All travel medical insurance policies include language that requires you to contact your travel insurance provider’s 24/7 Emergency Assistance Centre prior to obtaining medical assistance
Your policy will also likely include language stating that if it is impossible to contact your provider’s Emergency Assistance Center prior to obtaining medical treatment, you or some on your behalf must contact your provider as soon as possible.
The exact wording of these clauses will differ depending on your provider, but it’s important to be aware of and comply with these requirements, as failing to contact your provider in accordance with the terms of your policy may result in some or all of your medical treatment costs not being covered under your policy.
Here’s what you need to know about these requirements, along with some helpful tips to comply with them.
Why do travel insurance companies require that you contact them prior to seeking medical treatment?
There are many reasons why travel insurance providers require you to contact them before seeking treatment, including:
- Directing you to treatment providers: Travel insurance providers have a roster of preferred hospitals, clinics and physicians and whenever possible will direct you to one of these facilities for treatment to help ensure the quality of care you receive, that the treatment provider is appropriate for the treatment you require and to allow them to better coordinate and manage your care.
- Arranging direct billing with your treatment provider: In many cases, your insurance provider will be able to arrange direct billing for your claim with one of their preferred treatment providers so you won’t need to incur any out-of-pocket medical expenses. Otherwise, you may need to cover these costs out of pocket and seek reimbursement from your insurance provider later.
- Simplifying the claims process: If your insurance provider coordinates your care and treatment from the beginning, they can usually obtain most of the necessary documents and information directly from your treatment provider, which can help speed up and simplify your claim.
- Informing you if your treatment is covered: Contacting your provider before seeking treatment allows them to inform you if the treatment you are seeking is covered by your policy and if there are any coverage limits or restrictions prior to receiving treatment.
- Determining if your treatment is “medically necessary”: Emergency travel medical insurance only covers treatments that are considered “medically necessary”. For example, your insurance company may not recognize some diagnostic, medical and laboratory procedures as "emergency" benefits or necessary under your circumstances. If you receive treatments that are not considered to be medically necessary by your insurer, they may not be covered under your policy, and you may have to pay for them personally. Contacting your provider before seeking treatment can help reduce this risk.
What if there is no time to contact my insurance provider?
Insurance providers understand that there are extenuating circumstances under which you may not be able to contact them before seeking medical treatment. For example, if you suffer a serious medical issue like a heart attack or stroke or an injury that requires immediate medical attention.
In instances like this, your priority should be to seek medical attention first and contact your insurance provider - or have someone else contact them on your behalf - as soon as possible.
Here are a few tips you can follow to help make contacting your insurance provider easier when seeking treatment:
Call the Right Department
In most cases, your travel insurance provider will have two different departments you can call, each with different phone numbers. It’s important to be aware of the differences between these two departments and ensure you are contacting the correct one:
- Emergency Assistance Centre
This department is available 24 hours a day, 7 days a week and is where you should call if you are experiencing a medical emergency, require assistance with a claim or have an urgent question about your coverage.
The Emergency Assistance Centre will have a toll-free number for calls made from within Canada and the U.S. and a collect number for calling from outside Canada and the U.S. You should carry both of these numbers with you, as even if you are in the U.S., there may be rare occasions when the toll-free number doesn’t work and you may need to call collect.
If you are travelling outside Canada and the U.S., you will also want to find out how to make a collect call from your destination back to Canada ahead of time so you don’t have to figure it out in the heat of the moment when you are dealing with a medical emergency.
- Sales and Service Centre
This department is only open during regular business hours and is there to assist you with purchasing a policy, making changes to your policy and answering general, non-urgent questions.
You should not call this department if you are having a medical emergency or require claims assistance, as they may be closed. And if they are open, they won’t be able to help you and will simply refer you to the Emergency Assistance Centre.
The Sales and Service Centre will usually have different phone numbers from the Emergency Assistance Centre (a toll-free number to call from within Canada and a collect number to call from outside Canada) so make sure you are calling the Emergency Assistance number.
Quick and Easy Access to Emergency Contact Information
To ensure you can quickly and easily reach your insurer whenever necessary, we suggest you and your travel companion:
- Carry the emergency contact card given to you by your provider with you at all times when travelling. Sometimes this will be a physical card, but most often it will be included in your policy confirmation letter in digital format that you can print.
- Add your insurer’s emergency contact information in your cell phone’s contacts.
- Download your insurer’s emergency assistance mobile app to your cell phone - if they offer an app.
Carry Your Policy and Policy Number(s) With You
To expedite the process when contacting the Emergency Assistance Centre, it’s a good idea to have your policy and policy number(s) readily available.
We suggest you any of your travel companions carry a hard copy of your policy and policy confirmation letter with you, as well as download these documents to your cell phone in a location that is easy to access. You can also add your policy number(s) under your provider's emergency contact information in your cell phone.
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.