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What is a Travel Insurance Claim?

Travel medical insurance (also known as Visitors insurance) provides financial protection in case of medical emergencies, trip cancellations, lost baggage, or other unexpected travel disruptions. However, to receive reimbursement for your eligible expenses, you need to file a claim with your insurance provider.

A claim is a formal request submitted to your insurance provider, requesting reimbursement for covered expenses or direct payment to healthcare providers. Understanding how to navigate the claims process effectively ensures a smoother experience and prevents unnecessary delays or denials.

Before You File Your Travel Medical Insurance Claim

What happens before you file a travel medical insurance (or visitors insurance) claim can play a huge role in how easily your claims are processed.

Before you use your insurance, make sure you have reviewed your policy thoroughly. Familiarize yourself with what is covered and what is not covered in your policy. However, if you are in an emergency and are unsure whether your emergency is covered by your travel insurance, don't risk it! Get the help you need. The details can be sorted out later-your health and safety comes first.

How to Use Your Travel Medical Insurance

1. Download Your Insurance ID Card Beforehand

If the provider bills the insurance company directly, the claim is typically submitted electronically to your insurance administrator for review. Claims are processed in the order received and generally take 30 to 45 business days for review.

2. Present Your ID Card

When seeking medical treatment, show your insurance ID card to the healthcare provider. However, note that VisitorsCoverage is a marketplace, not an insurance administrator, so providers will not recognize the policy name. Instead, reference the PPO Network listed on your card for direct billing.

3. Pay Attention to Billing Practices

Many in-network providers may bill your insurance company directly, while others may require you to pay upfront and file for reimbursement. It is best not to leave any unknowns, so just call ahead of time and confirm the billing method your chosen healthcare provider uses.

Don't know what an in-network provider is? Don't worry. Learn more about it here.

Gather All the Required Documentation For Your Claim

To successfully submit a travel insurance (or visitors insurance) claim, you must provide proof of your incident and its extent. So make sure you keep all supporting documents that verify the incident that you will be filing a claim for. Here's what you need:

Travel Insurance Claim Checklist

Documents for Travel Medical Insurance Claims
Insurance ID card
Copies of your passport
Medical bills, receipts, and doctor's notes
Previous medical records or health history
Proof of payment (for any expenses paid out-of-pocket)
Documents for Trip Insurance Claims
Insurance ID card
Copies of your passport
Police reports (for theft or accident-related claims)
Flight cancellation confirmations, baggage delay reports, and trip interruption proof
Proof of payment (for any expenses paid out-of-pocket)

Tip: Make sure you know the difference between the two types of travel insurance policies and which one you have! Learn the difference here.

How to File a Travel Medical Insurance Claim

There are two types of billing scenarios: direct billing and pay-and-claim. Depending on the billing process used by your healthcare provider, the claims process will differ. Make sure you know the difference between the two processes before you use your insurance policy so nothing catches you by surprise.

It's important to note that direct billing vs. pay-and-claim only applies to medical claims. If you are filing a trip cancellation, trip delay, theft, or any other non-medical claim through a trip insurance policy, you will automatically follow the pay-and-claim process, as these types of claims always require you to pay upfront and seek reimbursement from the insurance provider.

Scenario 1

Direct Billing (Provider Bills the Insurance Company Directly)

Some healthcare providers work directly with your insurance administrator and submit claims electronically. Unfortunately, this is not a guarantee that your claim will be instantly approved. The insurance administrator must review the claim to determine if the expense is eligible under your policy, and you may still need to follow up.
Claims are processed in the order received and typically take 30 to 45 business days for review. During this time, you can take important steps to help ensure a smooth claims process:
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1. Hold On to Your Documents

Even though your healthcare provider has filed the claim on your behalf, there may be instances where the insurance company requires additional documentation from you before processing the claim.

While your claim is being processed, you will receive a document from your insurance company called an Explanation of Benefits (EOB). You can review the details of what your insurance provider needs by downloading your EOB and checking the remarks.

This could include:

  • Medical records
  • Direct billing records from the healthcare provider
  • A completed claim form
  • A completed accident questionnaire form
  • Medical bills or receipts
  • Physician's notes
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2. Monitor Your Claim

Regularly checking your claim status is essential. Log in to your insurance administrator's account to track updates. Your Explanation of Benefits (EOB) will clearly outline any missing information required to continue processing your claim, helping you avoid unnecessary delays.
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3. Staying Updated on Communications

Most updates and requests for additional information will be sent via email, so be sure to monitor your inbox for messages from the insurance company. Proactively checking your claim status can help keep the process moving.
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4. Need Help?

