It’s easy to understand why many travellers find it difficult to appreciate the true value that travel medical insurance provides.
After all, most travellers never need to make a claim, and it’s perfectly reasonable to question the value of something you’ve paid for and never used. In fact, only about 9% of Canadians who purchase travel insurance end up making a claim1. In addition, claimants are rarely aware of how high their treatment costs actually are, as medical bills are often invoiced directly to their insurance provider.
However, it’s also important to be aware that medical emergencies due to accidents, sickness, disease or other health issues are unpredictable and can happen to anyone, any time, anywhere - regardless of how young, healthy or careful you are.
And for snowbird, senior and boomer travellers, the likelihood of requiring medical treatment while travelling can increase significantly due to age, health and longer trip durations.
If you’ve ever had a to make a travel medical insurance claim, you already know all too well why travel insurance is essential.
And for those of you who have been lucky enough to never need to make a claim, we felt the best way to demonstrate the value of travel insurance was to share some examples of real-life travel medical insurance claims made by real Canadian snowbirds, seniors and boomers.
The following real-life claims were made for a variety of reasons, in different situations and for varying amounts. They also highlight how the policy you choose and providing full disclosure about your medical conditions can determine whether your claim will be approved or rejected.
1. A Financial Disaster Averted
Suffering a serious illness or injury while travelling can be financially devastating for individuals who don’t have adequate travel insurance, with costs sometimes climbing into the hundreds of thousands of dollars or more, as was the case for this individual.
|
Location |
Florida |
|
Age |
78 |
|
Paid Claim Amount |
$312,714.97 CAD |
|
The Facts |
A 78 year old man was admitted to a Florida hospital with chest pain. After testing, it was determined that the patient had 3 significant heart blockages that required surgery. He could not be repatriated home for surgery and underwent bypass surgery in Florida. |
|
Claim Result |
Claim approved. The claim amount of $312,714.97 was paid in full by the insurance provider. |
2. A Gut Check on Medical Costs
How much could a simple case of food poising possibly cost to treat? The answer might surprise you, as it did this woman.
|
Location |
Florida |
|
Age |
72 |
|
Paid Claim Amount |
$5,699.68 CAD |
|
The Facts |
A 72 year old woman was experiencing stomach pains, high fever and vomiting. She went to the Emergency Room where she was diagnosed with food poisoning, given treatment and underwent testing. |
|
Claim Result |
Claim approved. The claim amount of $5,699.68 was paid in full by the insurance provider. |
3. The Accident
Travel medical insurance doesn’t just cover diseases and illnesses, it also covers injuries resulting from events like falls, accidents and automobile collisions.
|
Location |
California |
|
Age |
63 |
|
Paid Claim Amount |
$47,435.42 CAD |
|
The Facts |
A 63 year old man was riding his bike when he hit a groove in the road and was thrown from his bike. He was found unconscious and brought by ambulance to the hospital, where he was given a CT-Scan and chest X-ray that showed fractured ribs and bruising, which he was treated for. |
|
Claim Result |
Claim approved. The claim amount of $47,435.42 was paid in full by the insurance provider. |
4. The U.S. Isn’t the Only Place with High Medical Costs
Think medical treatment outside the U.S. is so affordable that you don’t need travel insurance? Think again! Fortunately, this traveller was covered when she needed treatment in Mexico.
|
Location |
Mexico |
|
Age |
77 |
|
Paid Claim Amount |
$79,687.56 CAD |
|
The Facts |
A 77 year old woman fell down the stairs while at a restaurant and was taken to the Emergency Room with an injury to her right knee. X-rays identified a fracture that required surgery. |
|
Claim Result |
Claim approved. The claim amount of $79,687.56 was paid in full by the insurance provider. |
5. Check That Stability Clause!
This traveller had a pre-existing medical condition that was not stable when they purchased their travel insurance policy and required treatment for that condition while outside Canada. The treatment costs were covered because they purchased a personalized policy with NO stability requirement for pre-existing medical conditions.
If they had purchased a standard travel insurance policy their claim likely would have been denied, as they would not have met the stability clause requirements contained in most standard policies.
|
Location |
California |
|
Age |
65 |
|
Paid Claim Amount |
$68,658.25 CAD |
|
The Facts |
A 65 year old man had a heart attack and underwent bypass surgery two months before travelling to California. In order to travel to California, he bought a personalized policy with no stability period and pre-existing conditions. While in California he developed chest pains, underwent additional testing and was repatriated back to Canada by air ambulance for additional surgery. |
|
Claim Result |
Claim approved. The claim amount of $68,658.25 was paid in full by the insurance provider. |
6. The Denied Claim
This individual found out the hard way that it doesn’t pay to provide inaccurate information when applying for travel medical insurance. Remember, it’s essential to always provide full and accurate disclosure about your medical condition when applying for travel insurance and keep your insurance provider updated about any changes to your health after you purchase your policy.
|
Location |
Arizona |
|
Age |
55 |
|
Treatment Cost |
$92,651.90 CAD |
|
The Facts |
A husband bought travel insurance policies for his wife and himself. His wife was recently diagnosed with hardening arteries of the heart and was taking medication for angina. The husband decided not to declare his wife’s condition to save on the premium. While in Arizona his wife suffered a heart attack, where it was disclosed that she had a recent history of angina. |
|
Claim Result |
Claim denied. During the claim process, it became clear that the individual intentionally misrepresented the medical condition during the application process, voiding the policy. |
1Pollera Strategic Insights survey of 1,200 Canadians sponsored by the Canadian Association of Financial Institutions in Insurance (CAFII) (June 2018)
Disclaimer: The material provided in the Snowbird Advisor Insurance Learning Centre is for informational purposes only and does NOT constitute insurance, legal, financial or other advice, and should not be relied on as such. If you require such advice, you should speak with a qualified professional to assist you.
