How to Make a Travel Medical Insurance Claim | AMA Travel

How to Make a Travel Medical Insurance Claim

The last thing anyone ever expects when they’re travelling is to have a medical emergency. When these situations hit you, it can be chaotic: What facility should you use? Will you have to pay up front? What if you don’t speak the same language as the medical professionals?

We’re here to take you through the process so, when an emergency happens, you can focus on the task at hand, and we can take care of the details.

The Best Answer to an Emergency is Preparation

The first step in filing a claim starts long before the emergency hits. When you are filling out your medical questionnaire, it’s important to be as accurate as possible with your information. For example, if you do not disclose that you have ongoing medical treatments and this is discovered through the claim process, you may find out that you weren’t covered in the first place.

Our travel agents and insurance professionals are here to ensure you have exactly the right travel medical insurance you need, so the more information you give them, the better they can help.

After you purchase your coverage, you will be given a document with contact information to an assistance company. An assistance company is an independent third party company hired by your insurance provider to assist you in an emergency and adjudicate claims. You will also receive a card you can place in your wallet for easy access that will include their contact information and your policy number. Keep this close at hand.

You’re in an emergency

The first thing you should do is call the assistance company using the contact card you’ll keep in your wallet. The assistance company will refer you to a facility to handle the emergency, and if you don’t speak the local language, the assistance company will have people on staff who speak the most common languages who can interpret your needs to the professionals.

In an emergency, the assistance company will ask for:

  • your location
  • if you are currently safe
  • what is happening at that exact moment
  • if you can get to a hospital or clinic on your own
  • if you need an ambulance
  • what is your Alberta Health Care number or family physician's contact
  • is there an emergency contact for an individual at home
  • From there, the assistance company will recommend which facilities in your area to use, and if necessary they can contact emergency services so that you can get there quickly.

    Italian ospedale

    Q: What if I can’t get through to the assistance company by phone?

    If you are unable to get through to the assistance company there’s no need to worry: contact a family member at home, provide them with your policy number and the phone number for the assistance company, and they can contact the company on your behalf. The contact card also has an email address to contact them if calling by phone isn’t an option. However, their lines are open 24/7 with someone triaging calls as soon as they are received.

    Q: Will I not be covered if we can’t wait and I go to a facility before the assistance company can offer a recommendation on where to go?

    Not at all. If you were unable to get in contact with the assistance company, or if emergency responders couldn’t wait to be told where to go, call as soon as you are able. However, without contact with the assistance company, you may be required to pay for services up front and be paid back later. The facilities the assistance company recommends are frequently those who will bill your insurance company directly so you don’t have to deal with it, but the assistance company will always attempt to set up billing with any hospital.

    I'm in a medical facility and in contact with the assistance company

    The first thing the assistance company will check is if your claim is covered by your insurance plan, and if you have any pre-existing medical conditions. This may require your Alberta Health Care number to contact your family physician and attain those records. Claim forms will be sent to you to be filled out and sent back.

    If you are not covered for your specific emergency, you will be informed as soon as possible so you don’t incur medical services for which you are not covered.

    Keep in contact with the assistance company as the situation progresses. They communicate with the medical facility, as well as inform your insurance company of the end of emergency. This will help the claim to be paid out in a timely manner.

    hospital treatment

    Q: Can I change my coverage/extend the dates of my coverage while on the trip?

    You can extend your coverage while you’re away, but only if:

  • there's no claim you're currently in the process of making
  • you aren’t currently seeking treatment or need to see a medical professional
  • your coverage hasn’t lapsed, due to duration limitations and other reasons

  • If you are in a facility that works with the assistance company, the facility’s finance department will forward all bills to your insurance company. If you selected in your coverage to pay a deductible, you’ll have to pay that amount up front.

    If you are required to pay up-front, but your insurance coverage does in fact cover your situation, keep your receipts. Upon returning home, you can send them to the assistance company and you will be reimbursed. If you chose the coverage option that requires a deductible, the amount for the deductible will be subtracted from your reimbursement.

    Q: The assistance company is recommending that I come home but I want to stay. What happens to my coverage?

    Similar to the hospital or medical facility declaring the end of emergency, if the assistance company recommends that you should come home and you decide to stay longer, you will no longer be covered under your current policy for anything related to your condition that required emergency treatment.

    broken arm beach

    Handy Tips

    So, some handy tips to help you submit a claim:

  • Fill out your insurance claim forms promptly and properly including any other sources of coverage you may have
  • Keep your policy number and the contact for the assistance company close at hand
  • In the case of an emergency, call the assistance company as soon as you can
  • Keep all your receipts related to dealing with the emergency
  • Stay in contact with the assistance company throughout the process

  • At AMA, we offer comprehensive travel medical insurance so you don’t have to be worried when you’re abroad. To learn more, visit our travel medical insurance page, or contact your local AMA travel agent online or over the phone. We’ll be happy to give you peace of mind.

    About the Author
    Caleb Caswell
    Caleb Caswell is the digital copywriter for AMA Travel. When travelling, he enjoys not making plans and expanding his wardrobe. His top travel recommendation is trying Japan’s raw-chicken tataki. C’mon, live a little.