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dirtyjeffer
Anons on ignore, but not due to fear.
Premium
join:2002-02-21
London, ON
reply to Gone

Re: What happens when travel insurance rejects your claim

i think you would be surprised at what people will say to "get their way"...from my 20+ in retail, i've heard and seen it all.


Styvas
Go Canucks Go
Premium
join:2004-09-15
Hamilton, ON
reply to Gone
Personally, I think that the insurance company should cover a claim but -- except in those cases where there is obvious fraud or attempt to misrepresent -- charge the difference between the premium they paid and the premium they should have paid.

In other words, if answering the questions accurately would have resulted in a $1,000 premium when they only paid $300, charge them $700. If accurate answers would have made them ineligible for coverage, then refund the premium and reject the claim.
--
"Moving your Tylenol to the low shelf in your medicine cabinet is not the way to prevent children from falling off a stool when reaching for the top shelf." (said by Savant, May 2008)


OverrRyde

join:2007-04-10
Waterdown, ON
Reviews:
·Start Communicat..
reply to MaynardKrebs
said by MaynardKrebs:

So what about the questions specifically about women I asked before, only add in going on/off birth control pills? Those weren't answered.

What about a guy who gets/uses Viagra for the first time in the 90 days prior to a trip?

Are women systematically discriminated against because of issues like these? It just seems that they might be.

Actually no, viagra or the birth control wouldn't fall under stable. there is no way a dr can say that you had an upset stomach or gastro because of an adverse reaction to viagra or pill. we've had cases with older men using the pill and getting a stiffer longer than usual and he was covered. All that happens is that we chuckle about at work and wonder why he was the only one on the policy, travelling alone! hehe


OverrRyde

join:2007-04-10
Waterdown, ON
Reviews:
·Start Communicat..
reply to Gone
said by Gone:

said by dirtyjeffer:

from what i gather from your statements (which makes sense), people fill out the form, leave things out, so they get the $300 insurance rate instead of the $1000 insurance rate...then if a problem happens, complain about the coverage being denied due to a pre-existing condition (or failure to disclose)...i realize that wasn't the case in peterboro's example, but i think in many others it could be.

I think that's an overly simplistic view. I suspect in a lot of cases people either don't remember, or don't know how to accurately answer. One shouldn't confuse malice with ignorance.

This is true, most of the times people just forget what they take their meds for. alot of people dont even know why they take certain meds, thats scary.

But there are some that do refuse to answer honestly and then get dinged, but it's a small number, rarely even, we can tell when someone lied just by their tone of voice when we confront them about it.


OverrRyde

join:2007-04-10
Waterdown, ON
Reviews:
·Start Communicat..
reply to Styvas
said by Styvas:

Personally, I think that the insurance company should cover a claim but -- except in those cases where there is obvious fraud or attempt to misrepresent -- charge the difference between the premium they paid and the premium they should have paid.

In other words, if answering the questions accurately would have resulted in a $1,000 premium when they only paid $300, charge them $700. If accurate answers would have made them ineligible for coverage, then refund the premium and reject the claim.

That is how it works actually. If you are a misrep, we do reimburse your premium. In some cases you are offered to buy the correct policy but the condition you had to be seen for is still denied.


OverrRyde

join:2007-04-10
Waterdown, ON
reply to jaberi
sorry for all the replies, i dont know how to quote all of you in 1 reply!


Styvas
Go Canucks Go
Premium
join:2004-09-15
Hamilton, ON
reply to OverrRyde
said by OverrRyde:

said by Styvas:

Personally, I think that the insurance company should cover a claim but -- except in those cases where there is obvious fraud or attempt to misrepresent -- charge the difference between the premium they paid and the premium they should have paid.

In other words, if answering the questions accurately would have resulted in a $1,000 premium when they only paid $300, charge them $700. If accurate answers would have made them ineligible for coverage, then refund the premium and reject the claim.

That is how it works actually. If you are a misrep, we do reimburse your premium. In some cases you are offered to buy the correct policy but the condition you had to be seen for is still denied.

I understand that, as long as the denial is for something that never would have been covered, and not for an oversight on the application (again, I'm not excusing outright fraud here).

What I'm saying is that, other than cases of explicit fraud, the claim should be covered if it could have been covered, but at the correct premium. I realize that this is an unlikely business decision on the part of the insurance company. I'm saying that I think it SHOULD be that way, not that I expect it to be.
--
"Moving your Tylenol to the low shelf in your medicine cabinet is not the way to prevent children from falling off a stool when reaching for the top shelf." (said by Savant, May 2008)


elwoodblues
Elwood Blues
Premium
join:2006-08-30
Somewhere in
kudos:2
reply to Styvas
Why collect another $700 (your example) to pay out $1000's when they can just deny the claim? Not good business.


Styvas
Go Canucks Go
Premium
join:2004-09-15
Hamilton, ON
I made that point. Thanks for reading to the end of my post.


elwoodblues
Elwood Blues
Premium
join:2006-08-30
Somewhere in
kudos:2
My bad, I tend to skim over things...

jaberi

join:2010-08-13
reply to OverrRyde
thanks for answering my questions OverrRyde, sounds so simple yet it can get complicated... here is to living and learning every day!