Some of the Reasons for Claim Denial

Answer correctly to the Medical questions:
One of the main factors that can lead to a Claim denial is Improper answering to medical questions in Insurance application. While answering make sure you understand the questions well, If not ask the insurance agent. Use insurance company's help line to contact with experienced medical staff to clear your doubt. If you are not sure about your medical condition, then consult a doctor.

Recently a senior couple was billed $107000 despite having a travel health insurance only because of pre-existed heart condition, atrial fibrillation, which wasn’t disclosed on the insurance application.

So Never give incorrect answers to the questions, Always disclose any relevant information about your medical history while answering to insurance application. Failure to disclose can lead to some unfortunate surprises which may result in denial of your claim.


Understand Your policy
Usually travellers purchase Travel Health Insurance for peace of mind. First of all insured must understand the insurance policy that they had purchased. They should be aware of which all conditions are covered by the policy. Claiming for a medical condition or illness which is not covered by the policy can lead to denial of the claim.

Insured must make sure  which all pre existing conditions are covered by Insurance policy:
Pre-existing medical conditions attempt to address any medical condition that an insured had prior to travel, and therefore is not covered by the emergency nature of the travel insurance policy. Read my previous article to know about Pre-Existing conditions and its definitions.


Confirm the scope of your insurance policy:
Your provincial insurance policy will cover only a very small fraction of medical expense that could happen in an outside country trip. So make sure to insure yourself with a good travel insurance plan provided by a reputed and trust worthy private insurance company. Check how to choose the travel insurance.


Some Travel Health Insurance Tips

Matters that Snowbirds should be aware of

Before snowbirding to US vacation places, it would be appreciable if snowbirds check themselves to confirm whether they are aware of certain important matters such as...

• How to handle emergency situations like accidents or illness that may happen while they are in US.
• What are the tax implications on vacation home in US, if you own it.
• Will you have to file US tax return if you have earning from your US holdings.

How to handle emergency situations like accidents or illness
Emergency situations can be any thing like illness, accidents or baggage loss that may happen while you are travelling. So snowbirds  must make sure that they are well covered from all these. Provincial Health insurance will cover only a mere fraction of your outside country health care cost. Snowbirds are strongly advised to purchase an additional health insurance from a private insurance company before you leave your home province. Without insurance, an unexpected medical expense in the U.S could drain the savings of your life time.

Surveys of leading travel organization suggest that Comprehensive Coverage is the most important attribute to travel medical insurance. So find a reputable company that understands the risks of travelling with medical conditions, and that write insurance policies that actually cover insureds for such conditions, at reputable prices. Travel Organisations such as CSA(Canadian Snowbird Association) and Royal Canadian Legion recommends Medipac as a good option for travellers.

Declaration of foreign Property
Foreign property includes the US bank accounts and foreign stocks in your Canadian brokerage account. You have to mention this while you submit Your Canadian Tax return. in the form their will a question like -- "Did you own or hold foreign property at any time in 2011(Assessment Year) with a total cost of more than $100,000 (Cdn)?" -- and here you have declare your foreign property.

File US Tax Return and US Estate Tax
If you stay more than 122 days a year in US, then IRS (Internal Revenue Service) will treat you as a resident Alien. Submit IRS Form 8840, a Closer Connection Exemption Statement for Aliens to prove you are a resident of Canada so that you are exempted from filing Tax in US.

If you die while owning U.S. property worth of over 60,000 US Dollars, your executor will be required to file a U.S. estate tax return, whether or not any U.S. estate tax is payable. The typical Canadian snowbird's estate should be exempt from U.S. estate tax if the worldwide value is under 5 million US dollars. The exemption limit is changeable according to Government Decisions.

Travel Insurance Discounts

Travel Insurance Discounts are an interesting concept in the world of travel medical insurance. The type of discounts being offered by respective insurance companies might provide insight into the credibility of the insurance provider. Some insurance companies will merely use discounts as a ploy to attract unsuspecting potential clients; while other, more reputable, companies will use discounts as a basis to support their price/coverage models. 