If you experience delays or issues with your claim, our Claims Assist Team is here to help guide you through the process and provide support as needed. Our team receives limited information from the insurance administrator due to health and privacy regulations (HIPAA).

By staying informed and following these steps, you can help ensure your claim is processed as efficiently as possible.

Scenario 2

Pay-and-Claim (You Pay Upfront & Request Reimbursement)

In this case, you must pay for medical expenses upfront and then submit a claim to your insurance company for reimbursement. This process also applies to trip cancellations, trip delays, lost baggage, theft, and other covered trip insurance claims.

Steps for Filing and Getting Your Travel Medical Insurance Claim Processed

1. Access Your Insurance Administrator's Information

Log into your VisitorsCoverage customer account to find your insurance administrator's contact details and claims forms.

2. Gather Necessary Documents

Collect all required documentation, including copies of your passport, medical bills, receipts, and any other supporting paperwork related to your claim.

3. Complete and Submit the Claim Form

Fill out the claim form thoroughly and accurately, then submit it along with the required documents to your insurance administrator.

Important: You must file a separate claim for each instance you use your policy, whether or not you paid upfront. There is no option to combine multiple claims into one submission.

4. Securely Submit Your Documents

Upload your supporting claim documents directly to your insurance administrator's portal for faster and more secure submission. This method is significantly quicker than email or ground mail, helping expedite the claim process.

5. Claim Review Process

The insurance administrator will review your claim, which may take up to 30-45 business days. You can track the status of your claim by logging into your insurance administrator's account. View their .

During this stage, you will receive a document from your insurance company called an Explanation of Benefits (EOB). This document outlines the details of your claim, any additional documentation required (if applicable), and whether your claim has been approved or denied. Keep this document for future reference, as it contains all the important information related to your claim.

6. Claim Decision & Reimbursement

  • If your claim is approved, reimbursement will be processed via the payment method indicated on your claim form.
  • If your claim is denied, review the Explanation of Benefits (EOB) (available in your insurance administrator account) to determine if additional information is needed for further review.

7. Appealing a Denied Claim

If you notice discrepancies or errors in the claim decision, you have the option to appeal by following the appeal process outlined by your insurance administrator.

By following these steps and ensuring all required documents are submitted promptly, you can help expedite your claim process and receive the benefits you're entitled to. Click here to view more details about the claim process.

Insurance Company Claims Processes

We understand that the claims process can feel daunting, which is why we've created dedicated pages outlining the specific claims procedures for each of our major insurance partners. Simply locate your insurance administrator to review their step-by-step process.

Each company follows the policy terms outlined in your documents, including applicable benefits and exclusions. If you encounter any challenges, our team is here to assist you and provide the support you deserve.

How to Check the Status of your Travel Medical Insurance Claim

There are two ways to check the status of your claim: through your VisitorsCoverage account or your insurance administrator's portal.

We are honored that you have chosen VisitorsCoverage for your travel insurance needs, and we're dedicated to supporting you throughout your journey. As part of this commitment, we strive to make the claims process as clear and easy as possible for you.

For privacy reasons, we are limited in the amount of claim information we can access from the insurance administrator. Therefore, we only receive limited details about your claim. However, to help you keep track of your claims, we provide a quick and easy overview through your VisitorsCoverage account. Log in to access an overview of your claims, including their general status, corresponding claim ID numbers, reported claim amounts, and a summary of the determination. From there, you can also seamlessly navigate to your insurance administrator's portal for more detailed information and updates.

If you need more specific details or updates about your claim, you will need to log into your insurance administrator's portal. There, you can access your Explanation of Benefits (EOB) and get the full information you need.

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What Do Different Claims Statuses Mean

Claim statuses may vary depending on your insurance administrator, but they generally fall into four main categories: New, Pending, Approved, or Denied. Understanding these stages can help you track your claim and take necessary action when needed.

New - Claim Submitted

  • When your claim is first submitted to the insurance company, it will be marked as New until it is assigned for review.
  • Claims are processed in the order received. Don't be alarmed if it takes a month or more before your claim is moved onto the next stage. Your claim is important, rest assured will be processed.

