Reasons why a travel insurance claim may be declined


Your insurance agent Imana insurance Agency Ltd is here to help you understand the dos and donts of travel insurance.
No one wants anything bad to happen while they’re on vacation but if it does, travel insurance can help cover your expenses relating to a medical emergency, a cancelled or interrupted trip or lost baggage; unless your claim is declined.
We’re reviewing reasons why travel insurance claims are declined to help you avoid this situation and ensure you’ll be protected while you’re on vacation:

  • The incident wasn’t due to a sudden or unforeseen event.
  • The Government of Kenya issued a travel advisory before you booked.
  • Omitted or lied about a pre-existing condition.
  • Illegal activity.
  • Drug or alcohol consumption.
  • Not having the correct coverage for sports or certain activities.
  • Injuring yourself in a place that’s off-limits.
  • Lack of documentation.
  • Travel to uncovered region
  • Misrepresentation of facts when filing a claim

What is travel insurance?
Generally, there are several different insurance products that fall under the umbrella of travel insurance including:

  • Travel Medical Coverage – covers emergency medical expenses while you’re abroad including transportation to medical facilities or home to continue treatment.
  • Trip Cancellation Coverage – if you need to cancel your trip unexpectedly before you leave this protection can help reimburse you.
  • Trip Interruption Coverage – if you need to go home early unexpectedly due to an issue back home or you’re prevented from continuing your vacation this coverage will help reimburse you and cover the costs to get you home.
  • Baggage Coverage – this covers the basic necessities or luggage replacement if your baggage is lost stolen or delayed.

We’ll walk you through each of these reasons why travel insurance claims are declined and how you can avoid them.

Not a sudden or unforeseen event
Insurance is always for emergencies – unexpected events or disasters. Here are some travel insurance scenarios that wouldn’t be covered:

  • You booked a vacation but don’t feel like going anymore.
  • A close relative was in poor health when you booked a trip.
  • You forgot your luggage at home.
  • You wanted to go for a routine doctor’s visit while abroad.

The Government of Kenya issued a travel advisory before you booked
The Government of Kenya maintains travel advice and advisories for all countries. Check this database before you travel – if a travel advisory is issued before the date of booking your trip (and the purchase of your travel insurance policy) you won’t be covered if you try to make a claim related to that advisory.

For example, if you booked a trip to the Netherlands and a few weeks later you found out you’re expecting! But now you’re concerned about covid-19 and want to cancel your planned vacation. However, the Government of Kenya had posted a travel advisory about covid-19 before you booked. In this scenario you wouldn’t have coverage.

However, if a travel advisory is issued after you book your vacation and purchase your travel insurance, you’d be eligible to make a successful claim.
Let’s say you booked a trip to Hawaii and there was no travel advisory about covid-19. You book your trip and find out you’re expecting – and now covid-19 has spread to this beautiful island. In this case you would likely be covered because the Kenyan government didn’t issue a warning until after you booked your trip.

Omitted or lied about a pre-existing condition
A pre-existing condition doesn’t mean you can’t get travel insurance – but you do need to be honest about it. In some cases, you may be covered for that condition although your travel insurance premiums may be higher. Alternatively, you may be able to purchase travel insurance and just your pre-existing condition won’t be covered.
No matter what be honest on your insurance application as otherwise any claim you have can be denied due to misrepresentation.

Illegal activity
Illegal activities aren’t covered because you’re breaking the rules of wherever you’re visiting. It’s on you to know the laws before you go.

Drug or alcohol consumption
Drugs and alcohol impair our ability to make good decisions and increase our risk for an injury or illness. It’s not that you can’t consume any alcohol or legal drugs while you’re on vacation – it’s making sure you aren’t putting yourself at risk by being over-intoxicated or participating in an activity where alcohol or drugs can put you at more risk.

Not having the correct coverage for sports or adventure activities.
Vacation is for trying new things and participating in your favorite activity. But if you’re planning to do an adventure activity or your favorite sport abroad make sure it’s covered by your travel insurance. If it isn’t you may be able to get special add-on protection to cover that activity. Many tours or activity operators will also offer insurance if yours doesn’t cover you.
Here are a few activities that may not be covered without add-on protection:

  • Backcountry skiing snowboarding snowshoeing and snowmobiling
  • Base jumping
  • Bobsledding luge and skeleton
  • Canyoning
  • Ice climbing
  • Mountain biking
  • Mountaineering (over a certain elevation)
  • Paragliding or parasailing or hang gliding
  • Scuba diving (below a certain depth or without certification)
  • Skydiving

Keep in mind that what’s covered will vary by the insurance company. Talk to your insurance agent and they can help find you the coverage that will include that activity.

Injuring yourself in a place that is off-limits or out-of-bounds
If an area is marked as out-of-bounds or off-limits it’s generally for good reason. If you injure yourself while adventuring in such an area your claim will likely not be covered as you’ve chosen to break the rules ignore warnings and put yourself at a high level of risk.

Lack of documentation
You’ll need to provide documentation to your travel insurance company if you make a claim. If you can’t provide this evidence you may find your claim being declined.
Always keep copies of:

  • Written proof of cancellations
  • Doctor’s notes/reports and receipts
  • Police reports/abstracts
  • All receipts

Time of buying travel insurance can also impact a claim
It’s important to buy at the right time. If you want trip cancellation or interruption coverage you should purchase this coverage at the time of booking.
Travel medical insurance should be purchased before you leave. It can even be purchased while you’re travelling although there will be a waiting period before you’ll be able to use it (and the injury or illness must originate after that date).
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