Denied: The common reasons travel insurers will refuse your claim

A spokesperson from the Insurance Council of Australia said travel insurance doesn’t entitle you to unlimited cover, noting all policies have limits and exclusions, and it’s important to be informed and choose the right level of cover for your circumstances.

“Most travel insurance policies will cover people under the influence of alcohol up to 0.19 per cent, which is about four times the legal limit to drive in Australia,” the Insurance Council of Australia spokesperson said.

“Not all policies are the same. Understanding the Product Disclosure Statement is crucial as it details inclusions and exclusions, including cover for non-alcohol-related incidents.”

Motorbikes and scooters

If you’re not allowed to do it in Australia, your travel insurance policy probably won’t cover you if you do it overseas, regardless of the local law.

Suffer an injury or cause damage while riding a motorcycle, moped or scooter without a current, full Australian licence and travel insurance is unlikely to cover you. That’s despite the law in some countries that allow you to ride without a licence. For example, in Italy, anyone who holds a licence to drive a car can also ride a scooter or motorcycle up to 125cc capacity.

However, even in that case your travel insurance might not pay up if you make a claim against your policy without a full Australian motorcycle licence. Ride without a helmet and suffer an injury and your travel insurer has grounds to deny your claim, even if you are fully licensed.

Note that the same exclusions apply to motorcycle and moped passengers. Does your driver hold a valid license, are you riding sans helmet, or flouting local safety rules? You won’t be covered.

DFAT’s Do Not Travel list

Visiting a country or a region to which Australia’s Department of Foreign Affairs and Trade (DFAT) has applied a “Do Not Travel” advisory means your travel insurance might not apply in that area. The Do Not Travel list involves some obvious exclusions such as North Korea, Russia, Iran and Afghanistan, but also regions of some countries.

For example, India’s north-western Union Territory of Jammu and Kashmir and Colombia where it borders Venezuela both feature on DFAT’s Do Not Travel list. NRMA travel insurance also warns in its PDS that it will not pay claims that result from “you not following advice in the mass media or any government or other official body’s warning and [if] you did not take appropriate action to avoid or minimise any potential claim under your policy.”

The PDS of other travel insurance policies are generally less specific but the intent is the same. This is a tricky one. Suppose you were to fall over in Morocco’s Marrakech and break an arm. The city is one area of the country that has been affected by the recent earthquake, and widely reported in the mass media. However, unless the accident resulted from climbing over rubble caused by the earthquake it would seem unreasonable for any claim to be denied.

Pregnancy

While most airlines allow pregnant women to fly domestically until about 36 weeks, the cut-off date for travel insurance for pregnant women is usually much less, commonly 24 weeks or even less under some policies. Coverage may only apply for single, non-complicated pregnancies in which conception was not medically assisted, for example by IVF.

Theft and loss

Loss or theft must be reported to the police within 24 hours if you intend making a claim, and you need written proof.

“Unattended” has a sinister meaning in the travel insurance context. If you stow your suitcase in a luggage area on a train in Europe, that’s unattended, and so is leaving your phone by the pool when you take a dip. Any claim for loss of unattended possessions might be denied on the grounds that you did not take reasonable care.

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The same applies to any items left overnight in a motor vehicle, even if it’s locked in the boot or in the luggage compartment. If you’re staying in a hostel you need to stow your belongings when you go for a shower, otherwise they’re unattended.

One of the most common travel insurance claims is for loss of a smartphone. Cover for smartphones, cameras and laptops is limited and unless you pay for a premium plan the amount you can expect to receive if they’re lost or stolen is far less than their replacement value.

Sports

Most recreational sports are covered in a general policy but trekking above 3000 metres, the Running of the Bulls in Spain’s Pamplona, open water sailing and quad biking are generally excluded. So is skiing although cover is generally offered as an optional extra, but even that might not cover you for backcountry skiing, or riding on a snowmobile.