Our C.I.F. is designed to help us help the Client. The more information we have on a client the better we can assist to find the best plan. As brokers, we have access to most of the plans on the market. Every plan has their own application and questionnaire as well as their own definitions. So for us to be able to know your health will in turn help you.
Everyone has heard horror stories about someone having their claim denied. Why is that? Is it because all insurance companies are just looking to deny claims for their own benefit? The answer is, no. The fact is, that Insurance companies payout millions of dollars every year on claims.
So then why do people still have denied claims? There are four reasons why clients can have a denied claim:
- Eligibility – Every company has their own eligibility questions and if one of those questions are answered incorrectly, the policy would be voided.
- Category – Most plans on the market categorize individuals with more questions about the person’s health. If the Client does not answer the question(s) correctly, the policy can be voided and the claim would be denied. Note that there are some plans that have a contingent plan that could protect the Client from making a mistake in the Category section (each plan is different).
- Stability – Even though you may be eligible and in the proper category does not mean that you are covered for everything. With any pre-existing medical condition(s), you need to be stable for the stability period the category that you fit into. When we talk about stable or stability, this does not mean your definition of stable, this also, does not mean your Doctors definition of stable. The definition you have to go by is from the plan that you are on. Make sure you read their definition.
- General conditions, exclusions, limitations and restrictions – Every company has this. Some things may seem logical but others you may not know. You should always read through your policy wording to know and understand what you buy. We find, most people do not read the policy wording but then in the end, you would not be helping yourself by not reading it. Example of this would be a claim of alcohol intoxication and resulting in an injury to yourself.
As high as Travel Insurance rates may seem, surprisingly, they are not. The Travel Insurance business is a young industry. At the beginning, to purchase a policy, there were only two categories. One category for age and the other was the duration of the trip. It did not matter if a client was the healthiest person or the unhealthiest; there was just one price for that category. Over time, eligibility came into play and so did the health categories. Because why should someone, very healthy, have to pay the same for someone that had health problems? So, now we are into the era where there are no plans perfect for everyone out there. Travel Insurance for Insurance companies is one of the hardest industries to get right and make a profit. And yes, profit because all the companies on the market are not in the business just for fun. If they have a loss, things will change. As Brokers, we see this and try to mediate between companies and clients. Help both sides get what they want. Protect the client at a reasonable cost but at the same time sell and create revenue for the companies and also communicate to better their plans.
Rates are determined by three factors.
- The Canadian Dollar
- US hospital costs
- Medical inflation. Each year the US hospitals raise their rates around 8%
- Claim ratio
- Claim ratio is how the company much a company receives in sales compared to how much they had to payout from all the claims that came in
- For example; If the company receives $1,000,000 in revenue (sales from policies) but they had to payout $500,000 in claims (from hospitals, transportation…etc.), then the claims ratio would be 50%.
Ultimately, you are your last line of defense. This is your policy and need to make sure that everything is in order so that if you do need to put in a claim, it is covered. So, some steps to ensure that you purchase the right coverage are. In the event of any claim over a certain amount (differs from company to company. E.g. a claim over $2500), the Claims Department will go back to your Doctors record. They do not talk to you about your passed health or even talk to your Doctor(s). They just receive a copy of your medical history and go with that.
The biggest thing about coverage is to know what is on your Doctor’s record. As most people are not Doctors and when it comes to health and the medical field, how can you expect to know or understand everything the Doctor is telling you as well to remember it all (besides some of the obvious things, such as, you had a heart attack…), but saying that, it is still your responsibility to answer the travel health medical questionnaire properly. So, you must do what you must to either get a copy (or summary) of your medical records or to make your own, correct notes on paper/computer. Just anything that is accurate that you can go back on so you do not have to rely on your memory because the biggest lie you can tell yourself is, “I don’t need to write it down, I will remember that”.
Doctors are not insurance people and insurance people are not Doctors. When it comes down to conditions and stability, they do not always agree on these points. But when purchasing insurance, you will need to go by the words of the application and policy wording by the insurance company because it would be the insurance company paying the claim(s) and not your Doctor(s).
As you can see, Travel Insurance is extremely complicated. So then why would you or anyone want to risk paying for a complex purchase on your own or with someone that does not specialize selling this type of product? Ultimately, going through a Broker is your best bet. Do not forget, they can only advice and suggest the best plan, it is up to you to make sure that it is finalized properly and correct.
Travel Guardian’s Members Only REwards Program allows our clients to receive some great deals on three new sections.
- home & auto insurance,
- individual health insurance and
- perks – discounts and deals from various restaurant, attractions…etc.
With each of these new segments along with our travel insurance, you will find our MORE Program to be very rewarding. But do not take our word on this. Please compare today. You can either call us or click on the instant quote and check it out yourself.