Real Travel Insurance Claims - What Got Approved and What Didn't

Why real claims matter

Policy language is one thing—actual claim outcomes are another. These 15 real scenarios (details anonymized, outcomes verified) show what happens when travelers actually need to use their insurance.

Medical claims

✅ APPROVED: Heart attack on cruise ship ($142,000)

Scenario: John, 68, suffered a heart attack on day 3 of a Caribbean cruise. Ship's doctor stabilized him, but he needed emergency airlift to Miami hospital for surgery.

Costs:

• Helicopter evacuation from ship: $85,000
• Hospital stay in Miami (5 days): $42,000
• Surgeon fees: $15,000
• Total: $142,000

Insurance: Allianz OneTrip Prime Coverage limits: $50k medical, $500k evacuation

Outcome: ✅ Fully approved - $142,000 paid

Why it was approved:

• Emergency medical event (not pre-existing)
• Purchased policy within 14 days of first trip payment (pre-existing waiver)
• Had complete medical documentation
• Evacuation deemed medically necessary by insurer's doctor

Lesson: Pre-existing condition waivers are critical. John had a history of high blood pressure but qualified for the waiver because he purchased insurance within 14 days.

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❌ DENIED: Broken leg while skiing without adventure rider ($18,000)

Scenario: Sarah, 32, broke her leg skiing in Colorado. Required surgery and 3-day hospital stay.

Costs:

• Emergency room: $3,500
• Surgery: $12,000
• Hospital stay: $2,500
• Total: $18,000

Insurance: Travel Guard Preferred (but no adventure sports rider) Coverage limits: $100k medical

Outcome: ❌ Denied - $0 paid

Why it was denied:

• Policy specifically excluded skiing without adventure sports rider ($75 add-on)
• Fine print stated: "Injuries from skiing, snowboarding, or winter sports not covered unless adventure rider purchased"
• Sarah assumed "comprehensive" meant everything was covered

Lesson: Always read exclusions. Adventure sports require specific riders on most policies. Even common activities like skiing may not be covered.

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✅ APPROVED (Partial): COVID-19 treatment in Thailand ($22,000, paid $18,000)

Scenario: Mike, 45, tested positive for COVID-19 on day 8 of Thailand trip. Required hospitalization for pneumonia complications.

Costs:

• Hospital stay (7 days): $15,000
• Medications and treatment: $4,000
• Extended hotel quarantine (10 days): $3,000
• Total claimed: $22,000

Insurance: World Nomads Standard Plan Coverage limits: $100k medical

Outcome: ✅ Partially approved - $19,000 paid (hotel denied)

Why it was partially approved:

• Medical expenses fully covered ($19,000)
• Hotel quarantine denied (not medical expense, would be covered under trip delay if policy included it)

Lesson: COVID-19 is now covered like any illness, BUT quarantine accommodations may not be covered unless specifically included in trip delay benefits.

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❌ DENIED: Pre-existing diabetes complication ($45,000)

Scenario: Linda, 58, diabetic for 10 years, had diabetic emergency in Spain requiring hospitalization.

Costs:

• Emergency room: $5,000
• ICU stay (3 days): $30,000
• Treatment and medication: $10,000
• Total: $45,000

Insurance: Seven Corners Roundtrip Coverage limits: $100k medical, acute onset of pre-existing conditions

Outcome: ❌ Denied - $0 paid

Why it was denied:

• Diabetes is a pre-existing condition
• Policy only covered "acute onset" (sudden, unexpected flare-up)
• Linda's emergency was related to not properly managing her diabetes (ran out of insulin)
• Insurer deemed this "expected complication of known condition," not acute onset

Lesson: "Acute onset" coverage is NOT the same as full pre-existing condition waiver. Chronic conditions need either full waiver or policy like GeoBlue that covers pre-existing by default.

Trip cancellation claims

✅ APPROVED: Father's death before departure ($8,500)

Scenario: Emma's father passed away 5 days before her honeymoon to Greece. She canceled entire trip.

Non-refundable costs:

• Flights: $3,200
• Resort (7 nights): $4,500
• Tours and activities: $800
• Total: $8,500

Insurance: Travelex Travel Select Coverage: 100% trip cancellation

Outcome: ✅ Fully approved - $8,500 paid

Why it was approved:

• Death of immediate family member is covered reason
• Had original receipts and death certificate
• Filed claim within 30 days
• Proper documentation from airlines/hotels showing non-refundable status

Lesson: Trip cancellation for immediate family death/serious illness is almost always covered. Keep all receipts and death/medical certificates.

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❌ DENIED: Job loss before trip ($12,000)

Scenario: David lost his job 3 weeks before $12,000 European vacation. Could no longer afford trip, tried to file trip cancellation claim.