Pending - In Review

  • Once the claim is being processed, the status will change to Pending (or In Review).
  • At this stage, the claims team evaluates whether the expense is eligible under your policy and determines if any additional documentation is needed.

Approved or Denied

  • If the claim meets the eligibility criteria, it will be marked as Approved, and the necessary reimbursement will be issued accordingly.
  • Sometimes a claim is approved, however, there might still be a small amount due from your end due to deductibles and/or coinsurance. Your EOB will specify this for you.
  • If the claim is missing required documents, it may be marked as Denied—but don't worry. For many insurance administrators, "Denied" simply means they cannot proceed until the necessary paperwork is received.

Next Steps if Your Claim is Denied

  • If you see a Denied status, always review the Explanation of Benefits (EOB) for details on any missing documentation.
  • Submit the required information promptly to continue processing your claim.
  • If your claim is officially denied after review, you have the right to appeal the decision if you believe it was incorrectly processed.

By staying informed and monitoring your claim status, you can ensure a smoother experience and take proactive steps to resolve any issues.

Top Reasons Travel Medical Insurance Claims are Denied

1

Lack of Proof of the Incident

Insurance companies require clear documentation of the event that led to your claim. Whether it's a medical emergency, trip cancellation, or lost baggage, supporting evidence is essential. Without proof—such as hospital records, police reports, or airline delay confirmations—the insurer may be unable to verify your claim, leading to a denial.

How to Avoid It

Review your policy's claim submission timeline and file your claim as soon as possible. Gather all required documents and follow up regularly to ensure your claim is being processed.
2

Missing Necessary Medical Documents

For medical claims, insurers need detailed records, including doctor's notes, itemized bills, and proof of payment. Without these, they cannot confirm the treatment received, making it difficult to process your claim.

How to Avoid It

Ask your healthcare provider for all relevant medical documents, including receipts and physician statements, before leaving the facility. If additional paperwork is needed, follow up promptly to prevent delays.
3

Filing a Claim for an Uncovered Expense

Travel insurance policies have specific inclusions and exclusions. Claims for expenses that fall outside the policy's coverage—such as pre-existing conditions (unless covered), elective procedures, or cancellations due to non-covered reasons—are often denied.

How to Avoid It

Read your policy's benefits and exclusions carefully before your trip. If you're unsure whether something is covered, consult with your insurance provider before incurring the expense.
4

Delaying Notification to the Insurance Provider

Most policies require travelers to notify their insurance provider as soon as possible after an incident. Failing to do so can raise questions about the claim's validity and may result in a denial.

How to Avoid It

Report any incidents immediately. For medical emergencies, contact your insurer as soon as it's safe to do so. Many insurance companies offer 24/7 assistance hotlines for real-time guidance.
5

Waiting Too Long to Submit the Claim

Most travel insurance policies have strict deadlines for submitting claims, often within 60-90 days of the incident. If you wait too long, your claim may be denied simply because it was filed after the deadline.

How to Avoid It

Review your policy's claim submission timeline and file your claim as soon as possible. Gather all required documents and follow up regularly to ensure your claim is being processed.

The Bottom Line

The key to a successful travel insurance claim is preparation and attention to detail. Keeping thorough records, understanding your policy, and acting quickly after an incident can significantly improve your chances of approval. If you're unsure about any part of the process, don't hesitate to contact your insurance provider for clarification. By taking these steps, you can avoid unnecessary claim denials and ensure that you receive the benefits you're entitled to.

What is an Explanation of Benefits (EOB)?

At first glance, an EOB might seem complicated, but it's actually easier to understand than you might think! It's important to note that an EOB is not a billrather, it helps you understand the true status of your claim, including any payments issued to the claimant or any remaining balance owed by the insured person. Your EOB provides a clear breakdown of how your insurance administrator processed your claim, including:

  • How negotiated rates were applied within the PPO Network
  • How the provider visits were coded
  • Any deductibles or copays that were applied
  • Whether the claim was approved or denied
  • Remarks indicating what information is needed or why the claim was denied
  • Any balance owed by the insured or paid by your insurance administrator

View our detailed guide on how to read your EOB for a step-by-step explanation. If you need further clarification, our Claims Assist Team is always here to help!