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How to Make a Successful Travel Insurance Claim - The Definitive New Zealand Guide

Navigate the complexities of making a travel insurance claim with our definitive guide. Learn essential steps, from understanding your policy to effectively handling the claim process, minimise hassle and maximise your claim's success with our trusted tips.
Updated 11 June 2023

Summary
  • It takes seconds to buy travel insurance, but getting a claim paid can be time-consuming, frustrating, and, in some instances, best be described as wading through glue.
  • We are all too aware of insurers not meeting the expectations of their policyholders when a claim is lodged. The biggest complaints we hear concern the delay in decision-making, approvals and responding to questions.
  • Our guide is published to help explain what you need to know to avoid the hassle and frustration of claiming on a policy when you're overseas or back home in New Zealand. We aim to provide clear and detailed information on making a successful claim, avoid common pitfalls, and ensure your process is as smooth and quick as possible.
  • This is our guide's first edition; if you want to share something about your experiences, please contact our research team.

Our guide covers the following:
Video guidance: MoneyHub Founder Christopher Walsh focuses on how to make a travel insurance claim in the video below, focusing on reading the policy before you buy it, knowing the exclusions and being persistent with the insurer:

MoneyHub Founder Christopher Walsh shares his views on understanding your travel insurance policy to avoid a rejected claim

"It's crucial to fully comprehend your travel insurance policy to know what you are (and are not) covered for. Different policies will have varying levels of coverage, with some providing comprehensive coverage and others only covering the bare essentials. 

I can't emphasise this enough - always read the terms and conditions and policy details thoroughly, and don't hesitate to ask your insurer questions if anything is unclear. Claims usually get rejected because people don't read the policy, think they're covered, and find out they're not, which is never a good outcome".

If your trip involves specific activities like skiing, scuba diving, or other adventure sports, ensure that your insurance policy covers these activities. If it doesn't, you may need to purchase additional coverage - don't assume it does otherwise you risk buying something that's not fit for purpose".
Christopher Walsh
MoneyHub Founder

First Step: Understanding Your Policy is Essential

The responsibility on making sure you're buying the right travel insurance policy is on you - insurers sell "one fits some" policies and rely on the traveller to make sure it's what they need. Problems arise when a claim is made only to find there's no cover for the event. To help minimise the risk of a failed claim, we outline the steps to take in advance:

1. Read the Policy Wording

Understanding what your policy covers is crucial to ensure your claim's validity. Many New Zealanders look at a summary table of benefits, buy the policy and only read it in detail when they need to claim. 

However, that's too late - we strongly suggest reading the policy wording carefully and ensuring you understand what is and isn't covered. Remember, if something isn't explicitly stated as being covered in the policy wording, it's probably not covered; if you're in doubt, ask the insurer.

2. Declare Pre-existing Conditions

Many claims get denied because travellers fail to declare pre-existing medical conditions. Always declare any existing health conditions when you purchase your policy. You may need to pay an additional premium, but this ensures you're covered if anything related to that condition happens while you're away. Our guide to pre-existing conditions has more information.

3. Understand Exclusions and Where You Won't Be Covered

Most policies have exclusions, which are situations where the insurer won't pay out. Common exclusions include incidents involving alcohol or drugs, high-risk activities not covered by your policy, and claims related to undeclared pre-existing conditions. However, there are many more, and it's essential to be aware of them to avoid having a rejected claim. 

Video guidance: To help explain exclusions, MoneyHub Founder Christopher Walsh reads over and makes comments on Southern Cross, Cover-More and 1Cover's exclusions so you can understand the limits and what they mean:

What to Do When Something Goes Wrong and I Need to Claim

If you have to claim, there are several ways to organise everything. Our list below is what we believe is the best approach to minimise hassle and pushback from an insurer. 

1. Act Immediately
Inform your insurer as soon as an incident happens that might lead to a claim. Most insurers have 24/7 helplines you can call. Early notification speeds up the process and can help you get assistance and advice on the spot. 

2. Document everything
Keeping comprehensive records is crucial. Save all receipts, medical reports, police reports, or any other documentation related to your incident. If possible, take photographs or videos of the incident and any damage. 

3. Follow the Rules
Comply with all requirements and procedures outlined by your insurer. This includes reporting thefts to the police within 24 hours, getting medical treatment approved before it's carried out, and not admitting liability if you're involved in an accident.

4. Complete Claim Forms Thoroughly
Fill out the claim form completely and accurately. Be detailed and honest about what happened. Incomplete or inaccurate information can delay your claim or lead to a denial. 

5. Submit Supporting Documentation
Provide all necessary documents, such as medical reports, receipts, or police reports. The more evidence you provide, the better. If you're unsure whether a document is relevant, include it anyway. 

6. Stay Patient and Persistent
Claims can take time to process, especially if they're complex or involve large amounts. Stay patient and keep track of your claim's progress. If you feel your claim isn't being handled properly, be persistent and follow up with your insurer regularly by phone - this works better than email and gives you an immediate contact point.

