TravTalk - India

Insure against claim rejections

Often travel agents and tour operators pay little or no attention to travel insurance and it is looked upon as an obligation. Here are some points that agents should inform their clients to avoid their travel insurance claim from getting rejected.

- Sukhesh Bhave Deputy Vice President (Accident & Health Claims) SBI General Insurance

Planning a vacation for clients can sometimes get stressful in an effort to make it perfect and memorable for them. However, many travel agents and tour operators pay little attention to a crucial element – travel insurance – which is often acquired more as an obligation than as a protective cover against risks involved in travelling on a foreign land. Worse, your client could get a shock when their claim gets rejected due to their carelessne­ss in dealing with the policy. Here are some circumstan­ces under which their travel insurance claim can get rejected that you, as the service provider, can help them understand. Incorrect informatio­n:

One of the major reasons to affect claims settlement is inaccurate informatio­n furnished by the claimant while explaining the circumstan­ces under which the loss/damage has occurred. For example, if the insured has incurred a loss due to neglect (leaving valuables on display in car or baggage kept unattended or unlocked etc), it may result in non-settlement. Similarly, if the insured gets involved in an accident under the influence of alcohol or any intoxicati­ng drugs, the insurance company can reject the claim. If the insured - while applying for insurance - has not answered all questions truthfully and accurately, the claim can be rejected later on. Undeclared medical conditions:

Often, we gloss over the need to declare existing medical conditions in the insurance form. However, this could prove a costly mistake. In case the existing medical condition leads to an accident or falling sick in the transit, you could end up paying your own money for the treatment without any reimbursem­ent. Exclusions in the policy:

You will have to look for exclusions in every policy and judge whether you need them or not. These are the most common reasons for internatio­nal travel insurance claims getting rejected. Travellers mostly buy a policy by merely signing and paying the premium rather than reading a single line though they will take extreme care to fill up other travel documents such as visas. Hence, it is advisable for clients to understand the terms and conditions of a policy before buying one to avoid any unpleasant surprises. Missing documentat­ion:

When the client files a claim, ensure that it is substantia­ted with enough proof such as copy of bills and receipts (especially if it is a medical emergency), proving that they have availed the services. Moreover, they may furnish or keep ready contact details of the doctor who treated them. Adventure activities:

If the clients injure themselves while indulging in an adventure sport, the claim is unlikely to be entertaine­d as majority of policies are unclear regarding which sports should be categorise­d as adventure sports and a risk to life. Travelling against internatio­nal advisory:

Foreign and Commonweal­th Offices (FCO) and World Health Organisati­on (WHO) have a list of locations and places that are termed risky or unsafe for travel. If your clients are planning a vacation to such blackliste­d areas, an insurance claim will be rejected outright. Claiming beyond a time frame:

Insurance companies usually expect travellers to file a police report or seek medical assistance within 24 hours for their claim to be viewed as valid. Thus, a prompt record of the same on paper can get them faster reimbursem­ent. Changing rules:

The insurance company will modify or alter rules as per regulatory or internal guidelines. Travellers must read and understand the terms and conditions. The insurance company may be well within its right to reject the claim but if clients feel aggrieved with the decision, they have a right to complain.

They must check details of their policy to see if the explanatio­n offered by the company is a valid reason for the rejection. Sometimes, poorly explained documents can hamper their claims. ( The views expressed are solely of the author. The publicatio­n may or may not subscribe to the same.)

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