Alterations Express

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]This did not address the concerns I had.  Cold symptoms and flu symptoms are similar. Only a doctor can diagnose the flu - which was done AFTER I purchased the insurance.  I feel like this is just a way for the insurance company to make money.  Because I had COLD symptoms, does not mean that I HAD THE FLU.  Please review my claim. I will also be filing a complaint with the Airline about the use of this insurance.
Regards,
[redacted]

27
November 2017
 
To Whom It
May Concern,
 
Thank you
for the opportunity to provide a response to Mr. [redacted]’s recent concern
regarding his Trip Delay claim (UC88[redacted]).
Our
records indicate that the insured purchased insurance on 05/03/2017, which
became...

effective on 05/04/2017, to cover travel between 05/11/2017 through 05/17/2017.  The trip was interrupted on 05/16/2017 as a
result of Mr. [redacted] daughter, [redacted]’s, medical condition.  Due to this additional expenses were incurred
for hotel, meal and taxi expenses.  We
were not able to extend benefits as the Trip Delay coverage does not recognize
Sickness as a covered loss. 
Please see
the named, covered perils below:
Section
II - Benefits
TRIP
DELAY
The Company will reimburse the Insured up to the
Maximum Limit shown in the Schedule or Declarations Page for Reasonable
Additional Expenses until travel becomes possible to the originally scheduled
Destination, if the Insured’s Trip is delayed 12 or more consecutive hours and
prevents the Insured from reaching the intended Destination as a result of a
cancellation or delay of his/her Trip for one of the Unforeseen events listed
below:
(a) the Insured being involved in or delayed due to
a traffic accident while en route to a departure as substantiated by a police
report;
(b) Common Carrier delay;
(c) the Insured’s or Traveling Companion’s lost or
stolen passports, travel documents or money;
(d) the Insured or Traveling Companion is
quarantined;
(e) Strike;
(f) Inclement Weather which prohibits Insured’s
departure;
(g) Natural Disaster.
 
There were concerns raised by Mr. [redacted] in regards
to phone calls made when purchasing the policy and during the trip with our Customer
Service Representatives (CSR).  Our
management team reviewed the phone calls for the purchase of the policy on
05/03/2017 and during the trip on 05/17/2017. 
 
During the sales call on 05/03/2017, the CSR
discussed the terms and conditions of the policy along with quoting the
difference between the premium cost for the basic plan and the Cancel For Any
Reason upgrade.  There was also
discussion in regards to the potential cancellation should Mr. [redacted]’s daughter
become ill. 
 
Two phone calls were made on 05/17/2017, our CSR
spoke to both Mr. [redacted] and Ms. [redacted] separately.  During each phone call our CSR discussed the
full policy language for coverage under the Trip Delay benefit.  Our CSR advised that medical reasons was not
listed as a covered peril; however, a final decision cannot be made until a
licensed claims adjuster reviews the documentation.  Our CSR did advise to save all receipts and
submit for review. 
 
While we
appreciate the opportunity to review Mr. [redacted]’s claim, we are held to the
terms and conditions of the policy purchased. 
The policy does not provide coverage for Sickness under the Trip Delay benefit.  We have confirmed through the phone calls
that no coverage was guaranteed for the additional hotel, meal and taxi
expenses.  Unfortunately, we are not able
to provide coverage for the expense being claimed.
If the
insured has any further questions related to this claim, we welcome them to
contact our Claims Department at ###-###-####.
Of course,
we reserve all rights under the policy and the law, and none of our
communications may be construed so as to waive any of those rights.
If you
believe that coverage for all or part of this claim should not have been
denied, you may have the matter reviewed by the California Department of
Insurance at the following address and telephone numbers:  California Department of Insurance, Consumer
Services Division, Claims Service Bureau, 300 South Spring Street, Los Angeles,
CA 90013, ###-###-#### (outside California); (800) 927 - HELP (inside
California); (800) 482 4833 (TDD Only).
Sincerely,
 
[redacted]
Complex
Claims Adjuster

To
whom it may concern:
 
This
is in response to the additional concerns raised by Ms. [redacted] regarding her
claim.
 
