My International Travel Insurance provider (CoverMore - Commonwealth Bank Travel Insurance, Diamond Credit card) is delaying (or do not want to reimburse my medical bills such as hospital cost and other medical expenses over AUD 5000) occurred in Germany. I will be travelling until the end of November 2023 in Europe and SE Asia. I lodged my claim on the 01/06/2023 with all required documents (medical reports, hospital discharge letters, bank statements, receipts etc). I called them (CoverMore Travel Insurance) on the 5/7/2023. They responded to me per email, and it was more or less saying that they don’t want to pay and asking for documents I have already provided almost more than a month before.
I would like to know whether I can lodge a complaint with Commonwealth Ombudsman or is there any other organisation where I can seek help.
Prior to making any complaint, it would be useful for you to know if a claim is being refused, on what grounds the refusal is occurring. It is then worth checking if the refusal is valid/invalid under the credit card travel insurance cover terms and conditions.
If claim is to be accepted, it is worth finding out their usual claim settlement period after a decision is made. This could be days to weeks to a month or more. If funds are needed more urgently, this is something will need to raise with the insurer/underwriter to see if they can expedite settlement. It is worth noting Covermore on their website indicates they will respond within 30 days to assess and respond to claims. This means it might take 30 days to get a decision in relation to your claim…and currently it appears your claim has only recently been lodged and may be within in early days of the claim assessment period. This might be the case if they have requested additional information on the 5/7/2023 to allow them to assess your claim to make a decision. The request for information might also be a way for Covermore to extend their ‘within 30 days’ assessment period.
Choice has also covered credit card complementary insurance, which might also be a useful read:
In addition to @phb’s advice send the requested documents again and again if they ask because if you don’t their systems show they do not have them even if they do, and it can make a bad situation worse if they incorrectly close your claim for supposedly not submitting therm.
You should get an automated acknowledgement and often a ‘receipt number’. If you did not get an acknowledgement with or without a receipt number when you sent (and resend) them turn on the ‘return receipt’ and ‘delivery receipt’ features in your email client IF IT HAS IT.
Covermore’s systems may or may not not honour return receipts requests but if they do you get evidence they received your email with the docs. Not all email clients support them for sending and some do not make it easy to find where to set. In the Thunderbird client it is under options when composing to send
Regarding my IF above, not all email clients support that setting (including ‘consumer level’ gmail via the web browser!) so first check your client’s help to find out if it is there. If you use another client such as Thunderbird that does support it, it supports it even if operating a gmail account.
I have given them time until Friday (14/7) to let me know whether they are reimbursing my medical expenses or not. If not, I will lodge a complaint with AFCA.
I am using Gmail and there is an option to request a read receipt.
