Travel Insurance Claims Process Guide
Filing a travel insurance claim doesn't have to be complicated. Whether you've experienced a medical emergency abroad or faced an unexpected trip disruption, understanding how to properly submit your claim ensures faster processing and reimbursement. We'll guide you every step of the way.
Need to File a Claim?
Find the contact details for your provider on your insurance card. Or select your plan and administrator below for contact information.
Introduction to Travel Insurance Claims
Most plans Insubuy offers fall under these categories: travel insurance or travel medical insurance/visitors insurance.
Travel insurance
provides financial protection when unexpected events disrupt your travel plans or health while on a trip.
Travel medical insurance
(known as visitors insurance when visiting the USA) specifically covers emergency medical expenses incurred during your trip.
F visa student insurance
for international students studying at colleges and universities in the USA.
J visa exchange visitor insurance
for participants in officially sanctioned Department of State Exchange Visitor programs.
Expatriate insurance
which is major medical insurance designed for those living outside their home country for an extended period.
Annual travel insurance
for those who want yearlong medical protection for multiple journeys.
Common Claim Scenarios
What is a Travel Insurance Claim?
A travel insurance claim (or travel medical insurance claim or visitors insurance claim) is a formal request for reimbursement submitted to your insurance provider after you've incurred eligible covered expenses. Claims become necessary when you face medical emergencies requiring treatment or hospitalization, trip cancellations or interruptions due to unforeseen circumstances, lost or damaged baggage, or emergency medical evacuations, depending on what your plan covers.
First Steps
Before filing any claim, thoroughly review your policy documents to understand your coverage limits, deductibles, exclusions, and claim submission deadlines. Each insurance plan has specific requirements and procedures that must be followed for successful reimbursement. You can view your policy documents by visiting the MyAccount portal.
How Can Insubuy Help?
Insubuy serves as a neutral third-party insurance broker, connecting customers with the best travel and international insurance plans for their individual needs from various insurance administrators. While we're here to answer any questions and guide you through the process, all claims decisions and processing are handled directly by the insurance administrator listed on your policy. We cannot approve, deny, or expedite claims, but we're always available to help you understand claims procedures, connect you with the right resources, and advocate on your behalf.
These are some common claim scenarios that may occur depending on the type of travel insurance plan you have.
Travel Medical Insurance & Visitors Insurance Claims
- You get sick during your trip and must visit the doctor's office
- You suffer a nasty fall and need emergency medical treatment and hospitalization
- A doctor or other medical professional prescribes you prescription medication and/or medical supplies
- Emergency medical evacuation is deemed medically necessary by your physician
- You've suffered an acute onset of a pre-existing condition (plan-dependent) and need medical care
Travel Insurance Claims
- You're forced to interrupt your trip due to the sudden passing of an immediate family member
- You have no choice but to cancel your trip due to a severe illness
- You have a covered baggage issue such as loss, theft, or damage
- You suffer a serious illness or injury while traveling and your physician determines that emergency medical evacuation is medically necessary
- You contract a serious case of food poisoning and require emergency medical care
Understanding Your Policy
Essential Steps Before You Need to File a Claim
- Review Financial Responsibilities and Coverage Limits. Before your trip, thoroughly review your policy documents to understand your exact financial responsibilities. This includes identifying your deductible (the amount you pay first), your coinsurance (the percentage you pay after the deductible), and the maximum coverage limits for different benefits, such as emergency medical care or trip cancellation. You can find the policy documents on the webpage for the plan you are interested in prior to purchase, or within MyAccount and provided via email.
- Identify All Policy Exclusions and Non-Covered Expenses. Carefully read the "Exclusions" section of your policy to identify what is not covered. Common exclusions include services deemed not medically necessary, injuries from certain high-risk activities, or, depending on your plan, issues related to pre-existing medical conditions. Understanding these limitations prevents unexpected claim denials.
- Understand Key Policy Terms and Billing Procedures. Your policy terms and conditions explain how to use your insurance. Determine if your plan uses "direct billing" (where the provider bills the insurance company, common in PPO networks) or "pay-and-claim" (where you pay upfront and file for reimbursement). Please note that direct billing is at the insurance provider's discretion and is not guaranteed. Also, note the contact information for your claims administrator, which is listed on your insurance ID card.
