With the holiday season coming up, many are getting ready to travel. While most of us are aware of the benefits of buying travel insurance, we may not be aware of how to lodge a claim in case of an emergency and the various emergencies covered in a travel insurance plan.
What is covered
Broadly, travel insurance can cover against various contingencies and perils which customers may face during a journey, said Anurag Rastogi, member of executive management, HDFC ERGO General Insurance.
The various situations for which an individual is covered under travel insurance include emergency medical expenses (medical repatriation and evacuation), emergency dental expenses, lost or delayed baggage, flight delay/cancellation, loss of passport, interruption for frequent flyers, emergency evacuation, personal liability and hijacking.
According Sukhesh Bhave, head - accident & health claims, SBI General Insurance, travel insurance also covers trip cancellation where planned trip is cancelled before its commencement from India, trip curtailment, where the trip is shortened due to various reasons; missed connection -- while travelling outbound connecting flight is missed and hence traveller had to purchase a ticket; home burglary – burglary at home at India while on trip.
"We also provide hospitalisation daily allowance in case of hospitalisation and emergency cash advance in case of loss of checked in baggage. Insured may need emergency amount which has to be returned once he/she returns to India," Bhave said.
Subir Mukherjee, MD and founder, GreenLife Insurance Broking (GIBL), said, "In many nations, it is impossible to get admitted to a hospital without the necessary insurance, and costs can be extremely high, which is why travel insurance must be done imperatively. Loss of valuables and other documents such as one's passport, loss of baggage or a personal accident are other unforeseen circumstances for which customers can file a claim with their travel insurance provider."
Common claims
Claims are measured in two parameters – frequency and size. In terms of frequency, about 60% of all claims would be flight delay plus flight missed, said Tarun Mathur, chief business officer-general insurance, Policybazaar.com. However, the largest in terms of payout that insurance companies do is for medical emergencies. "The average ticket size is very high because when you go outside and have a medical emergency it is a large amount. That would attribute about 80% of the entire amount spent by insurance companies,'' he added.
In fact, flight delay claims are so common that some new-age general insurance companies have reduced the time required for a flight delay claim to be valid. For instance, Digit Insurance offers flight delay claims starting from as less as 75 minutes, said Vivek Chaturvedi, head of marketing, Digit Insurance.
According to Mukherjee, the most common reason for which customers file a claim is the cancellation of a trip due to medical conditions. "Either one has a medical emergency or the condition worsens to such a degree that they deem it better to cancel their trip and claim insurance,'' he said.
Time limit for filing a claim
While you should file the claim within 30 days (as per the General Claims Provisions) from the date of loss, companies generally consider delay in filing claim due to unavoidable circumstances.
"One should always try to at least intimate the claim to insurer in time. If in case an individual is unable to file a claim within the stipulated time, insurance companies consider the delay in claims submission due to unavoidable circumstances,'' said Rastogi.
While agreeing that insurers may relax the condition of 30 days subject to a satisfactory proof/evidence being produced on the reasons for the delay in filing, Bhave said that this is up to a maximum 60 days and it is at the discretion of the insurer to consider the same.
In fact, some companies allow up to 90 days from the date of loss to file the claim, Mukherjee said.
Documents required to file a claim
To file the claim for flight and baggage delay, one has to submit a Property Irregularity Report (PIR) and a letter from the airline mentioning the delay.
Common documents would include passport copy, visa entry and exit stamp.
In case of flight delay/cancellation customers may be asked for documents to show the amount of time the flight was delayed, how long the customer was forced to spend at the airport due which he missed his connecting flight or trip. This could include tickets, boarding pass, bills or proof of payment made to the resort or at restaurants at the airport, refund from the tour operator for cancelling the ticket, etc.
In case of a medical emergency, the documents are needed are: the treating doctor's report in case of a medical reason, original admission/discharge cards (if applicable), original bills/prescription/receipts.
In case of personal accident claim in addition to the above mentioned documents one would be required to show the death certificate (if applicable), discharge summary, post-mortem report (if applicable), police complaint and other documents as applicable, receipts and itemised bills for all expenses.
Why are claims rejected
Claims are usually rejected only because of fraudulent intent. Genuine claims are never rejected. Sometimes they are delayed if documentation is incomplete, said Mathur.
"If you make payment using credit card, then keep the original credit card statement as proof. In one instance, a customer had only a photocopy of the medical centre's bill, but he had the original credit card statement showing he had paid the money. So, the claim was approved as the insurance company got in touch with the hospital for the original,'' he added.
For medical treatment the policy could be rejected if the medical condition was pre-existing or non-disclosure of any medical history while buying the policy. There are also certain permanent exclusions and one should read the policy document carefully.
Chaturvedi said, "Honesty is the best policy when it comes to claims. There are some cases where the cause of the accident is invalid for a claim or the condition needed for the claim is not met. In these cases the claim may be rejected. Also informing the insurer immediately is necessary. For example, in hospitalisation cases, it is advisable to inform the insurer as soon as possible, so that they can suggest a hospital or whether you should return to India."
SUB-LIMITS WITHIN A TRAVEL POLICY
Sum assured-$ 1,00,000
Loss of passport – $300
Personal Accident – $20,000
Accidental death and disability – $2,500
Dental Cover – $500
Loss of Baggage – $1,000
Delay of baggage – $300
Trip Delay – $150
Trip cancellation – $600
Missed connection – $200
Personal liability is – $1,00,000
Emergency Cash Advance – $300
Source: GBIL
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