According to the medical documentation submitted, symptoms were present
prior to the purchase of Ms. [redacted]s policy; therefore, the condition is no
longer considered Unforeseen and meets the definition of a Pre-existing medical
condition.
 
We
ask that Ms. [redacted] please refer to the policy wording, which states in
pertinent part:
 
…(o)
PRE-EXISTING MEDICAL CONDITION EXCLUSION: The Company will not pay for any loss
or expense incurred as the result of an Injury, Sickness or other condition
(excluding any condition from which death ensues) of an Insured, Traveling
Companion, Business Partner, or Family Member which, within the 90 day period
immediately preceding and including the Insured’s coverage effective date: (a)
first manifested itself, worsened, became acute or had symptoms which would
have prompted a reasonable person to seek diagnosis, care or treatment; (b) for
which care or treatment was given or recommended by a Physician; (c) required
taking prescription drugs or medicines, unless the condition for which the
drugs or medicines are taken remains controlled without any change in the
required prescription drugs or medicines….
 
While
we wish the outcome of our review could have been more favorable, we must
adjudicate each claim in accordance with the terms and conditions of the policy
purchased by our Insured.  Therefore, we must maintain the denial of these
portions of the claim as it falls outside the scope of the coverage purchased.
Thank you for the opportunity to review and respond to Ms. [redacted]’s
concerns.  If Ms. [redacted] has any further questions relating to her claim,
we welcome her to contact our Claims Department at ###-###-####.
Sincerely,
Matthew [redacted] ([redacted])
[redacted]

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. 
Regards,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.As stated over and over again I can not provide with the medical certificate. I should've listened to co-workers advise and never booked with this airline, any other airline would cancel with out going through all this. I will make sure none of my family, friends and co-workers ever travel with you guys. 
Regards,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
All offices have acknowledged receipt of my Claim forms/faxes.  I know this because I had to repeatedly fax them, email them, or hand carry them in.    Regards,
Kandy [redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Hello [redacted] This message is in response to the message sent from [redacted]. I am very disappointed and unsatisfied with their service and they're communication with me regarding this matter. When I purchased the policy I was assured by the representative that sold me the policy that canceling the trip for a refund would not be an issue under the contract guidelines (the salesperson explained that medical issues would be covered by the insurer), it was only then did I decide to go ahead and purchase the policy. My 84 year old mother woke up with a stomach virus the next day. I consulted with her physician, whom was on vacation at the time and was advised by the physician’s assistant that it was a virus and her body would fight the virus. Her condition was worsening rather than improving at which point I consulted with another physician who advised me that in her condition she is highly contagious and that she should not fly. I was forced to cancel the vacation. It was at that point that I asked each physician to provide me with a doctor’s note explaining the situation. What I do not understand is why the insurer continues to defend their decision based on their clause explaining there was a pre-existing condition. A viral infection was not pre-existing and occurred after the policy was already purchased (they had no issue selling the policy furthering this point, the representative explained to me in detail that the policy I purchased would take effect within the next couple of hours after purchase (12:00 am)) and I find it very unprofessional and unethical for them to be using this same excuse over and over. It is evident that they need to be in contact with a physician regarding their definitions.  This illness could not have been predicted and because of that it is unfair that I am being forced to suffer and fight with this company over money that I am entitled to. The sales representative was adamant about selling the policy, ensuring coverage against illness and the two different physician notes should be sufficient proof that I am entitled to a refund. I would like to reiterate that I do not appreciate the way I am being treated by this company, especially since I trusted the sales representative when I was told (at the time of purchase) that I would be covered in this type of situation. Thank you for taking this into consideration,
Regards,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer.I spoke with [redacted] this morning, not [redacted] as I had mentioned in the original complaint. I also emailed her this morning explaining that the claim had taken so long to process that I had forgotten about the conversation I had with the claims department and how they detailed the required documentation needed to process a claim for "required to work". If that claim were not a viable option then why was I given detailed information on how to submit a claim for that reason? I was specifically told to submit a notarized letter from management stating I would be terminated if I failed to show up for work, which I did. A copy has been attached.AIG denying this claim is irresponsible and unacceptable. 
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,
[redacted]