- Know the Deadline for Claim Submission. Every policy has a time limit for how long you have to submit a claim after an incident occurs. This deadline is typically between 60 and 90 days, but you must check your specific policy documents for the exact timeframe. Filing a claim after this deadline is one of the most common reasons for denial.
Essential Documentation to Maintain
Recordkeeping practices for successful claims
- Insurance ID card and policy documents
- Passport, visa, and travel documentation
- Medical records and treatment receipts/bills
- Proof of payment for all expenses
- Travel itineraries and booking confirmations, if applicable
Direct Billing vs. Pay-and-Claim
Healthcare providers use two primary billing methods when you receive medical treatment: Direct billing and pay-and-claim.
Direct Billing
With direct billing, the medical facility or doctor's office submits the claim directly to your insurance company and receives payment from them. This method is common with hospitals and providers within PPO networks for comprehensive plans, though it still requires you to pay your deductible, coinsurance, and any non-covered expenses directly to the provider.
Pay-and-Claim
In the pay-and-claim method, you pay the full cost of services upfront and then submit a claim to your insurance company for reimbursement of eligible expenses. This approach is typical when visiting providers outside a PPO network, using fixed coverage plans, or when a provider chooses not to bill the insurance company directly.
Regardless of which billing method your plan uses, you must always file a claim form with your insurance provider.
Even when a provider bills directly, the claim form provides essential authorization for the release of your medical records and expedites the processing of your claim.
Without this authorization, the insurance company must request medical records separately from the provider, which significantly delays claim resolution.
Using Your Insurance ID Card
Your insurance ID card contains critical information that healthcare providers need to verify your coverage and submit claims. The card includes your certificate or policy number, the claims administrator's contact information, effective coverage dates, and important phone numbers for provider inquiries.
- When visiting a healthcare provider, present your ID card at check-in just as you would with any other insurance. Do not refer to it as "Insubuy insurance", as Insubuy is the broker, not the insurance provider. Instead, refer to the information on your insurance card. The provider's billing office will use the information on your card to verify your benefits and determine whether they can bill the insurance company directly.
- For plans that participate in a PPO network, visiting in-network providers typically results in direct billing and access to negotiated rates, reducing your out-of-pocket costs. However, fixed coverage plans generally do not participate in PPO networks, meaning you can visit any provider but won't receive network-negotiated discounts.
- If a healthcare provider doesn't recognize your coverage or seems unfamiliar with your insurance, remain calm and provide them with the claims administrator's phone number from your ID card so they can verify benefits directly. For significant medical expenses like hospitalization or surgery, contact your insurance administrator in advance in situations where it is possible.
Initial Steps
Immediate Actions to Take After an Incident
Contact Your Provider
Reach out to your claims administrator using the policy contact information on your ID card.
- If you don't have your ID card, log into MyAccount to retrieve your documents. Need assistance? Contact us!
- If you don't have your insurance ID card but you know your administrator, you can select it from the dropdown menu on this page or view our insurance partners.
Gather Documentation
Collect all relevant receipts, medical records, and proof of the incident.
Download Claim Forms
- Access your claim form on your plan administrator's website.
- Select your administrator from the dropdown menu on this screen for contact information.
Completing and Submitting Claims
Remember This When Submitting a Claim
When completing claim forms, provide thorough and accurate information. Include detailed descriptions of the medical services received or incident that occurred, the date symptoms first appeared, relevant past medical history, and complete addresses for all healthcare providers or other relevant official parties involved. Incomplete or vague information is one of the most common reasons for claim delays or denials.
Attach all required supporting documents to your claim submission, including original itemized bills and receipts, medical records and physician notes, prescription information with pharmacy details, and copies of your passport and proof of legal status. Submit a separate claim form for each family member and for each new medical condition or incident.
Claims can be submitted by mail to the address listed on the claim form, via email if your administrator accepts electronic submissions, or through secure online portals. Always keep copies of everything you submit—there's no guarantee that documents sent by mail will arrive safely, and you may need to reference them later.
Post-Submission Process
What Happens When You Submit Your Claim
After submitting your claim, the insurance company typically processes medical claims within 30 to 45 business days and trip insurance claims within 4 to 6 weeks, though timelines vary by administrator and claim complexity. Processing begins only when the administrator receives complete information, including all required medical records from your providers.
