Stories of young mothers being stuck with million-dollar hospital bills may make headlines, but the numbers prove the majority of claims are honoured, says one association president.
According to a recent KPMG survey of Canadian providers commissioned by the Travel Health Insurance Association (THIA), 95.3 per cent of Canadians who purchased individual travel health insurance policies had their claims paid.
Although great numbers, says THIA President Alex Bittner, they could be better.
“We're delighted that more than 95 per cent of travellers had their medical claims paid but that means that five per cent saw their claims denied,” says Bittner. “Insurance is designed to pay claims. Our goal is to see an increase in these high rates of successful claims.”
Respondents to the survey indicated that the amount of claims paid to more than 103,000 insured travellers exceeded $138 million.
A recent THIA survey of Canadians revealed that 18 per cent of respondents have inadvertently provided inaccurate health information on travel health insurance forms – something that is to be avoided as it can void an insurance policy. Fourteen per cent have deliberately provided inaccurate health information on travel insurance applications with half of those admitting that they did so to receive a lower rate. And, only 33 per cent have reviewed medical forms with a physician when applying for travel health insurance.
It was the story of Jennifer Huculak-Kimmel of Saskatchewan, who was on a family holiday in Hawaii when her water broke nine weeks early and only two days into the vacation. She had to undergo an emergency C-section and required over two months of hospital care for herself and her baby.
Unfortunately her travel insurance carrier, Blue Cross Saskatchewan, denied her claim citing nine different points of exclusion, and left her and her family with a hospital bill of almost $1 million US.
One of the major points Blue Cross cited was a bladder infection she had at four months into pregnancy causing her to hemorrhage. (continued.)
#pb#
Accuracy is crucial to ensuring that claims are paid in the event of a mishap while travelling, Bittner points out.
“Responding accurately to medical forms is the best way to have a carefree holiday and ensure that unexpected medical expenses will be covered by insurance,” says Bittner. “Provincial health plans only pay for approximately 9 per cent of out-of-country medical costs. If there is a medical questionnaire, it needs to be taken seriously.”
The top two reasons for denied claims include medical non-disclosure and misrepresentation and for pre-existing conditions that were not stable as required by policies.
THIA recommends that brokers remind their clients to do the following to have carefree vacations:
• Know your health and consult a health care provider if you have any questions;
• Know your trip - How long will you be gone? Are you a snowbird? Will you be travelling many times during the year? Do you plan to scuba dive or undertake any high risk activities?
• Understand your travel insurance policy – insurance companies have staff available to assist you and answer any questions related to policies.
