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Common factors for rejection of travel insurance claims

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International travel insurance

Common factors for rejection of travel insurance claims The International Travel & Health Insurance Journal has recently summarized some research by an Australian financial website listing the main reasons why insurance claims are rejected (ITIJ Issue 157, 2014).

Intoxicated during accident

The top reason for an insurance claim to be rejected by a travel insurer is that the policyholder was intoxicated at the time of the accident or injury occurred. This is why it is very important to fully understand the limitations of a policy before purchase to understand your risk and not get surprised by a rejection.

Participation in adventure sports

The second most common cause for rejection is because the accident occurred while participating in an extreme sport. Some policies do have coverage for some of these activities. It is important to note that some activities, such as motorcycle riding, while may not be considered extreme to most are NOT covered by some policies without some sort of adventure sports rider.

If you are anticipating doing some exciting activity while you travel, be sure to look for a sports rider and furthermore, that the activity you want to do is SPECIFICALLY LISTED on the rider. Some extreme sports, like motocross, are rarely covered, but check out the Diplomat America plan. Other activities, such as bungee jumping or white water rafting can be covered by several plans (Patriot America with rider, Travel Medical Basic with rider, Atlas America no rider needed).

Applicant's pre-existing conditions

The third cause for rejection is because the sickness was due to a pre-existing condition. It is important to note that some policies DO have limited coverage for pre-existing conditions for those policies), but these will have limitations. For example, a person must be stable before a condition could be covered.

if you are still recovering from illness or surgery, this will NOT be covered. Also, some specific pre-existing conditions are NOT covered generally under any circumstances. The most common pre-existing conditions that are excluded are pregnancy, cancer, HIV infection, and chronic illnesses.

Coverage for pregnancy

That leads to the fourth most common cause for rejection by travel insurers: complications of pregnancy. Atlas America (for travel to the USA) or Atlas International (travel anywhere else) covers complications of pregnancy in the first 26 weeks of gestation. NO OTHER policy will cover such complications due to pregnancy, so if this is of special concern, be sure you get the right policy!

In sufficient proof

One of the reason why insurance claims gets rejected could be because the insured /claimant has not provided considerable proof and within the given time frame.

Coverage in restricted areas

The final reason for rejection is because traveler is in a region where they have specifically been advised not to travel. Coverage is not provided in war zones and other places that the US State Department does not recommend travel. If you find yourself in a region where the US State Department advises travelers to vacate, some policies cover and even help coordinate your evacuation from that area.

Some policies cover injuries and losses due to terrorism. If any of these are a possible concern in your voyage, you can consider the Travel Medical Basic policy with specific coverage for terrorist attack.

The only information I would add to a potential client is that it is important, of course, to provide complete and accurate information on your application since this can also be a cause for a rejection later on. Furthermore, you should be aware of the procedure for using your insurance and filing a claim (if necessary). In my experience, insurance companies are more than willing to deal directly with a medical provider to arrange payment (the reverse may not be true).

You and/or the medical provider can give them a call and they should answer 24/7 for any medical emergency situation. It may be necessary to pre-certify medical costs with the company BEFORE they are incurred. These are generally high-cost expenses. For example, you must inform the insurance company within 24 to 48 hours of being in a hospital (if possible).

In this case, I would not rely on the provider to call, but I would advise you to call yourself, if you are able, to let them know what is going on. They will also be able to help you understand the claims process. When in doubt, I would make the easy, toll-free call and keep your mind at ease.

As always, we wish you safe and healthy voyages!

What does visitor travel insurance cover?

medical expensesHealth care expenses
Covers hospital expenses for sickness or accidents.
doctor visitDoctor visit
Insures Doctor visits for sudden injury or sickness.
pharmacy drugsPharmacy drugs
Doctor prescribed eligible pharmacy drugs expenses.
medical evacuation Medical evacuation
Medical evacuation expenses to nearest facility included.
repatriation of remains Repat of remains
Repatriation of remains to home country included.