Do This While You Wait
- Monitor your claim status through your insurance administrator's online portal or by contacting them directly using the phone number on your claim form. Most administrators provide claim tracking systems that show whether your claim has been received, is under review, requires additional information, or has been processed.
- If the administrator requests additional documentation, respond promptly to avoid delays. Common requests include more detailed medical records, additional receipts or proof of payment, clarification about the incident or medical condition, or confirmation of policy eligibility dates.
Once your claim is fully processed, you'll receive an Explanation of Benefits (EOB) document detailing the services or expenses claimed, the amount the insurance company approved and paid, any amounts applied to your deductible or coinsurance, expenses that were denied and the reasons why, and your remaining financial responsibility to the provider. The EOB is not a bill—it's an informational statement explaining how your claim was processed.
If your claim was approved, reimbursement will be issued according to the method you specified on your claim form. If you paid upfront, the insurance company sends payment directly to you. If the provider billed the insurance company directly, payment goes to them. Review your EOB carefully to ensure all charges were processed correctly and contact your administrator if you have questions about any decisions.
The following are general examples of necessary claims documentation. The exact required documentation will vary by plan and scenario. Please refer to your plan policy documents for more information.
Medical Claims Documentation
Essential Documents for Medical Claim Reimbursement
- Completed claim forms and authorization
- Original itemized medical bills and receipts
- Medical records and physician notes
- Prescription labels and pharmacy receipts
- Passport copies and proof of legal status
- Direct billing records (if applicable)
Trip Insurance Claims Documentation
Documents for Trip-Related Claims
- Trip cancellation/interruption: Medical certificates, death certificates, employer letters
- Travel delays: Carrier statements, boarding passes, expense receipts
- Baggage claims: Police reports, carrier reports, proof of ownership
- Emergency evacuation: Medical necessity documentation, evacuation service receipts
Understanding Claim Statuses
What Claim Statuses Mean During Processing
New / Submitted
The claim has been received and is awaiting assignment
Pending / In Review
The eligibility and documentation of the claim is actively being reviewed
Approved
The claim meets the criteria, and reimbursement is being processed
Denied
The claim was denied due to being an ineligible expense or due to lack of sufficient documentation
Processing Timelines and Communication
What to Expect
Being engaged yields better results As the insured, you have a certain level of responsibility to ensure your claim is adjudicated correctly. If you submit incomplete information, do not respond to requests for information and stay passive during the review process, the insurance company may not have the information needed to approve your claim.
Standard processing times by claim type: The insurance company typically processes medical claims within 30 to 45 business days, while trip insurance claims are usually completed within 4 to 6 weeks. Keep in mind that these timelines can vary depending on your administrator and the complexity of your specific claim. Processing begins only when the administrator receives complete information, including all required medical records from your providers, so submitting thorough documentation upfront helps avoid delays.
How to check claim status through portals: You can monitor your claim status by logging into your insurance administrator's online portal or by contacting them directly using the phone number provided on your claim form. Most administrators offer claim tracking systems that clearly show whether your claim has been received, is currently under review, requires additional information from you, or has been fully processed and paid.
Responding promptly to information requests: If the administrator requests additional documentation during the review process, respond as quickly as possible to prevent unnecessary delays in processing your claim. Common requests include more detailed medical records, additional receipts or proof of payment, clarification about the incident or your medical condition, or confirmation of your policy eligibility dates. Timely responses keep your claim moving forward and help ensure faster reimbursement.
Understanding EOB documents and payment details: Once your claim is processed, you'll receive an Explanation of Benefits (EOB) document that provides a complete breakdown of how your claim was handled. This important document details the services or expenses you claimed, the amount the insurance company approved and paid, any amounts applied to your deductible or coinsurance, expenses that were denied along with explanations for why, and your remaining financial responsibility to the provider. Remember that the EOB is not a bill—it's an informational statement explaining the insurance company's decisions on your claim.
Documentation Issues
Claim Denied Due to Documentation
Lack of proof of incident or expense: This occurs when you fail to provide the necessary verification that a covered event happened, such as a police report for stolen baggage, a carrier statement for a travel delay, or a medical certificate for a trip cancellation.
Missing medical records or receipts: Your claim may be rejected if it does not include essential medical documents like original itemized bills, physician's notes detailing the treatment, and pharmacy receipts for prescriptions.
