Vacationers need to do a deep dive on their travel insurance coverage before stepping on a plane, says Toronto insurance lawyer Rohan Haté.

When it comes to holidays, few travellers give much thought to insurance, preferring to rely on whatever coverage they get through their credit card company. But Haté says they could be in for a nasty surprise if they ever have to rely on that policy.

“People tend to assume their policy will cover everything, but if they’re not asking qualifying questions on the application, you can be sure there will be exclusions, which will generally be found in the fine print,” he says. “You need to read the policy to understand what’s covered and what’s not.”

Pre-existing condition exclusions

According to a survey by the Travel Health Insurance Association (THIA), as many as 47 per cent of Canadians have never looked at their policies — even though almost one-quarter of respondents said they have required medical care while abroad in the past.

Haté says some of the more common exclusions for coverage of medical expenses relate to pre-existing conditions that have not been stable for a certain period before travel. The THIA survey said more than half of respondents were surprised to discover that changes to prescriptions or even blood test results indicating a change in health status could trigger denials on the basis of medical stability.

In addition, many providers cut off coverage once the insured person passes age 64 and cap the length of covered trips at 15 days. Few policies cover women who are more than 31 weeks pregnant, and many will void coverage for injuries sustained under the influence of alcohol.

“Policies vary depending on who your provider is, so you have to check the precise definitions in your policy to understand where you might have some exposure,” Haté says.

The fine print on liability limits

In one of his own cases, Haté helped a client who was forced to dip into his own pocket to cover expenses after he was hospitalized for a heart attack while on a trip to the Caribbean.

In an effort to stay within the 15-day limit on his policy, the man had asked to be discharged from hospital, only to find himself declared “medically unfit” to fly home. His legal challenge focused on the cost of the additional 30 days he had to spend in the country while waiting for medical clearance to leave.

“He was caught between two definitions in the policy,” Haté explains.

Travellers who give their policy only a cursory look could also find themselves burned thanks to the complex and technical language typically used by insurance providers.

For instance, another of Haté’s clients ran into trouble after engaging an insurance policy with a general liability limit of $5 million. However, that total was broken down into smaller amounts, with strict limits to cover individual expenses such as food, travel, and car rental, among others. Although the woman’s total claim fell well short of $5 million, her insurance company refused to reimburse all her expenses because she had broken some of the lower itemized limits.

COVID-19 caution

Many of these issues predated the ongoing pandemic, but Haté says travellers should be even more cognizant of their policy wording in the era of COVID-19.

Although international borders have opened up considerably compared with the months following March 2020, he says that’s liable to change at short notice while some insurers are adding COVID-specific provisions to their policies.

“You can’t assume that your travel insurance will cover you in the event you’re not able to travel for a COVID-related reason,” he says.