Most travel insurance advice is about buying the policy. Almost none is about using it — which is unfortunate, because how you handle the first few hours substantially affects whether the claim gets paid in full.
The single most important step
Nearly every emergency medical policy requires notification before or immediately upon receiving care, and many require pre-approval for non-emergency hospital admission. Failing to make that call can reduce or void an otherwise entirely valid claim.
In a genuine life-threatening emergency, get care first. Then call as soon as anyone reasonably can — a family member can do it on the patient’s behalf.
People assume the assistance line is a bureaucratic hoop. It is not. Calling early usually produces a better outcome than presenting a bill afterwards, for a practical reason: the insurer can often arrange direct billing with the hospital, so you are not paying tens of thousands up front and waiting for reimbursement.
What the assistance line actually does
- Directs you to a facility appropriate to the problem, and one they work with
- Arranges direct payment where possible, so you are not out of pocket
- Coordinates with the treating physicians and monitors the case
- Organises repatriation to Canada where that becomes medically necessary
- Helps with the practical mess — translation, family communication, travel changes
Prepare three things before you travel
1. The policy number and 24-hour line, in two places. Printed in a wallet and saved in a phone. A policy nobody can find at 2am is not doing much.
2. Someone at home who knows the coverage exists. If the traveller is seriously unwell, they are not the one making the call. Tell an adult child or a sibling where the details are.
3. A written note of medications and conditions. Use generic drug names where you can — brand names differ between countries and cause confusion at exactly the wrong moment.
Keep everything
Claims are assessed on documentation. Collect it at the time, because reconstructing it later from another country is considerably harder:
- Itemised invoices, not just totals or credit card slips
- Receipts for anything you paid directly, including pharmacy
- The discharge summary and physician’s notes
- Any prescription records
- A note of who you spoke to at the insurer, and when
What it will not cover
Emergency medical insurance covers unforeseen emergencies. The test is not “is this medical?” but “was this unexpected and urgent?”
So it generally will not cover routine check-ups, scheduled follow-up appointments, refilling an existing prescription, dental cleanings, vision care, or elective procedures. Plan medication supply for the whole trip before departure — running out abroad is not an emergency for insurance purposes.
The other common exclusion is anything relating to a pre-existing condition that was not stable for the insurer’s required period before departure. A medication change in the weeks before travel is the usual culprit.
If a claim is refused
There is a defined path, and it is worth knowing it exists.
First, the insurer’s own internal complaint process, which ends with a written final position letter. With that letter you can approach the OmbudService for Life & Health Insurance — a free, independent, impartial national service whose members represent 99% of the Canadian market. It takes neither side. Beyond that sit the provincial regulators.
Denials must rest on a specific contractual ground and be justified in writing. If the reason given does not match what your policy actually says, that is worth challenging.
One thing worth doing today
If you have a trip booked, spend ten minutes now finding the assistance number and saving it somewhere you would find it in a hurry. It is the least interesting preparation you will do and the one most likely to matter.