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Cost of best US travel insurance for pre-existing conditions

Best travel insurance with pre-existing condition coverage -

For eg - Age: 40 years; Duration: 1 Month; Deductible: $0

Plan name
Pre-existing coverage
Estimate Plan Cost+
(Plan maximum coverage)
  • Covers acute onset of pre-existing conditions up to chosen maximum limit (aged up to 70 years).
  • Patriot America Plus Covid insurance offers coverage for coronavirus illness.
  • Available for US citizens visiting USA
Coverage: $50,000 - $1,000,000?
Price range: $90 - $170
Buy now
  • Covers acute onset of pre-existing conditions up to chosen maximum limit aged up to 79 years (excludes chronic and congenital conditions).
  • Atlas America Covid insurance offers coverage for coronavirus illness.
Coverage: $50,000 - $2,000,000 ?
Price range: $110 - $230
Buy now
  • Safe travel USA Comprehensive Covid insurance offers coverage for coronavirus.
  • Covers Acute Onset of a Pre-Existing Condition: Up to 69 years the limit is up to the Medical Maximum purchased per Period of Coverage. For any coverage related to cardiac disease, coverage is limited to $25,000 up to age 69 years and $15,000 for ages 70 and above. Above 70 years the Acute Onset benefits is reduced to a Maximum of $35,000, with a $25,000 Maximum Lifetime Limit for Emergency Medical Evacuation. Any repeat recurrence within the same policy period will no longer be considered Acute Onset of a Pre-Existing Condition and will not be eligible for additional coverage.
  • It offers coverage for visitors up to 89 years.
Coverage: $50,000 - $1,000,000 ?
Price range: $90 - $160
Buy now
  • Covers Up to $1,000 for sudden, unexpected recurrence of a Pre-existing Condition
  • Safe travel USA Covid insurance offers coverage for coronavirus.
  • It offers coverage for visitors up to 89 years.
Coverage:$50,000 - $1,000,000 ?
Price range:$90 - $160
Buy now
  • Covers unexpected recurrence of a pre-existing medical conditions up to $1000
  • Safe travel USA Cost Saver Covid insurance offers coverage for coronavirus.
  • Eligible for foreign residents visiting USA and worldwide
  • It offers coverage for visitors up to 89 years.
Coverage: $50,000 - $1,000,000 ?
Price range: $70 - $120
Buy now
  • Travel Medical Plus Covid insurance offers coverage for coronavirus.
  • Including USA: Acute onset of pre-existing conditions are covered up to $50,000 for age under 69 years and a coverage of $5,000 for age of 70-79.
  • Excluding USA: Acute onset of pre-existing conditions are covered up to $50,000 for age under 64 years and a coverage of $10,000 for age of 65-74.
Coverage: $50,000 - $1,000,000 ?
Price range: $160 - $290
Buy now
  • The policy maximum for this comprehensive insurance starts from $50,000 and provides up to $5,000,000. For people above age 80 years, they get a policy maximum of $10,000
  • Including USA: Acute onset of pre-existing conditions are covered up to $25,000 for age under 69 years and a coverage of $2,500 for age of 70-79.
  • Excluding USA: Acute onset of pre-existing conditions are covered up to $25,000 for age under 64 years and a coverage of $5,000 for age of 65-79.
Coverage: $50,000 - $1,000,000 ?
Price range: $110 - $180
Buy now
  • This plan is for Non Us citizens and Non US residents visiting the US.
  • Covers pre-Existing condition exclusion: 24 Months prior to the start date of coverage
Coverage: $50,000 - $1,000,000 ?
Price range: $130 - $220
Buy now
Best travel insurance with pre-existing condition coverage -
Plan name
Pre-existing coverage
Estimate Plan Cost+ with plan maximum coverage
  • Visit USA Insurance is an excellent medical insurance for tourists and holiday travelers, parents of students studying in the United States, new immigrants and visiting scholars in the USA.
  • Visit USA offers 3 plans to satify your requirements and budget.
  • Covers Acute onset pre-Existing condition up to Ages 65 and above: $2,500 ; All others: $20,000(excludes chronic and congenital conditions)
Coverage: $50,000 - $250,000 ?
Price range: $50 - $190
Buy now
  • It offers coverage for acute onset of pre-existing conditions up to 70 years.
  • Plan can be renewed up to 364 days.
Coverage: $50,000 - $130,000 ?
Price range: $40 - $80
Buy now
  • Foreign residents visiting USA and worldwide.
  • Plan can be renewed up to 2 years.
  • The plan provides Emergency Medical Evacuation of $100,000 for the Economy, Basic and Silver plan and covers up to policy maximum for the Gold and the Platinum plan.
  • Acute onset of pre-existing condition is covered up to policy maximum up to the age of 69.
Coverage: $50,000 - $175,000 ?
Price range: $40 - $60
Buy now

+ - Factors that determine the cost of US travel insurance plans:

Age of the traveler

The cost of travel insurance is directly proportional to the age of the traveler. The older the traveler and greater will be the cost of the visitors health insurance.

