Overcoming Travel Insurance Claim Denial Successfully

We recently assisted a client who faced an unexpected travel insurance claim denial. Despite submitting all necessary documentation and following the correct procedures, the client received a decline letter from their insurer. The reason cited was that the issue—misplaced passports for their children—was deemed within their control and therefore not covered under the policy.

The client reached out to us for assistance, and we immediately took over communication with the insurer. We carefully reviewed the policy terms and the client’s situation, identifying key points that had been overlooked in the initial assessment. We drafted a detailed response refuting the insurer’s reasons for denial, highlighting that the circumstances were indeed unforeseeable and outside the client’s control. We also emphasized the client’s adherence to all policy requirements and provided additional supporting evidence to strengthen the case.

In our communication, we informed the insurer of the potential escalations available to the client if the claim was not honored, including lodging a formal complaint with the Australian Financial Complaints Authority (AFCA). We maintained a professional yet firm tone, ensuring the insurer understood the seriousness of the matter.

After our intervention, the insurer reviewed the case again and retracted their initial decision. They issued a new approval letter, confirming that the claim had been accepted and that the client would receive the full settlement amount of $2,809.50. The client was relieved and grateful for our assistance in resolving the issue swiftly and effectively.

This case highlights the importance of understanding policy terms and being persistent when faced with an unfair denial. We are proud to have supported our client in achieving a positive outcome and ensuring their rights were upheld. If you ever face a similar situation, don’t hesitate to seek professional assistance—it can make all the difference.

Client and insurer identities have been kept confidential to respect privacy.