How to avoid travel insurance claim rejections

Find out the most common reasons for the rejection of travel insurance claims, including areas such as theft, pre-existing medical conditions, alcohol and dangerous sports.

If you're unlucky enough to have to make a claim after your holiday, the last thing you want or need will be to see this turned down by your insurer. Read on for more information on some of the most common reasons for claim rejections:

Non-disclosure of a pre-existing medical condition

One of the main reasons why people take out holiday insurance is to ensure that they won't be faced with huge medical bills should they fall ill abroad.

Stethoscope

However, if you're not completely honest about any pre-existing medical conditions you have when you take out your policy it could put any subsequent claim for medical expenses in jeopardy.

You need to answer all the questions on the application as honestly as you can and to disclose absolutely everything. Your premium may be slightly higher because of your honesty, but if you try to hide something you may find yourself uninsured for any treatment needed for the condition, or a related one.

It's likely that an insurer will expect you to have obtained the recommended vaccinations and treatments for your trip - depending on your destination, anti-malarial tablets may be one example. Not taking such precautions could lead to a rejected claim.

Insurers will have strict instructions for what you should do in order to claim back medical expenses, including obtaining receipts or, perhaps, calling a special 24-hour helpline.

Always try to follow these instructions to the letter, but most insurers will accept that - in emergency situations - this may not always be possible, and that getting the quickest access to care may be the priority.

Theft or loss of personal belongings

Most policies will offer some cover for any lost baggage and personal belongings whilst you're on holiday. However, because this cover can be abused, insurers ask for proof that you did actually own the lost object in the first place.

Mobile-phones

It's reasonable to expect someone to have sufficient proof of ownership for a high-value item, especially one bought recently. Where proof of purchase isn't available, insurers will often accept manuals for electrical goods or photo evidence of ownership - what the insurer will accept as proof of ownership should be outlined in your policy documentation.

If you are taking a high-value item on holiday and you don't have proof of purchase for it, you should think carefully about whether you really need to take it with you at all.

Failing to obtain a police report after a robbery or failing to notify your insurer of a theft within a certain time frame is another reason why a claim may be turned down. For example, your insurer may want you to report a theft within 24 hours of becoming aware of it, so leaving it until you get home before you contact your insurer's helpline may be too late.

Another thing to bear in mind is that insurers expect you to take reasonable care of your belongings in the same way as you would if you were using them at home.

You wouldn't leave your wallet unattended on a cafe table if you'd popped out for lunch from work, so if you do this on holiday an insurer may argue that a loss or theft was due to your failure to take reasonable care of your belongings.

Alcohol exclusion

Most travel policies contain a clause about alcohol consumption but, although it is often highlighted, it is rarely invoked, and only then in cases where there's a very strong link between drunkenness and the circumstances of the claim.

Twisting your ankle on a kerb after a few drinks is very different to being extremely drunk and diving into the swimming pool from your hotel balcony

The majority of insurers expect holidaymakers to have a few drinks on holiday, but when it appears that their judgement has been badly affected due to their drinking - and when this has a strong bearing on the circumstances of the claim - an insurer may decline the claim.

For example, twisting your ankle tripping over a kerb on the way back from a few drinks at the bar is different to being extremely drunk and diving into the swimming pool from your hotel balcony.

Adventurous sports

Policies will have varying degrees of cover for adventurous sporting activities so it's vital that you buy the cover most appropriate for what you intend to do on holiday.

Bicycle

Most policies will provide an activity list showing what's covered under the standard policy, and this list is usually quite extensive.

Many will offer standard cover for activities such as parasailing over water, or scuba diving to a depth of 30m if you are qualified or diving with an instructor.

However, many policies don't cover quad biking, nor other similarly hazardous activities. If you want insurance for such things, you may either need to pay an additional premium, or to look for a policy offering such cover as standard.

Travelling against FCO or WHO advice

Be warned that most insurance companies will not consider claims if you've travelled to countries or trouble spots against the advice of the Foreign and Commonwealth Office (FCO) or the World Health Organisation.

Scooter

If you're in any doubt talk to your insurer, or look to the FCO website for guidance.

Motorbikes and mopeds

Some policies will not cover claims resulting from riding a motorbike or moped above a certain engine size, typically 125cc.

Check the wording of your policy under general exclusions to see if the insurer has conditions regarding riding mopeds and motorbikes. You may find you're covered if you want to ride a smaller 50-125cc machine, but nothing more powerful without the insurer's explicit permission.

Remember...

It's worth remembering that the vast majority of claims are paid out, and those that aren't are often down to genuine objections raised by the insurer - for example, non-disclosure of pre-existing medical conditions, claims which just aren't covered by the policy, failure to follow procedures, or fraudulent claims.

If you feel that you have had a genuine claim wrongfully rejected there is usually a referral procedure outlined by the insurer

Customers should always check the policy wording fully to ensure that they are choosing appropriate cover for their trip and for the activities they intend to participate in whilst abroad.

What to do if a genuine claim is rejected

If you feel that you have had a genuine claim wrongfully rejected there is usually a referral procedure outlined by the insurer.

An initial complaint would normally go directly to the insurer or claims handler. If the problem cannot be resolved it would then go to the underwriters, and as a last resort it could be taken to the Financial Ombudsman.

By Martyn John