Type of travel insurance

Comprehensive travel insurance which provide exhaustive coverage are more expensive than fixed benefit travel insurance.

Medical maximum coverage and deductible options

The price of visitors medical insurance is directly dependant on the maximum medical coverage and inversely proportional to the deductible of the plan chosen.

Region of coverage

Travel insurance depends on the coverage region. The cost for visitor health insurance for the United States is most expensive.

Duration of travel insurance

The longer the duration of visitor medical insurance required, the higher will be the cost.

Travel Insurance for Pre-existing - FAQ's

Which travel insurance covers asthma?

Travel insurance is coverage only for unexpected medical expenses while you are on a trip away from home. Some companies offer coverage for what they call "acute onset" of a pre-existing condition (excluding chronic or congenital disorders). This would be a life or life-style threatening situation that cannot wait to be taken care of when the trip is over.

It must be "acute" meaning that it came on suddenly and needs to be taken care of quickly (defined as within 24 hours of symptom onset). A "pre-existing condition" does not necessarily have to have been previously diagnosed. If it is reasonable to assume that this condition started in the patient before the start date of the insurance, then it will be considered pre-existing to the policy. Note that the exclusion for chronic (conditions that worsen over time) and congenital (conditions a person is born with) limit greatly the application of this exception.

If asthma is not considered chronic, then an emergency due to asthma could be covered by a policy which covers at least "acute onset" of pre-existing conditions. If a person requires regular medication and/or doctor visits for their asthma, this will NOT be covered and will have to be paid by the insured completely out of pocket.

Note that in the US, the same medications can differ widely in costs depending on the pharmacy you use and some medications (generally generics) for common illnesses can be purchased for $40 per month at the Walmart pharmacy (although there may be long wait times). Also, some drug companies have special "coupons" available online for some of their drugs. There are often "discount cards" available at pharmacies and other stores for prescriptions that are free to use.

These are all resources your visitor can use to avoid paying full price for costly required medications should they run out while they are in the US. Other countries may not require a prescription and may not be as costly to obtain. Having a prescription with you, however, may be a good idea to ease getting the medication and show authorities you are allowed to have it (in the case of regulated substances which can vary country to country).

Do I need to declare arthritis on travel insurance? Do I have to declare rheumatoid arthritis on travel insurance?

No. When you purchase any of our travel insurance plans, they offer guaranteed coverage with no medical questions. However, be aware that they all exclude pre-existing medical conditions. So, please take any medications you use regularly or for flare ups of your conditions since these will not be covered by travel insurance. As far as I know, arthritis cannot lead to a life-threatening situation, so will be excluded from coverage by short-term travel policies.

If you are a frequent traveler and want major medical coverage in any country to which you travel, you can opt for global medical policies which will (after the first year, generally) cover all aspects of health costs.
You can Compare and buy Global health insurance policies. To apply for these policies, you will have to reveal your entire medical history and you are not guaranteed coverage.

The application must go through underwriting and you can be approved, rejected, or approved with exclusions. In any case, you can opt out of the policy 10 days from your approval for no cost to you or simply reject the exclusions they require on the policy. Note that these policies are best for people who want health insurance for a whole year, or better, longer.

Once you are approved on the plan, you are guaranteed coverage year after year and the price is determined by your age group, not your individual medical history. So, in the case of a global medical insurance application, you would have to declare your arthritis on the application and you may or may not be covered for that illness by the policy they offer you.

Can you get travel insurance if you have a pre-existing condition?

Absolutely, yes! Travel insurance is meant to cover you in the unlikely event of a sudden illness or accident while you are on your trip. Even if you have a pre-existing condition that complicates treatment, that is not relevant to the coverage for an unexpected illness or injury.

Naturally, your pre-existing conditions themselves are excluded from coverage, so you should pack as much medication as you will comfortably need for your trip.

Is osteoarthritis a pre-existing condition?

Yes. Any medical condition you have been diagnosed with or are being treated for will be considered pre-existing to a new travel policy. If you take regular medication for your condition, this will not be covered by the policy. However, should you, for example, have an accident and break a bone, this would be covered even if your condition may have made you a little more vulnerable to the break (unless you were being particularly reckless).

Accidents are generally always covered (car accidents are more complicated because if you were not at fault, the driver's insurance may cover part of your injuries) unless caused by intoxication.So, even if you have osteoarthritis or some other pre-existing condition, you are still eligible for coverage by a travel insurance policy which will protect you from sudden illness or accident/injury while you are on your trip.

