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Travel Insurance

How to Make a
Travel Insurance Claim

Published
Updated
8 min read
By EGE Insurance Advisory Team, licensed by FSRA Ontario
Quick Answer
Call the insurer’s 24/7 assistance line before you receive treatment whenever you possibly can. That single call is what turns a reimbursement fight into a managed claim, many policies reduce or deny benefits when treatment goes ahead without notification. Then keep every original receipt and report, and submit inside the policy deadline.
24/7
Assistance lines operate around the clock
Call first
Before treatment whenever possible
30–90 days
Common claim submission deadline
Originals
Keep every receipt and report

1 Step One: Call the Assistance Line First

Every Canadian travel medical policy includes a 24/7 emergency assistance number, printed on your certificate and usually on a wallet card. It is not a customer-service line, it is the operational centre of your claim.

  • It can direct you to a hospital the insurer works with, which often means direct billing instead of you paying up front
  • It can guarantee payment to the hospital so treatment is not delayed
  • It opens the claim file at the moment of the emergency, with the insurer's own record of events
  • It confirms what is authorised before costs are incurred
Many policies reduce benefits, sometimes substantially, when non-emergency treatment proceeds without prior notification. If a true emergency prevents the call, have a companion or the hospital call as soon as you are stable.

2 The Full Claim Process, Step by Step

  1. Call the 24/7 assistance line before treatment if at all possible, and note the file or reference number they give you.
  2. Follow their direction on where to be treated. A network facility often bills the insurer directly.
  3. Keep every original document, itemised bills, receipts, prescriptions, and the medical report describing diagnosis and treatment.
  4. Get the diagnosis in writing, not just the invoice. Insurers assess the medical event, not only the amount.
  5. Submit the claim form within the policy deadline, commonly 30 to 90 days after the event, check your certificate for the exact figure.
  6. Respond quickly to requests for medical records, including any authorisation form the insurer needs to obtain your Canadian file.
  7. Keep copies of everything you send. Claim files can move between adjusters.

3 Documents to Keep

Assemble these as you go rather than after you get home. Reconstructing paperwork from another country weeks later is the hardest part of any claim.

DocumentWhy It Matters
Itemised hospital or clinic billInsurers reimburse line items, not summary totals
Medical report / discharge summaryEstablishes diagnosis, treatment, and that the event was an emergency
Prescription receiptsEmergency medications are often reimbursable
Proof of paymentCard statements or receipts showing you actually paid
Proof of travel datesBoarding passes or itinerary confirming the trip window
Assistance-line reference numberLinks your file to the insurer's own record
Police or incident reportRequired for theft, accident, or third-party involvement
Photograph every document before you hand over an original. Phone photos have rescued more claims than any other single habit.
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4 Deadlines and Timelines

Two clocks matter, and they are different. The first is your deadline to submit; the second is the insurer's time to decide.

  • Notification: immediately, or as soon as medically possible
  • Submission: commonly 30 to 90 days after the event, per your certificate
  • Assessment: often several weeks, longer when overseas medical records are requested
  • Payment: after assessment, by cheque or direct deposit, less any deductible
Missing a submission deadline is one of the few claim problems that cannot be argued on the merits. If you are waiting on a document, submit the claim anyway and send the document when it arrives.

5 The Most Common Reasons Claims Are Denied

Non-disclosure
Most common
A condition or medication not declared on the application, discovered when the insurer reviews your medical file.
Unstable pre-existing condition
Frequent
The condition changed inside the look-back window, so the related claim falls outside coverage.
No prior notification
Avoidable
Non-emergency treatment obtained without calling the assistance line first.
Not an emergency
Definitional
Routine care, follow-up, or treatment that could reasonably have waited until you returned to Canada.

The first two are decided long before the trip, on the application form. Our pre-existing conditions guide covers how to get that part right.

6 If Your Claim Is Denied

A denial is a decision, not a verdict. Insurers have internal appeal processes, and Canada has an independent ombudservice for general insurance disputes.

  1. Request the denial reason in writing, with the specific policy clause relied on.
  2. Read that clause against your certificate. Denials sometimes cite wording from a different plan tier.
  3. Gather contradicting evidence, a physician's letter confirming stability or confirming the event was a genuine emergency carries real weight.
  4. File a written internal appeal with the insurer's complaints officer.
  5. Escalate to the General Insurance OmbudService (giocanada.org) if the internal process ends without resolution.
  6. Keep your broker informed throughout. EGE Insurance advisors can help interpret the wording and assemble the appeal file.
Claiming on a parent’s Super Visa policy instead? The process differs in places, see our Super Visa insurance claim guide.

7 How to Make the Claim Easier Before You Leave

  • Save the assistance number in your phone and on paper
  • Carry a printed certificate, not only an email
  • Tell a travelling companion where the policy details are
  • Keep a current medication list with you
  • Answer the medical questionnaire from your pharmacy printout
  • Confirm the trip-length limit covers your return date, see the annual vs single-trip guide

Browse the full library on Insurance Guides, or start a quote on Travel Insurance.

Summary: Travel Insurance Claims

Key Takeaways
  • Call the 24/7 assistance line first, before treatment whenever possible
  • Network facilities often mean direct billing instead of paying up front
  • Keep itemised bills and the medical report, not just receipts
  • Submission deadlines are commonly 30 to 90 days after the event
  • Non-disclosure is the top reason travel medical claims are denied
  • You can appeal internally, then escalate to the General Insurance OmbudService
  • Photograph every document before handing over an original

8 Frequently Asked Questions

How do I make a travel insurance claim in Canada?
Call the insurer's 24/7 emergency assistance line before treatment if possible, follow their direction on where to be treated, keep all itemised bills and medical reports, and submit the claim form within your policy's deadline, commonly 30 to 90 days after the event.
Do I have to call before going to the hospital?
Whenever you possibly can, yes. Many policies reduce benefits when non-emergency treatment goes ahead without notification. In a life-threatening emergency, get treatment first and have someone call the assistance line as soon as you are stable.
How long do I have to submit a travel insurance claim?
Deadlines vary by policy but commonly fall between 30 and 90 days after the medical event. Check your certificate for the exact figure, and submit on time even if you are still waiting on a document.
What documents do I need for a travel medical claim?
Itemised hospital or clinic bills, the medical report or discharge summary showing diagnosis and treatment, prescription receipts, proof of payment, proof of travel dates, and the assistance-line reference number. A police or incident report is needed for theft or accidents.
Why was my travel insurance claim denied?
The most common reasons are non-disclosure, an unstable pre-existing condition, no prior notification, and non-emergency treatment. See our pre-existing conditions guide.
Can I appeal a denied travel insurance claim?
Yes. Request the denial reason in writing with the policy clause cited, file a written internal appeal with the insurer's complaints officer, and if that ends without resolution, escalate to the General Insurance OmbudService.
Will the insurer pay the hospital directly?
Often yes, if you call the assistance line and are treated at a facility the insurer works with. That is one of the strongest practical reasons to call before treatment rather than paying up front and seeking reimbursement.
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