Incomplete or inaccurate claim forms: This is a common reason for delays or denials, happening when you submit a claim form with vague descriptions, missing dates, or incomplete addresses for healthcare providers.
Delayed notification to insurance provider: Policies often require you to contact the claims administrator immediately when an incident occurs, especially for significant events like hospitalization; failing to do so can jeopardize your claim.
Filing claims beyond deadline limits: Every policy has a strict time limit for claim submission, typically 60 to 90 days, and your claim will be denied if you file it after this window has closed.
Coverage Exclusions
Claim Denied Due to Exclusion
Excluded pre-existing medical conditions: This refers to medical conditions you already had before your insurance coverage began. Unless your plan specifically covers the acute onset of a pre-existing condition, any claim for treatment related to that known condition will likely be denied.
Plans covering the acute onset of pre-existing conditions do NOT cover ALL pre-existing conditions for all individuals. Refer to your policy documents for coverage specific to your plan.
Non-covered activities or destinations: Your policy may explicitly exclude coverage for injuries sustained while participating in certain activities (like adventure sports) or while traveling in specific countries or regions.
Expenses exceeding policy limits: Every policy has a maximum dollar amount it will pay for specific benefits. If your eligible expenses, such as for hospitalization or baggage loss, go above this stated coverage limit, the insurance company will not reimburse the amount that exceeds the limit.
Services deemed not medically necessary: This means the insurance administrator determined that a medical treatment or procedure was not essential for your diagnosis or recovery according to standard medical practices. Claims for services like elective procedures or treatments considered experimental are typically denied for this reason.
Thoroughly Review the Denial Letter
- Carefully read the insurer's formal denial letter to understand the specific reason(s) your claim was rejected.
- The letter should reference the exact clause or exclusion in your policy wording that justifies the denial.
Analyze Your Policy Documents
- Obtain a copy of your full policy wording (often called the Certificate of Insurance or Description of Coverage). You can access your policy documents by logging into MyAccount or through your administrator's online portal.
- Compare the reason for denial stated in the letter with the terms, conditions, limitations, and exclusions detailed in your policy to see if you agree with their interpretation.
Gather Relevant Documentation and Evidence
- Collect all original documents related to your claim, such as receipts, medical reports, police reports, flight itineraries, and any correspondence with travel providers.
- Organize any new evidence that could help refute the insurer's reason for denial. For example, if denied for a pre-existing condition, you might need a letter from your doctor clarifying the condition's status before your trip.
Contact the Insurance Administrator
- Who to Contact: Reach out directly to the claims department of the insurance provider or the assistance company that handles their claims. Contact information (phone number, email, mailing address) is typically found on the denial letter or in your policy documents. Or you can view our insurance provider partners for administrator contact information.
- How Can Insubuy Help? While Insubuy is a neutral broker and we cannot make claims decisions, we are happy to answer any questions you may have and help you through the process. Do not hesitate to contact us if you have any concerns about your claim that the administrator has not addressed!
Initiate the Internal Appeals Process
Insurers are required to have a formal internal appeals or complaint resolution process. The steps for this process will vary by provider and will be outlined in your policy documents.
- Draft a formal appeal letter. In the letter, clearly state your policy number, claim number, and that you are appealing their decision.
- Methodically address the specific reason for the denial and present your counterargument, referencing your policy wording and the evidence you have gathered.
- Submit your appeal letter and all supporting documentation via the insurer's required method (e.g., online portal, certified mail, or email). Keep a copy of everything you send and make sure to keep track of the date it was sent.
Claims Process FAQs
Coverage varies by policy. Review your policy documents in MyAccount for specific coverage details, limits, and exclusions. Common coverages include medical expenses, emergency evacuation, trip cancellation, and baggage loss.
Download the appropriate claim form from your MyAccount portal, complete it with all required information, gather supporting documentation (receipts, medical records, etc.), and submit according to your insurance administrator's instructions.
Contact your insurance administrator directly using the information on your insurance card. Many administrators also offer online portals where you can track claim status in real-time.
Once approved, payment is typically issued within 30 days. Payments can be made via check, direct deposit, or direct payment to providers, depending on your administrator's procedures and your policy terms.
If your claim is denied, you'll receive an explanation. You have the right to appeal. Review the denial reason, gather additional documentation if needed, and follow your administrator's appeal process. Contact Insubuy if you need assistance understanding the denial or appeal process.
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