Which travel insurance covers heart attack?

This is a tough question. And, unfortunately, the answer depends on where you are traveling to and from.
For people that are traveling to the US from abroad:
As a broker, I am not a medical professional, so I can only tell you this from the insurance side of the question. Generally speaking, the most common cause for heart attack as I understand it is due to plaque build up in the person's arteries.

Since that build up happens slowly, over time, I think it's fair to say that it would NOT be covered by any travel health insurance. This is because travel health insurance excludes pre-existing conditions from any coverage (even emergency coverage if they are chronic or congenital). So the answer for the common cause of heart attacks is NO. So, foreigners run a risk (hopefully a small one) when traveling here.

Health insurance can still help with costs of accidents and other unexpected illnesses while on vacation. However, the answer is be different for people who are US residents traveling abroad. US residents can purchase trip cancellation plans and some of those waive the pre-existing condition exclusion IF you purchase them within a short time of your initial trip deposit (that is the earliest date you pay for any portion of your trip).

Check out trip cancellation plans. Notably, the GeoBlue student and travel plans also waive the pre-existing condition exclusion for people who had creditable prior insurance coverage, and these plans are only available to US residents with US domestic coverage. And, for travel plans for US residents going abroad, some, like the Safe Travels Outbound plans, will cover pre-existing conditions IF they have been stable in the last 6 months (meaning there have been no changes, episodes, or changes to medication in that time frame). You can Compare Safe Travels Outbound Insurance plans.

Is arthritis covered by insurance?

No. Travel health insurance is meant to cover a sudden illness or accident, such as you get a stomach flu or you twist or break your ankle. Since arthritis is not a life-threatening illness, it will not be covered by a short-term travel plan. Should you require regular medications or ointments, you should bring them or purchase ointments available in the visiting country for your condition.

Some countries may not require prescriptions to purchase medications. However, you should be cautious in using a new medication since there may be side-effects of concern. You may want to stick to what you know or consult with your own physician if you can.

General - FAQ's

Can I travel to the USA without travel insurance?

Definitely, one can travel to the US on a tourist visa without travel insurance, however it is very important to have travel medical insurance as it can be financially suicidal being admitted to an US hospital without any insurance.

The healthcare costs in the US are extremely high and good travel insurance will put your mind at ease during your international travel.

When should I take out travel insurance?

It is always recommended to purchase travel insurance before you depart your home country and start the travel. This is to make full and genuine use of the insurance so that you are covered from day One when you are in a foreign country.

However, you can also purchase the insurance after arriving at your destination country. Some insurance plans might have arrival time restriction where the insurance must be purchased within 30 days after arriving in the destination. This time could be 6 months as well depending on the age of the person.

Is travel medical insurance necessary?

Some of the countries have made it mandatory to have travel insurance before starting the travel. While the travel insurance takes care of the unexpected incident coverage travel plans extend their coverage benefit to cover emergency coverage in case of sudden recurrence of a pre-existing condition, repatriation, evacuation, trip interruption, baggage delay and loss which definitely makes a very necessary requirement for a traveler.

What are the benefits of travel insurance?

Travel insurance not only covers the unexpected incidents and injuries and takes care of the hospital costs, it also extends coverage for acute onset of pre existing condition, emergency evacuation, repatriation, trip interruption, trip delay, baggage loss or delay...some of the travel insurance plans offer coverage for adventure sports.

Resourceful visitors medical insurance information

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Covid19 travel insurance for international travelers

While travelling in the midst of a coronavirus pandemic, one must ensure that they have the right travel health insurance with proper Covid-19 coverage. At America visitor insurance travelers can get visitors insurance for Covid -19 illness.

We offer a range of options for visitors where they can compare using our Visitors insurance for Covid19 comparison tool based on the factors like the travelers age, duration of travel, the maximum coverage required, deductible and the need for pre-existing conditions or for covid coverage.

Travelers can narrow down their search further by applying the “filter” option for Covid19 available in the tool. Please know we are here to help you make the best, informed decision to get coverage even for COVID19! Let us know how we can assist you. Feel free to contact us by email or phone at any time.

US visitors insurance providers

You can find reliable US insurance providers like International Medical Group(IMG), Seven Corners, WorldTrips, Global Underwriters, Travel Insure, GeoBlue, HTH Worldwide and INF insurance.

US visitors insurance providers

IMG
SevenCorners
WorldTrips
Global Underwriters
GeoBlue
Trawick
TravelInsure
INF

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