7. Consider Professional Assistance if Things are Dragging 
If your claim involves a large amount, you might want to seek help from a professional, such as a lawyer or an insurance claim specialist. This can be particularly helpful if your claim gets denied or you encounter any other complications.

What Are My Options if the Claim Is Denied?

Travel insurers are regarded as quick to deny a claim, although we believe this to be a misconception despite stories such as this wrongly denied claim in 2022. Our suggested process is as follows:
 
1. Review the Insurer's Reason
If your claim gets denied, your insurer must provide a reason. Review this reason carefully and check it against your policy's terms and conditions. If your claim is stated in the policy as an exclusion, then there is no further possibility to progress the claim, and you'll have to accept the insurer's decision. 

2. Appeal the Decision
You can appeal if you believe your claim was unjustly denied. Start by writing a letter to your insurer detailing why you believe the denial was incorrect, providing any additional evidence you might have. 

3. Seek External Review
If your appeal is denied, you can escalate your complaint to an independent external review scheme, such as the Insurance and Financial Services Ombudsman (IFSO). Remember, the key to a successful travel insurance claim is understanding your policy thoroughly, acting promptly when something goes wrong, and keeping thorough records.

Frequently Asked Questions

The questions below are not insurance advice - please contact your travel insurer for anything specific to your policy.

I'm buying travel insurance for the first time and don't want to have a claim rejected - what do I need to know?

We suggest following this process:
  1. Be Proactive: Don't hesitate to ask questions when buying your policy. If you don't understand something, it's better to get clarity from the start.
  2. Ensure Adequate Coverage: If you're planning specific activities like skiing, bungee jumping, or other adventure sports, you might need additional coverage. Always check this beforehand - don't assume it's covered even if the policy doesn't say it's not.
  3. Save Policy Information: Always keep your policy number, the insurer's contact information, and the details of what your policy covers saved in an easily accessible place (preferably in digital and physical forms).
  4. Medical Authorisation: Some policies require authorisation before receiving medical treatment. If you're unwell, contact your insurer as soon as possible to avoid a potentially unapproved medical bill.
  5. Double Check Travel Advisories: Remember that travel advisories from the New Zealand government can impact your insurance coverage. If a travel advisory has been issued for your destination, check with your insurer to ensure you're still covered; check your destination on Safe Travel. 
  6. Policy Extensions: If you decide to extend your trip, make sure to extend your travel insurance policy too. This will ensure continuous coverage while you're away.

What is the typical timeframe for a travel insurance claim to be processed?

It varies depending on the insurer and the complexity of the claim. Generally, insurers aim to review and respond to a claim within 10-15 business days, but paying out may take longer. 

Is there a deadline to file a travel insurance claim?

Yes, most policies require you to file a claim within a specified period after the incident. Check your policy details for this timeframe, or contact your insurer to confirm.

What if my travel insurance claim is rejected due to an error on the claim form?

You usually have the right to correct errors and resubmit your claim. However, providing accurate information from the start is essential to avoid delays.

How does the excess work when making a claim?

An excess is the amount you'll need to pay towards a claim. The excess amount varies depending on your policy and the type of claim, and it will be deducted from the payment you receive from an insurer - you don't need to pay it in advance. Our travel insuranceexcess guide has more details.

What if I don't have all the necessary documentation for my claim?

Contact your insurer to discuss your situation if you can't provide all the necessary documentation. They may be able to provide alternatives or guidance on other forms of evidence they can accept.

Can I file a travel insurance claim if I've cancelled my trip for personal reasons?

This depends on your policy coverage. Some travel insurance policies offer 'cancel for any reason' coverage, which may cover cancellations due to personal reasons. However, this is typically an add-on and may not be included in standard policies.

Do I need to inform my insurer about a minor incident even if I don't plan to claim it?

While it may seem unnecessary, informing your insurer about any incident during your trip is generally good practice, even if you don't intend to make a claim. This is particularly important if the incident could potentially lead to a larger claim in the future.

How can I prove the value of personal belongings that were lost or stolen during my trip?

Insurers generally require proof of ownership and value when you're claiming for lost or stolen items. This could include purchase receipts, bank or credit card statements, or even photos that show you with the item.

What should I do if my insurer doesn't respond to my claim?

If you haven't heard from your insurer within their stated response time, following up is important. You can do this by phone, social media messages and email. Keep a record of all your communications if you need to escalate the situation.

Who pays for the medical costs upfront, the insurer or me?

It depends on the situation and the insurer. In some cases, the insurer can arrange direct payment with the hospital. However, in other scenarios, you might need to pay out-of-pocket first and then get reimbursed by your insurer. Always contact your insurer as soon as possible when you need medical assistance to understand the process.

Who pays upfront for accommodation or alternative travel arrangements in case of flight cancellations or delays?

Generally, you must pay upfront for any alternative arrangements or additional accommodations required due to delays or cancellations. You can then claim these expenses with your travel insurance provider. Remember to keep all receipts and document everything, as you will need these for your claim. However, it's always best to confirm this process with your insurer.
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