I had a freak accident in Spain and needed a $10K emergency surgery. Now my travel insurer is ghosting me. What should I do?

Stacia followed the process for making a claim with her travel insurer, but she has been ghosted. The insurer isn’t responding to her claim at all, and now Stacia is left with $10K on her credit card and no idea what to do.

Fortunately, lawyers say she has options — provided the surgery actually is covered.

Confirm coverage first

According to experts, the very first thing Stacia needs to do is to confirm that she actually suffered a covered loss.

“First, confirm that your policy includes emergency medical coverage,” Keith Ligori, an attorney and cofounder of Ligori & Ligori, told Moneywise, “A policy that protects your airfare or hotel reservations may not cover surgery abroad. Check the medical benefit limit, deductible, exclusions and any notification or authorization requirements, including exceptions for emergencies.”

While travel insurers may use slightly different terminology, typically, Stacia would need emergency medical coverage in order for the surgery to be paid for.

“An unexpected accident requiring medically necessary surgery is the type of situation emergency medical coverage is designed to address,” Chrissy Valdez, Senior Director of Operations at Squaremouth and a licensed travel insurance agent, told Moneywise. “However, having travel insurance doesn’t automatically mean your policy includes this benefit.”

Valdez said to look at the full certificate wording to determine coverage, focusing on the coverage limits, deductibles, and exclusions.

“For example, an accident during an excluded activity could affect coverage,” she explained.

Follow the proper channels for making a claim

If Stacia does have coverage, the next thing she needs to do is make sure she’s followed the proper process for making a claim.

“Make sure you’ve formally submitted the claim through the process listed in your policy,” Ligori said. “Don’t assume that calling an assistance hotline completes that step. Submit the required medical records, itemized bills, receipts and accident documentation, and keep copies and proof of submission.”

Valdez said it’s also worth confirming with the claims department that you’ve submitted everything you need.

“If you’ve already received treatment and now need reimbursement, contact the claims department to confirm your claim is complete and ask whether it needs additional medical records, bills or receipts,” she said.

Get lawyers and regulators involved

If Stacia has gone through the proper channels and has heard nothing from the insurer, it’s probably time to take action to protect her rights.

“If the company continues ignoring you, contact your state’s insurance department,” Ligori suggested. “For a U.S. policy, your home state’s department is a useful starting point and can help identify the appropriate regulator. A complaint can prompt a review of the insurer’s handling and a response.”

While Ligori said that a complaint wouldn’t necessarily guarantee payment or a resolution, it might at least get the insurer to respond to approve or deny your claim so you can follow proper appeals channels if your claim is denied.

The website you purchased your travel insurance from can also sometimes be helpful in resolving conflicts.

“If you purchased your policy through Squaremouth and your claim has been denied or you’re unhappy with how it’s being handled, you may be eligible for help through Squaremouth’s Zero Complaint Guarantee Service, which offers claims advocacy and mediation,” Valdez said.

Many other travel insurance comparison platforms and brokerage firms also offer similar support.

If those steps fail, getting an attorney involved is probably your best bet.

Emanuel Galimidi, a former insurance defense lawyer and current personal injury attorney with Galimidi Law, said there are two possible options.