Unfortunately, many people who buy insurance don't read the fine print. This can lead to disappointment and frustration when a claim is curtailed or isn't paid at all because there is limited or no cover. In the case of travel insurance its particularly important to understand the detail because of the number of different risks insured. To help understand the typical cover, I'll run through what's in a typical UK travel policy document. There's no substitute for reading the detail of your own policy but hopefully this gives quick & helpful guide.
This policy starts with an introduction and policy definitions. Then there are sections on health, general conditions, claims conditions, emergency assistance, and reciprocal health arrangements with other countries. The main body of the policy is given over to the schedule of benefits, and finally there's two regulatory sections on the complaints procedure and data protection.
The introduction is essentially a preamble and, amongst other things, highlights that a policy holder must be a permanent resident in the UK, the age limits covered, and the fact that most elements of the cover are subject to some form of excess.
The definitions section primarily relates to the terms used in the schedule of benefits. For instance, it lists the hazardous activities which are covered by the policy and those that aren't and those that are covered only when professionally organised and supervised.
The health section is an important one as by claims value this is the biggest risk covered. It highlights that the insured is committing to the insurer that at the time of taking out the policy & booking the trip the insured is /are healthy, and fit to travel & undertake each trip.... so if you claim as a result of an undisclosed medical condition you might not be covered. Disclosure of medical conditions to the insurer is therefore absolutely vital, and the section stipulates the conditions that require disclosure to confirm cover. These include any medical condition suffered in the 12 months prior to cover being taken out and prior to any trip; some specific conditions suffered in the last 24 months; and also some more serious conditions if they have ever been suffered. The latter category includes heart conditions, high blood pressure, blood clots, high cholesterol and any cerebrovascular problems. Cover may be given for a disclosed condition, sometimes at an extra cost. The disclosure requirements also apply to medical conditions that arise after the policy has been paid for.
The general condition section is pretty standard. It notes where there is dual insurance, the policy would cover only a proportionate share of the claim. An example would be where loss or theft of property is also covered under a household contents policy. The section also includes a 'reasonable precaution' clause noting the insured must take reasonable precautions to avoid illness, disease and injury, and loss, theft or damage to property. Finally it describes the policy cancellation arrangements.
The claims section again is standard. It provides contact details and also summarises the key 'does and don'ts' in regards to making a claim which are....do notify the insurer, preferably by phone, within 31 days of the claimable event or as soon as is possible thereafter, and if you are aware of any legal proceedings, inform the insurer immediately. Do retain any damaged property which is being claimed. Do not negotiate, admit or repudiate any claim without the written authority of the insurer. Do provide supporting evidence as requested by the insurer - without bills and receipts the insurer may not pay the claimed costs. The cost of providing evidence falls on the claimant except if the insurer requires an independent medical examination - that would be an insurer cost. Most of the rest of the section sets the rules in regard to fraudulent claims (they do happen!)
The general exclusions section describes circumstances which are not covered by the policy. I won't list them all, but they include war & terrorism; hazardous activities unless they are specified as covered; driving without a full UK licence; self inflicted injury & suicide; unlawful action against the insured; losses not directly associated with the claims incident; travel to countries against FCO advice. Emergency assistance section like claims gives contact details and summarises what to do in the event. The instructions are straightforward. Smaller medical costs can be dealt with in the same way a non-medical claim but if the medical costs are higher, the assistance company must be contacted and they will advise and arrange medical assistance as required with the costs being guaranteed, including air ambulances for critical cases.
Moving on to reciprocal health arrangements, this section deals with countries with which the UK government has reciprocal arrangements. The advice is to take an EHIC card when travelling in the European Union, the European Economic Area and Switzerland. To encourage this the insurer will waive the medical emergency excess if accepted costs are reduced by use of an EHIC card. In Australia certain treatment is free under MEDICARE so it is an insurer requirement to sign up at the local MEDICARE office over there after having received the first treatment. Details of what treatment's free can be obtained in the Health Advice Booklet for Travellers available at UK post offices.
The schedule of benefits section is the core the policy and should be read carefully. Again I'm not going to go through the detail here but in summary the cover is for
- Cancellation or curtailment - Catastrophe - Missed departure - Travel delay & holiday abandonment - Baggage delay - Personal property - Personal Money, passport & documents - Emergency medical & other expenses - Hospital benefit - Personal accident - Personal liability - Legal expenses
For each of these benefits, a cover limit and excess per person or family is specified. The medical cover per person is measure in the £ millions which is typical of most travel insurance offerings.
So what conclusions do I draw from this quick run through?
My overriding recommedation is read through the policy carefully and understand the cover. In particular, understand the exclusions, cover limits and excesses. The cover can vary significantly between policies. Also ensure that all medical condition disclosure requirements have been met. Second to medical costs, cancellation & curtailment is the biggest insured risk by claims value, so pay attention to the cover limits and excesses as they apply to this risk. Ask yourself, is the policy cancellation and curtailment limit sufficient to cover the costs of the holidays you are taking, and are the excesses acceptable? Then once purchased, make sure that you follow the claims and assistance procedures as stipulated in the policy document. This way you'll minimise the chances of an unsuccessful claim.
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