel Leaders, Rice Lake, WI. “We work very hard to qualify our customers on what they are purchasing and why.” But what can happen when clients just don’t cooperate and won’t listen to their agent’s advice?

“With regard to insurance denial of claims, the only time I’ve had a significant denial of a claim on a typical cruise travel incident was in a case where the client decided to purchase a policy through an insurer other than the in-house Travel Guard policy I offer and recommend,” said Amber Blecker, a CruiseOne agency owner from Aurora, CO.

In this specific situation, a flight to Quito was cancelled due to an airport closure, which put the clients at the risk of missing their Galapagos cruise. The airline would not reschedule the clients in time for them to catch the required charter flight from Quito to Baltra. “I was able to get them rescheduled into Guayaquil the next day and on to Baltra in time for embarkation, but the trip insurer denied part of the claim on the grounds it didn’t fall under their trip delay or interruption provisions,” says Blecker.

Stress to your clients who purchase travel insurance on their own that the policy features and choices they make can impact whether they’re paid or not, should a problem occur.

Review the Policy Purchased before Travel: Once the client has purchased the right policy, he or she should still review it carefully prior to travel to understand the features and requirements. It can make a difference between knowing what options are available when a negative situation arises or, in contrast, feeling left in the dark.

“For example, when weather delays a flight there are important differences and time frames for Missed Connection, Travel Delay and Trip Cancellation,” says, Isaac Cymrot, vice president, sales and industry relations, Travel Insured International. He says the industry has worked hard to write the policy language in ways that make the coverage clear. If the clients are in doubt, Cymrot advises them and their agents to contact the insurance company’s customer care department with questions.

Don’t Throw Anything Out: If a claim has been denied, the first question is why did that happen? Was it not covered under the policy or was it because no documentation had been submitted for the specific expense?

Sheri Machat, senior vice president, MH Ross Travel Insurance Services, says: “If there are medical bills, were receipts obtained to submit [to the insurer]? If luggage was lost, was it documented at the time?” According to Machat, the most important part of filing a claim is to make sure that there are receipts and documentation substantiating what happened and that the occurrence is something covered under the terms of the policy.

“Keep every receipt of documentation [for the claim],” Cymrot stresses. “Paper isn’t heavy and won’t put you over the weight limit in checked luggage.” Especially when traveling internationally, he says, hospital documentation can be very difficult to retrieve once the client leaves the hospital.


Lost luggage
Lost luggage is one of the most common incidents where insurance can bail your clients out.


Sabine Harris, a CruisePlanners agent from Tampa, says she has been pretty lucky with insurance, and the one issue she has had was a recent claim finally paid after eight or nine months. “But this was because my client did not get the proper paperwork in,” says Harris.

Tell the Story in Your Claim: TravelSafe Insurance says one issue that sometimes arises is that clients don’t send things that help show what happened in the right sequence. The story should make sense to an insurance examiner reading it for the first time. It must be documented along each step of the way. And in the rush to file, TravelSafe notes that people sometimes forget some of the nitty-gritty details that are really pertinent to the adjudication of the claim.

Air Tickets May or May Not be Refundable: Air tickets can constitute one of the most confusing and frustrating parts of the process. Nonrefundable does not always mean nonrefundable. Many times airlines won’t help, but, that said, sometimes they will, insurers say. That’s particularly the case if a serious medical situation or death is involved.

But while the insurer may work hard behind the scenes to process a claim, occasionally the airlines will only speak with the insured person. So clients may be asked to assist in talking with an airline.

Hand Holding by a Travel Professional: From Blecker’s perspective, the agent remains critically important in the claims process: “I do believe there is a difference in insurance companies, but it is also about counseling a client when an incident happens, to ensure they preserve the lines of communication with the trip insurer, getting the insurer involved as early as possible, and to see that the client maintains a proper paper trail of receipts and documentation.”

If the Claim is Denied, Appeal: “Read the denial and understand the reason behind it,” stresses Deb Auxier, marketing manager, Travelex Insurance Services. “If your claim is denied, you have the right to appeal your claim directly with the underwriter. Remember to provide all additional facts or documents to support your claim.”

TravelSafe says that if the first examiner doesn’t think the information provided shows the claim is payable, the file will likely be referred to a second examiner for another review. Only then would claim have the potential of being denied. And even if that occurs, the client is typically invited to submit any additional information he or she feels is relevant to the claim so that the claim can be reviewed again.

Most insurers say they want to pay all valid claims, but clients must pick the right policy and they must have that important paper trail. “Other than that one incident, from an insurer with whom I’m not familiar, my clients’ claim history has been quite favorable,” notes Blecker. She says she’s experienced only minor denials of small items that were either in excess of policy limits or not directly related to the claimed incident.

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