An example of a travel insurance discount that has little to do with proper coverage is a companion discount, or a discount offered for online transactions.

When establishing a risk profile for a traveller, one that is based on medical conditions, the method of purchase and a discount thereon, is irrelevant. Where such discounts exist, this may be a clear indication that the insurance provider knows very little about what is actually at risk, and may not be able to handle complex medical emergencies, should any arise.

Same goes with companion discounts. Travelling with a companion has little impact on the medical condition of another. 50% of the Canadian population is married (75-80% of the snowbird market) and will travel with a companion/spouse. One might argue that since a traveller has a companion that in the event of a medical emergency someone is available to act on the insured's behalf. Traveller's typically travel to destinations where there are plenty of people, which mutes this case.

Now, reputable travel insurance companies that provide loyalty or claim free discounts seem to understand the risks involved in properly insuring travellers for emergent medical/health conditions. Discounts offered for loyalty are geared toward a class of individual that is more cautious and conscientious - someone who is more dedicated, whether toward an organization or their health.

Claim Free Discounts are geared toward those individuals that are healthy and or do not make frivolous travel insurance claims. Travel insurance truly is exists to mitigate the financial risks of having a major medical incident while travelling, rather than minor check-ups. Clients that recognize this fact are more apt not to make travel insurance claims, and therefore are offered a discount on the insurance policy based on the number of years they have gone without an insurance claim. This model has existed for years in other insurance industries, and has been successfully been implemented into only a few travelinsurance plans.

Do you have faith in travel insurance?

Here is a great example of a travel insurance company that is interested in one thing - profits!

Do you have faith in travel insurance?

If you read between the lines, you will see that terms of the policy were open to interpretation, and that where the medical term in the policy is being interpreted by a medical professional, ie doctor, the client is covered; whereas, where being interpreted by a lawyer with limited knowledge in the medical field, the claim is denied. Either way you read the article, it appears the claim should have been paid.

I have read other articles, however, that are more clear cut, and the insureds tried to use the media to corner the insurance companies, and force them to pay a travel insurance claim on a clearly deniable scenario. A great example of this is where the client gets drunk, falls off a balcony, submits a claim for his or her injuries, the claim is denied based on the level of alcohol in his or her blood, then goes to the media as a victim! Get serious. Does the insured not realize that they are only harming their image, and that for the most part the public will read between the lines and side with the travel insurance company that denied the claim in the first place?

That said, regarding the article, should you happen to read the comments from the readers on the travel insurance industry, it is evident that – regardless of the shameful act of the insurance company in this particular case – the readers haven’t a clue about what travel insurance is about and why a person of sound mind should purchase coverage.

Travel Insurance Coverage is for emergency health care, and it should not considered for the coverage of any pre-existing condition, routine medical review, or to expedite treatment of a condition in a foreign country where medical care is not accessible in Canada in a timely manner.

There are unique travel insurance companies, however, that promote the concept of coverage for stable pre-existing conditions. Whether through their regular travel insurance plan, or through a special underwritten insurance policy, always disclose all pre-existing conditions. Reputable plans will be able to offered coverage for most stable pre-existing conditions.

Travel insurance is a contract. And the contract in the case of travel medical insurance is contemplated for the coverage emergent medical conditions of sound people of sound mind. People that binge drink and that are alcoholics in reality cannot be considered of sound mind, and therefore coverage for alcohol abuse and alcoholism is never a covered term under any travel insurance contract. Alcoholism would be considered an unstable pre-existing condition, and therefore not covered.

Travel Medical Insurance - Emergency Assistance Services

Medical emergencies while travelling are the impetus behind purchasing travel medical insurance. But what does an insurance company know about medical emergencies? When one buys travel medical insurance, are they not merely reducing their potential financial risk? Why should you consider the a travel insurance policy anything more than a financial product?

Well...YES! Travel medical insurance can greatly reduce the risk of the financial perils that are associated with a medical emergency that may occur while travelling - especially to the United States where health care costs are out of control!