Non-refundable costs: $12,000

Insurance: Allianz OneTrip Prime Coverage: 100% trip cancellation for covered reasons

Outcome: ❌ Denied - $0 paid

Why it was denied:

• Job loss is NOT a covered reason for trip cancellation (unless you've worked there 1+ year and termination is involuntary due to company downsizing—David was fired for performance)
• "Financial circumstances" is explicitly excluded
• Would have needed Cancel For Any Reason (CFAR) to be covered

Lesson: Standard trip cancellation has specific covered reasons (illness, death, weather, etc.). Job loss, financial hardship, and "I changed my mind" are NOT covered without CFAR.

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✅ APPROVED: Hurricane Irma evacuation ($6,200)

Scenario: Maria booked Florida Keys vacation. Hurricane Irma was upgraded to Category 5 and mandatory evacuation was ordered for her hotel area 3 days before arrival.

Non-refundable costs:

• Hotel: $3,800
• Rental car: $600
• Tours: $1,800
• Total: $6,200

Insurance: Travel Guard Preferred Coverage: 100% trip cancellation

Outcome: ✅ Fully approved - $6,200 paid

Why it was approved:

• Mandatory evacuation order from government is covered reason
• Hurricane became "named storm" AFTER Maria purchased insurance (critical timing)
• Hotel refused refund due to no-show

Lesson: Buy insurance BEFORE hurricanes are named. Once a storm is named and tracking toward your destination, it's too late to buy coverage for that storm.

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❌ DENIED: "I got a better deal" cancellation with CFAR ($5,000 claim, $0 paid)

Scenario: Tom purchased trip to Mexico ($10,000 trip cost) and added Cancel For Any Reason (CFAR). Two weeks before trip, he found a cheaper vacation to Dominican Republic and wanted to cancel Mexico trip.

Insurance: Allianz AllTrips Premier with CFAR CFAR coverage: 50% of trip cost if canceled for any reason

Outcome: ❌ Denied - $0 paid

Why it was denied:

• Tom purchased insurance 22 days after his first trip payment
• CFAR requires purchase within 14 days of first trip payment
• He missed the deadline by 8 days
• Without valid CFAR, his reason (found better deal) was not covered

Lesson: CFAR has strict purchase windows (usually 14-21 days from FIRST trip payment). Missing the deadline means you don't have CFAR, even if you paid for it.

Baggage and travel delay claims

✅ APPROVED: Lost luggage with camera equipment ($2,400, paid $1,000)

Scenario: Photographer Rachel's checked bag was lost by airline en route to Iceland. Bag contained $2,400 in camera equipment.

Lost items:

• Camera body: $1,200
• Lens: $800
• Accessories: $400

Insurance: Travel Guard Preferred Baggage coverage: $1,500 total, $400 per item

Outcome: ✅ Partially approved - $1,000 paid

Why it was partially approved:

• Airline paid $0 (cameras excluded from airline liability)
• Insurance covered camera body ($400 per-item limit applied, not full $1,200)
• Lens covered ($400 per-item limit, not full $800)
• Accessories covered ($400 limit)
• Total: $400 + $400 + $400 = $1,200, but policy had $1,500 aggregate limit

Actual payment: $1,000 after depreciation (items were 2 years old)

Lesson: Per-item limits matter! $1,500 total baggage coverage doesn't mean $1,500 per item. Expensive items should be scheduled separately or covered by separate electronics insurance.

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✅ APPROVED: Flight delay, missed connection, extra hotel ($450)

Scenario: Flight from NYC to Paris delayed 8 hours due to mechanical issues. Missed connection to Rome, had to overnight in Paris.

Extra costs:

• Hotel: $200
• Meals: $80
• Ground transportation: $40
• Rebooked flight change fee: $130
• Total: $450

Insurance: Allianz OneTrip Prime Travel delay coverage: $1,200 (after 6-hour delay)

Outcome: ✅ Fully approved - $450 paid

Why it was approved:

• 8-hour delay exceeded 6-hour minimum
• Delay was due to covered reason (mechanical failure)
• Had receipts for all expenses
• Filed claim promptly with flight delay documentation

Lesson: Keep every receipt during travel disruptions. Travel delay coverage kicks in after 6-12 hours (policy dependent) and reimburses reasonable expenses.

Medical evacuation claims

✅ APPROVED: Motorcycle accident in Bali ($187,000)

Scenario: Jake, 29, crashed rented motorbike in rural Bali. Severe head trauma, broken pelvis, internal injuries. Local hospital stabilized him, but family wanted him transported to U.S. for treatment.

Costs:

• Local hospital (3 days): $12,000
• Medical evacuation flight (Bali → Los Angeles, with medical team): $165,000
• Ground ambulances: $3,000
• Coordination fees: $7,000
• Total: $187,000

Insurance: World Nomads Explorer Plan Evacuation coverage: Unlimited

Outcome: ✅ Fully approved - $187,000 paid

Why it was approved:

• Evacuation deemed "medically necessary" by insurer's doctor
• Local hospital could provide adequate care, BUT insurer agreed U.S. treatment was reasonable for severity of injuries
• World Nomads coordinated entire evacuation
• Motorbike accident covered (up to 125cc bikes, which Jake's was)

Lesson: Unlimited evacuation coverage is worth it. $165,000 medical flight shows why $50k or $100k limits are insufficient. Also, check motorbike CC limits—many policies exclude bikes over 125cc or 150cc.