I purchased both Travel Guard Policies 919936824, 919936856 on June 3, 2016 as you can see in the confirmation email from Travel Guard.  The included Travel Policy Certificate guarantees (in highlight) that the when the insurance plan is purchased within 21 days of initial trip payment, Pre-Existing Medical Condition Exclusion is Waived as part of the Extra Coverage.  I have pointed this out to the Claims Adjuster, [redacted] at Travel Guard but she didn't take this account when she determined that my mother's medical condition as pre-existing and therefore claims are not qualified.  I believe she needs is missing the whole focus of my claim.  As the policy certificate states, the pre-existing condition is waived when the insurance plan is purchase within 21 days of the initial trip payment.  The lengh between May 14, 2016 and June 3, 2014 is 20 days.  Even if Travel Guard claims that the policy is effective since June 4, 2016, it still falls within 21 days.  Travel Guard took 3 months to delay the claims payment and trying to avoid the claims payment with invalid argument.  My claims are valid and they fall under the Pre-Existing Condition Waiver therefore they should be processed as such with correct payments.  Please help enforce Travel Guard to abide by the policy that they advertised and I paid for. Thank you for your assistance.

8/15/2017
To whom it may concern,
Thank you for the opportunity to provide a response to Ms.
[redacted] recent concern regarding her Trip Cancellation Claim No. [redacted].
To provide an update, our records show that this Trip
Cancellation claim had been filed on 6/10/2015 as Ms. [redacted]...

was unable to
obtain her passport. The policy extends coverage for cancellations that meet
one of the covered, named perils outlined within the description of coverage.
Ms. [redacted]’s reason for having to cancel did not meet one of those covered,
named perils. Thus, the claim was denied.
“Section II Benefits
TRIP CANCELLATION AND INTERRUPTION
The Company will reimburse the Insured a benefit, up to the
Maximum Limit shown in the Schedule or Declarations Page if an Insured cancels
his/her Trip or is unable to continue on his/her Trip due to any of the
following Unforeseen events:
(a) Sickness, Injury or death of an Insured, Family Member,
Traveling Companion or Business Partner;
(1) Sickness or Injury of an Insured, Traveling Companion or
Family Member traveling with the Insured must be so disabling as to reasonably
cause a Trip to be canceled or interrupted or which results in medically
imposed restrictions as certified by a Physician at the time of Loss preventing
your continued participation in the Trip;
(2) Sickness or Injury of a Family Member not traveling with
the Insured must be so disabling as to reasonably cause a Trip to be canceled
or interrupted and must be certified by a Physician;
(3) Sickness or Injury of the Business Partner must be so
disabling as to reasonably cause the Insured to cancel or interrupt the Trip to
assume daily management of the business. Such disability must be certified by a
Physician.
(b) Inclement Weather causing delay or cancellation of
travel;
(c) Strike causing complete cessation of travel services at
the point of departure or Destination;
(d) the Insured’s Primary Residence being made Uninhabitable
or Inaccessible by Natural Disaster, vandalism or burglary;
(e) the Insured, or Traveling Companion is hijacked,
quarantined, subpoenaed or required to serve on a jury;
(f) the Insured and/or Traveling Companion is directly
involved in or delayed due to a traffic accident, substantiated by a police
report, while en route to the Insured’s Destination;
(g) a Terrorist Incident in a City listed on the Insured’s
itinerary within 30 days of the Insured’s scheduled arrival;
(h) the Insured or Traveling Companion is involuntarily
terminated or laid off through no fault of his or her own more than 14 days
after an Insured’s effective date of coverage provided that he or she has been
an active employee for the same employer for at least 1 year. Termination must
occur following the effective date of coverage. This provision is not
applicable to temporary employment, seasonal employment, independent
contractors or self-employed persons.”
The customer has indicated that she did not receive a copy
of her Description of Coverage at the time of purchase, which would explain
what the policy covers.  When the
insurance coverage was opted for on the airline website, a prompt was provided
which gave the customer an opportunity to review the terms and conditions of
the coverage prior to following through with the purchase.
Additionally, it has been confirmed that Ms. [redacted] was
provided a complete copy of her Description of Coverage by email (at [email protected])
on 4/6/2015 (9:08 PM). The email provided a link which would have taken the
customer directly to the complete policy wording.
If the insured has any further questions related to this
claim, we welcome them to contact our Claims Department at 1-800-826-1300.
Of course, we reserve all rights under the policy and the
law, and none of our communications may be construed so as to waive any of
those rights.
Sincerely,
[redacted] (Complex Claims Adjuster)

To whom it may concern:
 
This is in response to the concerns raised by Mr. [redacted] regarding
his Trip Cancellation claim.
 