BUT...a medical emergency often is not just a stubbed toe or a broken arm, where you go to the hospital or doctor, you get fixed and pay $100, then submit a claim to the insurance company for reimbursement. Sometimes a medical emergency can be a complicated condition, such as a heart attack, or vehicle accident. In such emergencies, a traveller needs assistance to navigate the complicated medical systems they will find abroad when travelling. If your medical emergency finds you incapacitated or bed ridden, you will require a great deal of assistance. This is where the services of the travel medical insurance company come into great use.

Travel insurance companies almost always use a emergency assistance services company to manage any medical emergencies of insured travellers when travelling. These companies are ofter knowledgeable about the health systems abroad, and the protocols required in order to receive appropriate care. However, you must be cognisant that these companies also, are responsible to applying the travel insurance policy to an insured's medical emergency, and to determine if the traveller is actually coverage by the insurance they purchased.

So what happens in the event of a medical emergency when travelling? Well, the first thing that you should do is manage the emergency first. Call 911 or the local authorities for help. Then, and when able, contact your travel insurance company. This is where minutes can save lives! Often these emergency assistance companies will answer your calls for assistance using call-center staff that are not medical professionals! They then screen the call to determine if medical attention is required. If such is the case, the call will be transferred to a medical professional, either a doctor or nurse.

Imagine talking with a $10 per hour call center clerk, during a heart attack, then waiting on hold to receive proper instruction from a real doctor or nurse.

There are some emergency assistance companies that take their roll in providing emergency medical assistance services very seriously. Such companies strictly use medical professionals to answer their emergency assistance lines. That means during a medical emergency, where minutes can save lives, an insured's call for assistance is answered immediately by a real doctor or nurse. There is no screening process and no waiting on hold for an available nurse.

When selecting a travel medical insurance policy, do your research! Read travel insurance surveys and reviews. Ask about the emergency assistance services that support your insurance policy. If the emergency assistance lines are not staffed exclusively with medical professionals, then the travel insurance policy should not be considered. Minutes can save lives, and when its your life, make the right choice.

Check out the emergency assistance services and travel medical insurance product recommended by the Royal Canadian Legion - www.RCLInsurance.ca. It appears they only use nurses to respond to medical emergencies.

Travel Insurance Pre-Existing Conditions

Travel insurance pre-existing conditions are one of the most important areas of concern for any travel insurance plan. Next to eligibility criteria, pre-existing medical conditions can dictate whether or not you have actual insurance coverage, should a medical emergency occur while on vacation.

While an individual may purchase travel medical insurance for peace of mind, they must remain cognizant of that fact that an insurance policy is a contract and has, by definition, conditions and clauses that may render the contract for insurance ineffective, or null and void. Pre-existing conditions are an example of such clauses, and therefore one should fully understand these prior purchasing the travel health insurance policy, and more importantly prior to travelling.

Travel Insurance Reviews

Travel insurance 101 talked about the importance of a Canadian traveller understanding their travel medical insurance policy they've purchased prior to traveling. That is the most important aspect to snowbird insurance.

But, how does one know what type of travel health insurance to purchase?

Well, the are several important Canadian associations that support the travel, snowbird and senior lifestyles; namely, the Canadian Snowbird Association and the Royal Canadian Legion. These associations make up Canada's most experienced travelers who know and understand the importance of protection.

Travel insurance 101

Travel insurance - the best way to start  a blog about travel insurance is to describe the what's important in a travel insurance product. Well its the policy! You can buy cheap, you can buy expensive, or somewhere in between. Bottom line is - if you don't understand your travel insurance policy, you're throwing your money away!

Most travellers think that nothing will happen on their travels. And, most are right. But that's not why we buy travel insurance. Some buy travel insurance for the trip cancellation portion. Some buy it emergency medical insurance. Some buy it for the baggage insurance. And some buy it for all of the above coverages. Mostly travellers buy travel insurance for peace of mind.