Travel Insurance Claim Rejected in India? Your Rights and How to Appeal

Travel insurance claims are rejected at a higher rate than almost any other insurance product — often on grounds that are technically ambiguous, poorly disclosed at the time of purchase, or simply contrary to IRDAI regulations. Whether your claim involves a medical emergency abroad, a cancelled flight, lost baggage, or a cut-short trip, the rejection may not be final.

Medical emergency abroad: the most common and most valuable claim

Pre-existing condition exclusions

The most frequent ground for rejecting overseas medical claims is that the condition treated was “pre-existing.” This exclusion is legitimate — but it has strict limits under IRDAI guidelines:

• The pre-existing condition must be clearly and specifically excluded in the policy wording. A general reference to “pre-existing conditions” without a clear definition is ambiguous and must be resolved in the policyholder's favour.
• The treating condition abroad must be directly caused by the pre-existing condition — not merely coincidentally present. A diabetic traveller treated for a broken leg from a fall is not claiming for a diabetes-related condition.
• If the condition was disclosed at the time of purchase and no exclusion was specifically added, the insurer accepted the risk at the premium charged. Post-claim rejection on the basis of a disclosed condition is contrary to the contract.

The 24/7 assistance obligation

Under IRDAI Travel Insurance Guidelines, travel insurers are required to operate a 24/7 emergency assistance centre for overseas medical emergencies. If you could not reach assistance, if the cashless facility was unavailable, or if the insurer failed to pre-authorise necessary treatment — these are service failures that do not extinguish your reimbursement rights.

The insurer cannot refuse a valid medical claim simply because you were unable to obtain prior authorisation in a genuine emergency. Reimbursement must follow the actual costs incurred.

Medical evacuation

Where a treating physician certifies that medical evacuation is necessary, the insurer is obligated to arrange and fund the evacuation. A refusal to pre-authorise evacuation does not eliminate the insurer's liability for the actual evacuation costs if evacuation was medically necessary. Document the treating physician's recommendation in writing — this is the key evidence for an evacuation claim dispute.

Trip cancellation and curtailment

Trip cancellation claims are rejected when the insurer argues the reason for cancellation is not a covered event, or that the policyholder failed to obtain documentation in time.

Your appeal should focus on two points:

• Was the reason excluded? The insurer can only deny a cancellation claim if the reason is explicitly excludedin the policy wording. Rejection for a reason that simply isn't listed as a covered event — when it is also not listed as an exclusion — is not valid. Ambiguity favours the policyholder.
• Documentation: If cancellation was due to a medical emergency, obtain a certificate from the treating physician. If due to a death in the family, obtain the death certificate and relationship documentation. The insurer must specify exactly what documentation is missing — they cannot reject on vague documentation grounds.

Baggage loss and delay

For baggage loss claims, the primary evidence is the airline's Property Irregularity Report (PIR) — filed at the airport when baggage is reported missing. Under IRDAI guidelines, the insurer must accept the PIR as the primary evidence of loss. They cannot demand additional proof that is practically impossible to obtain after the fact.

For baggage delay claims, the airline's written confirmation of the delay duration is the key document. The policy will specify a minimum delay threshold (typically 6–12 hours) — confirm that your delay exceeded this threshold and attach the airline's confirmation.

Depreciation disputes on baggage valuation: the insurer can apply depreciation to the value of lost items, but must reference the depreciation schedule in the policy. Arbitrary depreciation amounts that are not grounded in the policy schedule should be challenged.

Flight delay compensation

Flight delay benefits are payable when the delay exceeds the minimum threshold stated in the policy. The required evidence is the airline's official delay notification — not a screenshot of a flight tracking app. Obtain the official statement from the airline and attach it to your claim. Rejection for insufficient documentation should specify exactly what document is missing; if the rejection is vague, challenge it on that basis.

Late intimation

Travel policies typically require prompt notification of a claim. As with motor insurance, late intimation alone — without the insurer demonstrating actual prejudice — is not a valid ground for rejection of a genuine claim. If you were hospitalised abroad and unable to notify immediately, document the circumstances of the delay. The insurer must show how the delay prejudiced their ability to investigate.

Foreign currency claims

For claims denominated in a foreign currency, IRDAI guidelines require the insurer to convert at the exchange rate applicable on the date of the incident, not the date of settlement. If your claim was converted at an unfavourable rate, challenge the conversion methodology.

How to appeal a travel insurance rejection

1. Gather all primary evidence: treating physician's reports and certificates, hospital bills, PIR (for baggage), airline delay confirmation, death certificate or medical certificate (for cancellation). The insurer must specify precisely what is missing — respond to each deficiency point.
2. Write to the insurer's Grievance Redressal Officer citing the specific rejection ground and the IRDAI regulation or principle that applies.
3. File on IRDAI IGMS simultaneously.
4. Escalate to the Insurance Ombudsmanafter 30 days. Travel insurance disputes are within the Ombudsman's jurisdiction for claims up to ₹30 lakh.