Advocate Law Group
Travel and Accident Insurance – What it is
Travel and accident insurance purchased by people who expect that they will be protected from the various risks they face while traveling. Although most Americans have health insurance that covers them when they are near their homes, and many have coverage wherever they travel in the 50 states, most health policies do not offer the same level of coverage (if any) when the policyholder leaves the country’s borders. For instance, Medicare does not cover anything when the policyholder is overseas, and other insurance plans are even more limited and only provide coverage when the policyholder is in a ‘local’ area. Considering over 90 million Americans traveled outside of the country in 2018, according to the U.S. Commerce Department’s National Travel and Tourism office, these gaps in coverage can create significant problems.
Travel and accident insurance purports to solve these problems by filling in the gaps in coverage. There are a wide variety of travel and accident insurance plans that offer different levels of coverage. For example, while some travel and accident policies will only cover emergency evacuations and accidental death, others cover emergency medical expenses as well. Additionally, while some policies will cover travel to virtually anywhere, others will place restrictions on certain countries/territories (e.g., areas prone to war, areas without medical facilities, etc.). It is important to note that these policies generally only take effect after the policyholder begins travel (most plans define this as being at least 100 miles away from home).
Common Problems with Travel and Accident Insurance
The attorneys at Advocate Law Group P.C. have recently seen more and more cases of insurance companies engaging in bad faith practices to deny valid travel and accident insurance claims. Although insurance companies are happy to sell travel accident policies and collect premiums, some insurers will do whatever they can to keep from paying out when it comes time to pay policyholders or beneficiaries. In particular, Advocate’s lawyers often see travel and accident insurance claims wrongfully denied when the policyholder suffers from adhesion-related injuries while traveling.
Adhesions are a common medical condition and are usually non-life threatening. An adhesion is a band of scar tissue that forms on the inside of the body on organs or other body tissue. Adhesions are usually created by the body’s attempts to heal internal damage. Surgery is thus the most common cause of adhesions, but they can also be caused through infections, other conditions like Crohn’s disease, and some people are just born with them.
Occasionally adhesions can pose severe risk of harm, major complications and even death. Adhesions start to create problems when they cause organs and other internal body parts, which are usually very slick, to become caught on the less-slick adhesions and/or locked together. These sorts of conditions are known as adhesive disease and can be responsible for intestinal obstructions, dysmenorrhea, infertility, and even death.
Many travelers have found themselves in a difficult situation when adhesions created problems while they are traveling in abroad. When this occurs, the traveler will usually need to receive medical care as soon as possible — due to the nature of adhesive disease, waiting to return home before receiving treatment is generally not an option. So, best-case scenario, if all goes well and hospitals in the foreign country are able to treat the injury successfully (which usually requires surgery), the traveler will still be stuck with expensive medical bills.
Although travel and accident insurance is designed to protect travelers in scenarios like this, some insurers will reject claims for adhesion-related treatments by arguing that these injuries are the result of a pre-existing condition. In the vast majority of cases, this argument is flat-out wrong and unlawful. Adhesions almost never should be regarded as a pre-existing condition; they typically cause no symptoms, so most people are not aware they even have them. Further, even if a doctor warned you that you are at risk for adhesions (say, following abdominal surgery), the knowledge you are at risk does not mean you have a pre-existing condition. The only scenario where adhesions could constitute a pre-existing condition would be if you were treated for adhesive disease within the policy’s lookback period. Given the nature of adhesions, this scenario is very rare and few if any adhesions should properly be considered pre-existing conditions.
How we can help
If an insurer rejects valid travel and accident insurance claims or denies a claim for adhesion-related injuries under the reasoning that adhesions are a pre-existing condition, they are most likely engaging in bad faith. Insurance bad faith lawsuits can be well worth the effort. If you win a bad-faith lawsuit, you are eligible to recover not only the value of the original claim, but also attorney fees, punitive damages for the insurer’s bad behavior, consequential damages, and even damages for emotional distress. At the Advocate Law Group, our partners have over a half-century of experience taking on insurance companies and winning big for our clients. Our partners know the insurance industry from the inside and out and understand what it takes to successfully handle a bad-faith lawsuit. If you think your insurance company is rejecting valid travel and accident insurance claims or engaging in bad faith, contact us today for a free consultation.
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The attorneys in the Advocate Law Group network bring decades of real-world experience in both law and insurance.