What is a Claim?

Photo By: Hui Quan Yang

Claim

A request to have a medical expense paid by the insurer.

GOOD TO KNOW

Depending on the plan, you cannot or may not need to file a claim if:

  • You have not exceeded the deductible or co-insurance amount stated in your plan (the medical expenses you incurred abroad are less than the total amount you agreed to pay before the insurer starts paying).
  • Your insurer pays the medical provider directly at the time of service because you were pre-approved for care.

IMPORTANT

Check if your plan has a right to examine clause. In addition to reviewing your medical files, some insurers require you to be examined by their appointed doctors after you file a claim. Insurers also have the right to recover costs if a claim has been overpaid.

ASK BEFORE YOU BUY

When is the deadline to submit a claim?

Learn more in IAMAT’s Guide to Travel Health Insurance
  • Did you know?

    You are not covered if you need medical care or hospitalization as a result of drinking alcohol.

    The majority of travel health insurance plans exclude injuries resulting from alcohol consumption. Some plans do cover injuries related to alcohol use but you cannot exceed the maximum allowable blood alcohol levels.

  • Did you know?

    Your travel health insurance plan is a legal contract. When you purchase a policy, you have to adhere to the terms set out within that specific policy for the insurer to fulfill their obligation to provide coverage.

    Remember that insurance only covers you for unforeseen and unexpected events – an unstable pre-existing condition or participating in activities that can increase your risk for personal harm or injury put your coverage at risk.

  • Did you know?

    Medical questionnaires are required to be completed at the time of purchase if you are over a certain age (typically over 60) or have a pre-existing condition. These forms can be complex and include medical jargon. If you need help, ask the insurance provider for clarification. Many insurers also want your doctor to sign off on the medical questionnaire.

    If you file a claim, insurers will look closely at the answers on your medical questionnaire to see if they match your medical file before accepting your claim.

  • Did you know?

    Mental health coverage is excluded from most standard travel health plans.

    If you have a first time mental health event or need care for a pre-existing psychiatric condition, you will have to pay out-of-pocket for medical services and prescription medication you need abroad.

  • Did you know?

    If your existing insurance benefits plan or credit card (primary coverage) doesn’t fully or adequately cover you for your health condition, you will need to get supplemental or secondary coverage (also known as excess insurance).

    This additional plan pays for medical expenses after your existing or primary coverage has reached the payout limits. The secondary insurer pays the balance of your medical costs.

Photo By: Sharif Hossain Sourav