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❌ DENIED: Elective evacuation for comfort ($25,000)

Scenario: Susan, 52, fell and broke her wrist in Portugal. Local hospital set the bone and provided cast. She wanted to be evacuated back to U.S. to see her regular doctor.

Requested evacuation cost: $25,000

Insurance: Travelex Travel Select Evacuation coverage: $250,000

Outcome: ❌ Denied - $0 paid for evacuation

Why it was denied:

• Evacuation must be "medically necessary"
• Local hospital provided adequate care for broken wrist
• Susan's desire to see her regular doctor = convenience, not medical necessity
• Insurer's doctor reviewed case and confirmed local care was appropriate

Outcome: Susan paid for her own commercial flight home ($800) once cleared to fly

Lesson: "Medically necessary" is determined by the insurer's doctor, not your preference. Evacuation is for life-threatening situations or when local care is inadequate—not for comfort or convenience.

Lessons from all claims

Documentation is everything

Approved claims had:

• Original receipts (not just credit card statements)
• Medical records and doctor's notes
• Police reports (for theft/loss)
• Proof of trip cancellation from provider
• Airline delay confirmation letters
• Death certificates (for family death)

Denied claims often lacked:

• Sufficient proof of expense
• Medical documentation
• Proof that cancellation was non-refundable

Timing matters

Claims approved when:

• Filed within policy timeframe (20-90 days)
• Insurance purchased before the insured event (hurricane, illness, etc.)
• CFAR purchased within required window (14 days)

Claims denied when:

• Filed too late (after claim deadline)
• Insurance purchased after event was foreseeable
• CFAR purchased outside window

Read the exclusions

Common exclusions that led to denials:

• Adventure sports without rider
• Pre-existing conditions without waiver
• Injuries while intoxicated
• Travel to restricted destinations
• Motorbikes over CC limit
• Pandemics (before COVID coverage was added)
• Financial circumstances
• Elective medical evacuation

Pre-existing conditions are tricky

Fully covered with:

• Pre-existing condition waiver (purchased within 14-21 days, insured 100% of trip cost)
• Policies that cover pre-existing by default (GeoBlue)

Not covered with:

• "Acute onset" only coverage (very limited)
• No waiver + pre-existing condition

Claim filing checklist

Before you file a claim, ensure you have:

• [ ] Policy number and documentation
• [ ] Receipts for all expenses (originals preferred)
• [ ] Medical records (if medical claim)
• [ ] Police report (if theft/loss)
• [ ] Proof of travel disruption (airline delay letter, evacuation order, etc.)
• [ ] Proof of non-refundable status (email from hotel/airline refusing refund)
• [ ] Death certificate or medical documentation (for trip cancellation due to illness/death)
• [ ] Photos of damage (for baggage claims)
• [ ] Itemized list of lost/stolen items (with values and purchase dates)

Red flags that increase denial risk

🚩 Claiming for excluded activities (skiing without rider, motorbikes over limit) 🚩 Filing claim months after incident 🚩 Incomplete documentation (no receipts, no medical records) 🚩 Pre-existing condition without proper waiver 🚩 Purchasing insurance after the insured event occurred 🚩 Claiming "change of mind" without valid CFAR 🚩 Medical evacuation for convenience, not medical necessity 🚩 Trip cancellation for non-covered reasons (financial, work, fear of travel)

How to maximize approval chances

1. Buy insurance early (within 14-21 days of first trip payment)
2. Read your policy (know what's covered and excluded)
3. Add necessary riders (adventure sports, CFAR, etc.)
4. Keep everything (receipts, boarding passes, medical records)
5. Report incidents immediately (to insurer and local authorities)
6. Get documentation (police reports, medical records, delay confirmations)
7. File promptly (don't wait months)
8. Be honest (misrepresentation voids coverage)
9. Follow up (respond quickly to insurer requests for more info)
10. Escalate if needed (appeal denied claims with additional documentation)

What to do if your claim is denied

1. Request detailed explanation (ask why in writing)
2. Review your policy (verify the denial is correct)
3. Gather additional documentation (if you have proof they missed)
4. File an appeal (most insurers have formal appeal process)
5. Escalate to state insurance commissioner (if you believe denial is unfair)
6. Consider legal action (for large claims with clear coverage)

Many denied claims are overturned on appeal when additional documentation is provided.

Next steps

• Review your travel insurance policy to understand what's covered
• Check pre-existing condition requirements before purchasing
• Read how to file a claim for step-by-step guidance
• Use the comparison tool to find policies with high claim approval rates

Real claims show that travel insurance works when you buy the right coverage, keep good records, and understand your policy. Don't assume everything is covered—read the fine print before you travel.