Help! Need to file a trip cancellation with insurance due to pregnancy
 

Hi-
I'm new to the forums here but I thought this would be the best place with answers. My husband and I planned a trip to Australia in November 09. It was booked this past August and we purchased travel insurance through the agency we booked with. 2 weeks after booking we found out that I was pregnant and we thought that it would be ok to travel still so we never called. I just spoke with my doctor and she is against traveling overseas during my pregnancy. However, when a friend of mine called the insurance to see what was covered (hypothetically done before i made the call) they said pregnancy is a very "iffy" scenario. Yes, they would need a doctor's note but it would have to be something extremely serious with high risk and complications.
My question is what is the best route to file a claim and should we use another reason perhaps a family emergency. Also, is the insurance company allowed to ask for medical records (proof) or is the doctor's signature on the form enough.

We've never had to file a claim before and this is our first time purchasing insurance. any suggestions would be appreciated.

Thank You

The very first thing that you do with any insurance question, READ THE POLICY. What does the policy say about pregnancy? The policy should also give directions for filing a claim. Absolutely the insurance company can and will ask for proof -- that could include medical records. READ THE POLICY.

Regarding "using another reason perhaps a family emergency" -- well, that would be insurance fraud, so I wouldn't recommend it.

May I ask WHY your doctor is against you traveling to Australia? It seems you might be 3 or 4 months pregnant at the time of the trip, right? I don't know about your situation, and I'm not a doctor so I'm not giving medical advice (perhaps she does have a good reason), but I went to France when I was 5 months pregnant, and I have a friend who went to Italy when she was 7 months pregnant. I'm just not sure what the concern is and think you ought to be questioning it before you up and cancel your trip.

I agree with sf7307. There are plenty of women who have taken plenty of trips while they are pregnant, especially in the early stages as it seems you would be. I would get more information from your doctor about why she is so against the idea before making any decisions about your trip.

(Also agree with sf7307 about the insurance fraud. Even if it were ethical to make up a reason, I imagine the insurance company would want documentation of some sort before just handing you money.)

I agree with above, also - as far as claiming a "family emergency" there are limits for who in the family and what conditions and they will want proof of all of that.

And it also depends on the specific policy you got and what coverage it offers, they vary widely.

I also traveled to a distanct country when I was at about the same stage of pregnancy and it was a great trip. I went to a 3rd world country, where the medical facilities are far less than Australia.

I cannot imagine why a physician would make a blanket statement against overseas travel.

Deb

If you can go. Go. Once you have the baby, it may be 18 years before you have the time to go to Australia as a couple and then you won't have the money!

Agree that you need to read the policy.

A "family emergency" wouldn't be ground for cancellation unless it is real and documented - as in a parent having a heart attack or something. You can't just say Aunt Tily isn;t feeling well.

As for the pregnancy - I would ask your doctor WHY you shouldn;t be flying. I'm working with 4 pregnant women at the moment and all have been OK'd to fly by their MDs through the 7th month - barring any specific issues arising. If you MD were to send a letter to the insurance company I'm sure she would have to say WHY you shouldn't fly for them to reimburse you. Otherwise the insurance company is likely to read this as you've changed your mind and got the MD to write a note.

You must read your specific certificate/policy - definitions, coverage, exclusions, claims requirements, etc.

Usually, to be covered for cancellation due to pregnancy, there must be a complication, and there are specific conditions in that regard. From a recent certificate: "“Complication of Pregnancy” means a condition whose diagnosis is distinct from pregnancy but adversely affected or caused by pregnancy. It does not include any condition associated with the management of a difficult pregnancy not consisting of a classifiable distinct Complication of Pregnancy." And, "Injury or Sickness must be so disabling as to reasonably cause a Trip to be canceled."

For a claim to be paid, you must have a covered reason and you must be able to document that. Of course, the insurance company is allowed to, and will, ask for medical records. You'll likely be asked to sign an authorization for release of medical records. And, no claim is paid until the adjuster has everything they want/need. You'll need a great deal more than "a doctor's note". Most policies exclude anything relative to "normal pregnancy".

As for "family emergency", again, read the coverage in your policy. Not all policies even cover things like a death in the family, only sickness or injury or death of you or your traveling companion(s).

It seems odd that you would not have discussed your trip with your doctor when you learned you were pregnant, and that, all of a sudden, your doctor is just against your traveling overseas while pregnant.

Whatever statement you or your doctor makes initially to your insurance company cannot be modified later and must be backed up by medical records.

You also must be very careful about interpreting what any representative of the insurance company tells you on the phone. The adjusters stick to what's included in your certificate/policy and it won't matter what anyone else tells you.

Unless your doctor has some compelling reason why you should not travel overseas while pregant, I agree with others who recommend going on your trip!

And, even though a reason may be compelling to you, it may not qualify for a successful travel insurance claim.

Do you want to go or are you looking for a way out to get your money back? If you want to go, then ask your MD specifically what s/he is concerned with and go from there - either towards the trip or towards getting documentation to file a claim.

If you don't want to go, perhaps because YOU are concerned about travel during pregnancy or the financial implications with a baby on the way, then the policy will not cover you just for that reason. That is why travel insurance offers trip cancellation insurance with reasons and a much higher priced product that allows you to cancel for any reason.

Do not commit insurance fraud, even if the doctor will help you - you run a high risk of getting caught, will feel rotten about doing it later, and are setting a bad example for your baby.

I'm not sure why you need to cancel either. The 2nd tri-mester is the absolute best time to travel prior to the baby coming. My wife visited Paris & Puerto Rico, both in between her 6th & 7th months. Unless you have a medical condition that prevents you from traveling, seems too me like your Dr. is a bit over-zealous. Enjoy Australia.

Note that "cancel for any reason" policies have their own restrictions and limitations. Some reimburse you only 50% or pay only for change fees.