According to the information provided, Mr. [redacted] cancelled the
trip due to a business meeting being cancelled as a result of the threat of...

a
terrorist incident.  Unfortunately, we
are unable to cover the loss as this is not a covered reason under the Trip
Cancellation benefit. 
 
Please refer
to the policy wording, which states in pertinent part:
 
Section
II Benefits TRIP CANCELLATION AND INTERRUPTION
The Company will reimburse the Insured a benefit, up
to the Maximum Limit shown in the Schedule or Declarations Page if an Insured
cancels his/her Trip or is unable to continue on his/her Trip due to any of the
following Unforeseen events:
(a) Sickness, Injury or death of an Insured, Family
Member, Traveling Companion or Business Partner; (1) Sickness or Injury of an
Insured, Traveling Companion or Family Member traveling with the Insured must
be so disabling as to reasonably cause a Trip to be canceled or interrupted or
which results in medically imposed restrictions as certified by a Physician at
the time of Loss preventing your continued participation in the Trip;  (2) Sickness or Injury of a Family Member not
traveling with the Insured must be so disabling as to reasonably cause a Trip
to be canceled or interrupted and must be certified by a Physician; (3)
Sickness or Injury of the Business Partner must be so disabling as to
reasonably cause the Insured to cancel or interrupt the Trip to assume daily
management of the business. Such disability must be certified by a Physician.
(b) Inclement Weather causing delay or cancellation
of travel;
(c) Strike causing complete cessation of travel
services at the point of departure or Destination;
(d) the Insured’s Primary Residence being made
Uninhabitable or Inaccessible by Natural Disaster, vandalism or burglary;
(e) the Insured, or Traveling Companion is hijacked,
quarantined, subpoenaed or required to serve on a jury;
(f) the Insured and/or Traveling Companion is
directly involved in or delayed due to a traffic accident, substantiated by a
police report, while en route to the Insured’s Destination;
(g) a Terrorist Incident in a City listed on the
Insured’s itinerary within 30 days of the Insured’s scheduled arrival;
(h) the Insured or Traveling Companion is
involuntarily terminated or laid off through no fault of his or her own more
than 14 days after an Insured’s effective date of coverage provided that he or
she has been an active employee for the same employer for at least 1 year.
Termination must occur following the effective date of coverage. This provision
is not applicable to temporary employment, seasonal employment, independent
contractors or self-employed persons.
 
This policy defines the following:
“Terrorist
Incident” means an act of violence by any person
acting on behalf of or in connection with any organization which is generally
recognized as having the intent to overthrow or influence the control of any
government, that is deemed terrorism by the United States Government other than
civil disorder or riot, that is not an act of war, declared or undeclared, that
results in Loss of life or major damage to property.
 
It has been verified that the trip
was cancelled due to the risk of a terrorist incident.  Based on the documentation included in the
claim file, we have determined that the expenses being claimed are not covered
under the terms of the policy.  .  While we wish the outcome of our review could
have been more favorable, we must adjudicate each claim in accordance with the
terms and conditions of the policy purchased by our Insured.  Therefore, we must maintain the denial of
this claim as it falls outside the scope of the coverage purchased.
 
AIG Claims Inc. is a separate company from [redacted] and [redacted]; Mr. [redacted] would need to raise his concerns regarding the
communication with these companies directly with them.
 
Thank you for the opportunity to review and
respond to Mr. [redacted]’s concerns.  If Mr. [redacted]
has any further questions relating to his claim, we welcome him to contact our Claims
Department at ###-###-####.
 
