Travel insurance/health insurance claim problem

Corruptedmorals

Hi, I was wondering if anyone has any advice/experience as to the next step that should be taken in this situation or if the travel insurance can refuse medical expenses.

I am currently making a claim for curtailment and medical expenses for costs arising from clinic attendance, curtailment, hospitalisation and emergency flight home from the US on my travel insurance policy. I believed that my health insurance had no relevance on this. The travel insurance company is refusing to cover the medical expenses (which are by far the largest part of the claim, $6250ish) because I have health insurance. The health insurance is refusing to consider the claim because I did not ring their international assistance number at the time when in America. There's also another aspect, there is a global debt recovery agency acting for the hospital who have said they will pressure the travel insurance agency into paying.

I was wondering, where do I go from here? I will be sending along with travel insurance details a brief note to the debt recovery agency about the travel insurance/health insurance deadlock. The health insurance group need to be contacted again- letter and/or phone, not sure which. Can they just completely dismiss the medical expenses side even with pressure from the debt agency? Their cover booklet does say 'You must ring your health insurer at the time of claiming' NOT 'at the time of illness etc.'. It also says that the health insurer must make the first payment and when they reach their limit, the travel insurer will pay the rest. It says nothing about what they do if you void the health insurance aspect.

I probably sound hopelessly naive here, this was my first independent holiday and the travel agent has proved hopelessly inept at all stages of planning- not least providing insurance proof only 2 days before travel, with no cert of insurance, emergency assistance number, policy booklet or policy number. This delayed everything as I got sick very quickly and it was all my family could do to obtain all of this, ring the number and arrange a last-minute flight home. Nobody had any idea of where the health insurance came in- I thought travel insurance was so neccessary for America because health insurance wouldn't cover it. Thanks for any advice.

ravima

have you given your health insurance details to your travel insurers? You need to do so and perhaps they will sort matters out.

The reason travel insurers want details of health insurer, is that if there is dual cover, and that is for them to decide NOT you, then both contribute in proportion to the level of cover.

marmart

Does the travel agent belong to the IATA ?

Corruptedmorals

ravima wrote: »

have you given your health insurance details to your travel insurers? You need to do so and perhaps they will sort matters out.

The reason travel insurers want details of health insurer, is that if there is dual cover, and that is for them to decide NOT you, then both contribute in proportion to the level of cover.

Yes, I had to on the claim form- policy number, company name, policy name. The letter I received back stated that they could not consider medical expenses because I had health insurance. I understand why they are saying that but if the health insurance cannot consider it then is it the same as not having any health insurance? I think getting a letter from the health insurers stating that they wont cover it and why they wont and sending that to the travel insurers may help.

Corruptedmorals

marmart wrote: »

Does the travel agent belong to the IATA ?

They don't appear to be. It's under an umbrella insurance group, who are regulated by the Irish Central Bank and list the Irish Broker's Association and PIBA on their website, but not IATA.

broker2008

The first time I read the post, it appeared that you got a discount for your travel insurance policy because you had health insurance. If this is the case, the first 55, 65 or €100,000 of an inpatient claim occuring will be picked up by the health insurance plan under their Accident & Emergency section- because you took a discount in premium. One of the conditions is that you have to ring or make contact with their medical contacts while abroad for assistance before getting any work done, the US in particular
.

On second read, did the travel agent arrange the travel insurance policy on your behalf and then asked if you already had health insurance plan?

PM me the relevant company names and some details of when and how you made contact and I try to read the t&c's if you don't want to post details here.