Claims made by families when travelling can be more complicated than when individuals make a claim alone. More people traveling means there will be multiple medical records, all of your suitcases (or bags) and very possibly many flights to cancel. Claim examiners have an internally established list of items they review prior to approving a claimant’s payment, and by knowing what they do, travelers may be able to provide better documentation from the beginning.
Documentation Requirements Examined By Assessors
Each legitimate travel insurer has developed an examination checklist of documentation based upon the General Insurance Code of Practice in Australia or similar frameworks such as the ABI Code in the U.K.. In general, assessors ask families to supply:
Booking confirmation documents for each person listed on the booking
Medical reports detailing the exact nature of illness with ICD-10 diagnosis codes where applicable
Police reports regarding theft or loss submitted no later than 24 hours after the event
Receipts showing proof of payment using the credit card or financial institution associated with the traveler(s)
Written timelines documenting the events surrounding the claimants’ accident and/or injury; this document should be signed by the claimant/policy holder
If documentation required is missing, it typically causes assessors to request additional information. This is typically the number one reason why claims take longer than ten business days to process and ultimately settle (the service time frame most travel providers advertise). Companies specializing in multi-traveler/family type policies in Australia (such as Go Insurance), tend to post these types of requirements for preparation online so families may gather necessary documentation prior to filing a claim.
Pre-existing Conditions And The Under 18 Rule
Pre-existing medical conditions are responsible for almost half of all disputed claims world wide. Research completed by the Association of British Insurers states approximately one-in-four rejected travel claims cite undiagnosed conditions. Families’ claims become increasingly difficult due to younger children who are often covered under parents’ policies and therefore must disclose their own medical history.
Three areas are reviewed by assessors:
Was the condition diagnosed prior to commencement of coverage?
Were symptoms exhibited during a defined ‘look back’ period (usually 90 or 180 days)?
Was any prescribed medicine or treatment being administered at time of departure?
Travelers frequently fail to report asthma in their minor children, or that their child had a visit to the doctor for an ear infection recently. Even if related to the claim filed, failure to disclose can result in nullification of the family’s policy through standard duty-to-disclose provisions.
Regional Differences That Shape a Decision
The country in which the incident occurred influences how fast a claim can move. Those claims originating from countries participating in reciprocal healthcare arrangements (for example: Australia and Belgium, Finland, Ireland, Italy, Malta, Netherlands, New Zealand, Norway, Slovenia, Sweden and the U.K.) normally resolve more quickly since a portion of the expense of treatment is borne by public healthcare programs. Claims originating from the United States on average require the longest amount of time to settle due to extensive itemized billing received from hospitals which can include thousands of dollars in bills.
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