Online travel insurance provider 1Cover believes that one out of four people who claim to have read the terms and conditions of the policy they're buying in reality have not done so.

Purchasers are asked to check a box on the website to verify they've read the full terms and conditions. But 1Cover's managing director, Eddie Feltham, says the number of clicks on that box doesn't tally with the number of clicks on the terms and conditions page.

"When you check how many have actually clicked on them, only three out of four have done so," he says.

Travel insurance accounted for one in six complaints to the general insurance ombudsman in 2008-09 and disputes involving general insurance (which also covers car insurance, home building and contents insurance) were up 34 per cent overall.

Ombudsman John Price says the bottom line is that people need to read the policy carefully.

"The devil is in the wording," Price says. "People need to understand the conditions, they need to understand the exclusions and limitations that may apply, they need to understand what a pre-existing condition is, what unattended luggage is, whether they can hire a motorbike in Bali ..." Feltham says there literally isn't any "fine print" in policy documents these days. "It's all there - it's just that people don't read the policy."

Just as spending $100 on a shirt that's too small is a waste of money, so is getting travel insurance that doesn't fit your circumstances, Feltham says, and you won't know that if you don't check what you're buying.

A senior financial analyst with researcher Canstar Cannex, Harry Senlitonga, says no form of insurance should be bought on the basis of price alone. "It's not just about price; it's about the level of cover and the inclusions," he says. Canstar Cannex recently released its inaugural report into travel insurance, rating 44 comprehensive international, medical-only and domestic policies. In comprehensive insurance, it found the cheapest premium for a single person's worldwide cover for a week ($54) was nearly half the most expensive ($102). On a 100-day policy, premiums ranged from $282 to $1577. So how do policies differ? Here are some things the experts suggest checking:

The excess Senlitonga says that as a rule the lower the premium, the higher the "excess" or loss you'll have to wear before your insurance cuts in. That means you may end up with a policy where it's not worthwhile making claims for things such as lost cameras or stolen luggage. So the first thing you should check is the size of the excess and whether you can pay to have that reduced to a nil excess.

Item limits Ombudsman Price cites a case where a traveller lost $160,000 in jewellery - about 10 separate items - only to discover that the policy had a cap of $500 an item, which translated into a maximum payout of $5000. "It was very clearly spelled out in the policy. This is where people need to do their homework," he says. Canstar's Senlitonga says the danger is in focusing on the total limit, not the individual item limits. You may be able to pay extra to increase an item limit or to make sure particular items, such as sports gear, are covered.

Pre-existing medical conditions This is a regular area of dispute, Price says. "Policies vary incredibly" in what constitutes a pre-existing condition, he says, and you should check what is and isn't covered. Feltham says 1Cover's travel insurance automatically covers 40 or so common conditions "but what you don't want to find out is that you're not one of those and it would have only cost you a few dollars to cover a condition that's just cost you a few thousand dollars in the US".

Unattended luggage Another regular dispute is over what constitutes unattended luggage. Many policies specify that the insurer isn't liable for lost belongings if they were unattended - and that could mean because you left the table to check the menu or because you didn't use the hotel safe.

Definitions What's the difference between piste, off-piste and out-of-bounds when you're skiing? One skier's off-piste might be an insurance company's "out of bounds", says Feltham. Check all definitions and "make sure you're talking about the same thing", he says.

Emergency services Consumer group Choice says you should ask your insurer what emergency services are available at your destination. Not all emergency services are the same, it says in its report on travel insurance. "While you should get a free or reverse-charge phone number with insurance policies, the quality of the medical and other services you can call on when overseas may vary. Some companies have a presence in many countries; others have offices in Australia only, outsourcing medical emergency services to other foreign assistance companies."

If something does happen on your trip, you should be familiar with the steps you need to take to ensure a successful claim, ombudsman Price says.

This is likely to involve getting something in writing from the local police or the airline, hotel or other service involved.

Feltham urges people to do this straight away - even if it's a foreign-language document that has to be translated subsequently. "It's a lot harder two months later writing to a ferry company in Greece to get them to confirm the ferry was late and that's why you couldn't get to the airport," he says.

You should contact your insurer to let them know what's happened, so they can guide you as to the next steps. A QBE spokeswoman says insurers' policies differ in areas such as whether you must use a public hospital, for instance.

Feltham also suggests photographing your belongings before you leave, especially those for which you no longer have receipts or credit card statements, so you have evidence of ownership.

One last tip: make sure you're covered the whole time you're away. Feltham says a simple mistake is to count a period such as December 10 to 17 as seven days, when it's actually eight.

Dispute over medical emergency

Susan Parris has two pieces of advice for travellers to Asia: first, buy travel insurance; second, if you have an accident, insist your insurance company provides a medical officer or flies you to Australia or Europe for treatment as soon as possible.

Susan's daughter, Marissa, went to Asia in August 2006, planning to work there for seven months. In November she was involved in a serious accident, suffering second- and third-degree burns. Susan contacted her daughter's insurer to let them know what had happened — also arranging travel insurance for herself — and flew to Macau to join her daughter. "The whole time she [Marissa] was there, there was no visit from a medical officer from the insurance company," Susan says.

Instead, Susan received phone calls from the insurer checking on Marissa's progress, which Susan felt ill-equipped to judge as a businesswoman with no medical experience. After three weeks the insurer flew Marissa home to the burns unit at Concord Hospital.

It provided a nurse escort only after Susan insisted she couldn't be responsible for her daughter's medical supervision. The insurer subsequently refused to meet Marissa's costs and a settlement had to be reached with the help of the insurance ombudsman.