A couple from Quebec, planning a multi-stop international trip, purchased a travel medical insurance policy. During their trip, one spouse experienced a medical emergency requiring hospitalization. Upon returning to Canada, they submitted a claim. The insurer denied a portion of the claim, stating a 'pre-authorized treatment' clause was not met. What does this clause typically require?

Question: A couple from Quebec, planning a multi-stop international trip, purchased a travel medical insurance policy. During their trip, one spouse experienced a medical emergency requiring hospitalization. Upon returning to Canada, they submitted a claim. The insurer denied a portion of the claim, stating a 'pre-authorized treatment' clause was not met. What does this clause typically require?

Answer options:

• That the spouse obtain approval from their primary care physician in Quebec before travelling. ✅ That the insured inform the travel insurer prior to receiving non-emergency or extensive medical treatment abroad.
• That all medical expenses be paid upfront by the insured before seeking reimbursement.
• That the insured must use a specific network of hospitals provided by the insurer.

Correct answer: That the insured inform the travel insurer prior to receiving non-emergency or extensive medical treatment abroad.

Explanation: A pre-authorized treatment clause in travel insurance often stipulates that the insured or a representative must contact the insurer before undergoing certain non-emergency or extensive medical treatments abroad, allowing the insurer to assess necessity and arrange direct billing.