Travel Insurance Denied in Canada? How to Appeal Your Claim

Travel insurance is designed to protect you from the financial consequences of medical emergencies, trip cancellations, lost baggage, and other unexpected events when travelling outside your home province or abroad. Yet travel insurance claims are among the most commonly denied in Canada — often for reasons that can be successfully challenged.

If your Canadian travel insurance claim has been refused, this guide explains your rights and how to fight back.

Common Reasons Canadian Travel Insurance Claims Are Denied

Pre-existing Condition Exclusions

This is the single most common reason for travel insurance denial in Canada. Most travel insurance policies exclude claims related to conditions that were not "stable" for a defined period (commonly 90 days, 180 days, or even longer) before the departure date.

"Stability" clauses typically mean the condition has not:

• Required a new medication, or a change in medication dosage
• Required a visit to a physician or specialist
• Had new symptoms, worsening symptoms, or a new diagnosis
• Required hospitalisation or emergency room treatment

If you had a medication change, a doctor's visit, or any adjustment to treatment within the stability period — even for a minor reason — the insurer may deny all claims related to that condition, and sometimes related conditions.

Non-Disclosure of Medical History

Travel insurance applications ask about your medical history. If the insurer believes you answered health questions inaccurately — even inadvertently — it may void the policy and deny all claims, not just those related to the undisclosed condition.

Trip Cancellation: Reason Not Covered

Trip cancellation coverage typically requires a specific insured reason (illness, death of a family member, job loss, natural disaster). If the reason you cancelled your trip is not on the list of covered reasons, the claim will be denied. "Cancel for any reason" upgrades exist but are not standard.

Failure to Get Pre-Approval for Treatment

Many travel insurance policies require you to contact the insurer's emergency assistance line before receiving non-emergency treatment. If you sought treatment without prior contact, the insurer may deny or reduce the claim.

Alcohol or Drug Exclusions

Claims arising from incidents where the policyholder was intoxicated or under the influence of drugs are typically excluded. Insurers sometimes apply this exclusion broadly.

Adventure or High-Risk Activities

Claims related to activities like skiing, scuba diving, snowboarding, or motorised sport may be excluded unless a specific rider was purchased.

Your Legal Rights as a Canadian Travel Insurance Policyholder

Travel insurance in Canada is regulated at the provincial level. Your rights depend on the province where the policy was purchased:

• Ontario: Regulated under the Insurance Act, R.S.O. 1990. Complaints to FSRA or OLHI.
• Quebec: Regulated under the Act Respecting Insurance and the Civil Code of Quebec. Complaints to the AMF.
• British Columbia: Regulated under the Financial Institutions Act. Complaints to BCFSA.
• Other provinces: Similar provincial regulatory frameworks apply.

All major Canadian travel insurers are members of the Canadian Life and Health Insurance Association (CLHIA) and are subject to the OmbudService for Life & Health Insurance (OLHI) for individual policy disputes.

How to Appeal a Denied Travel Insurance Claim

Step 1: Get the Denial in Writing

Request a detailed written denial specifying:

• The exact policy clause or exclusion applied
• The factual basis for the denial (e.g., which medical event triggered the stability clause)
• What evidence the insurer relied upon

Step 2: Review the Stability Clause Carefully

Read the stability clause in your policy with extreme care. Common issues include:

• Medication changes: Some clauses exclude changes in dosage, not just new medications
• Related vs unrelated: The insurer may claim the condition that caused your medical emergency was related to a pre-existing condition — even when the connection is tenuous
• Physician visit for routine monitoring: Some stability clauses are triggered by routine visits, not just new symptoms

Step 3: Gather Medical Evidence

Obtain from your physician:

• A letter confirming the stability of your pre-existing conditions during the stability period
• Confirmation that the medical emergency was unrelated to any pre-existing condition (if applicable)
• Medical records covering the stability period

Step 4: Internal Appeal

Submit a formal written appeal to the insurer's claims department. Include your medical evidence and specific policy arguments.

Step 5: OmbudService for Life & Health Insurance (OLHI)

If the internal appeal fails, refer the complaint to the OLHI at olhi.ca or by calling 1-888-295-8112. The OLHI handles travel insurance disputes for member insurers.

Step 6: Provincial Regulator

If the insurer engages in unfair claims practices, file a complaint with your provincial regulator (FSRA, AMF, BCFSA as applicable).

Trip Cancellation vs Medical Claims: Different Processes

Note that trip cancellation claims (for cancelled flights, hotels, tours) may be handled by a different team than emergency medical claims. Make sure you submit your claim to the correct department and reference the correct policy section.

Fight Back With ClaimBack

ClaimBack helps Canadians challenge denied travel insurance claims with professional appeal letters that address stability clause disputes, non-disclosure allegations, and pre-existing condition arguments.

Start your travel insurance appeal with ClaimBack

Related Reading

• How to Write an Insurance Appeal Letter
• Common Reasons Insurance Claims Are Denied
• Internal vs External Insurance Appeal: What's the Difference?