Sincerely,
 
[redacted]
 
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]I understand the businesses response and covering what the policy does.  The policy is clear, and while I believe that it should reasonably cover hurricane damage to the destination causing trip cancellation, I recognize that I cannot change the policy.  I take issue with the fact that I am still being charged for a policy that did not cover anything for a flight I no longer have.  I would like a refund of the premium, since the policy is not only useless in my current situation, but I also no longer have the flight the insurance policy covered.
Regards,
[redacted]

To whom it may concern:
 
This is in response to the concerns raised by Ms. [redacted].
 
We are unable to pre-approve or pre-deny a claim over the phone. We can only advise information based on the terms and conditions of the policy purchased by our insured. We strongly encourage Ms....

[redacted] to contact our Claims Call Center at ###-###-#### option #3 to initiate a formal travel insurance claim.
 
Ms. [redacted] should have her policy # [redacted] available when contacting the Claims Dept. since this will be required to initiate the claim.
 
Once the claim is initiated and the necessary information is obtained, we will be able to properly review and adjudicate Ms. [redacted]’s claim based on the terms and conditions of the insurance policy purchased.
 
Thank you for the opportunity to respond to Ms. [redacted]’s concerns regarding her travel
insurance policy.
 
Sincerely,
 
Matthew F[redacted]
 
[redacted]

To whom it may concern: We are in receipt of the credit card statement; however we still require the medical information previously requested to determine coverage as outlined in the policy purchased.  The policy purchased excludes certain medical conditions; therefore further information is required in order to determine coverage.  Once the additional medical information is received, we can continue to review the claim. Sincerely, [redacted] Claims Director /by

April 21,
2017
 
To Whom It
May Concern,
 
Thank you
for the opportunity to provide a response to Mr. [redacted]’s recent concern
regarding his Trip Cancellation claim (UC8100010655).
Our
records indicate that the insured purchased insurance on 12/13/2016,...

which
became effective on 12/14/2016, to cover travel between 12/22/2016 through 12/25/2016.  The trip was cancelled on 12/14/2016 as the
result of a medical condition.  Per the
medical certificate completed by the Physician, they had indicated that
symptoms were first present in October of 2016, and treatment had been received
on 11/22/2016 and 12/14/2016.  As
treatment had occurred prior to and including the effective date the condition
was deemed to be Pre-Existing.
The policy
does offer a Pre-Existing Medical Condition Exclusion Waiver.  In order for this waiver to be in effect
there are three conditions that need to be met. 
The Physician advised that the insured was not medically able to travel
at the time the insurance was purchased on 12/13/2016.  As this criteria for the Pre-Existing Medical
Condition Waiver was not met, we were not able to apply the waiver.
Please see
the pertinent policy wording:
Section
IV
EXCLUSIONS
AND LIMITATIONS
GENERAL
EXCLUSIONS
This
plan does not cover any loss caused by or resulting from:
…(o)
PRE-EXISTING MEDICAL CONDITION EXCLUSION:
The
Company will not pay for any loss or expense incurred as the result of an
Injury, Sickness or other condition (excluding any condition from which death
ensues) of an Insured, Traveling Companion, Business Partner or Family Member
which, within the 60 day period immediately preceding and including the
Insured’s coverage effective date: (a) first manifested itself, worsened,
became acute or had symptoms which would have prompted a reasonable person to
seek diagnosis, care or treatment; (b) for which care or treatment was given or
recommended by a Physician; (c) required taking prescription drugs or
medicines, unless the condition for which the drugs or medicines are taken
remains controlled without any change in the required prescription drugs or
medicines.
 
PRE-EXISTING
MEDICAL
CONDITION
EXCLUSION WAIVER
The
Company will waive the pre-existing medical condition exclusion if the
following conditions are met:
(1)
This plan is purchased within 1 day of Initial Trip Payment;
(2)
The amount of coverage purchased equals all prepaid nonrefundable payments or
deposits applicable to the Trip at the time of purchase and the costs of any
subsequent arrangements added to the same Trip are insured within 1 day of the
date of payment or deposit for any subsequent Trip arrangements;
(3)
All Insured’s are medically able to travel when this plan cost is paid.
This
coverage will be terminated and no benefits will be paid under this
Pre-existing Medical Condition Exclusion Waiver coverage if the full costs of
all prepaid, nonrefundable Trip arrangements are not insured.
 
While we
appreciate the opportunity to review Mr. [redacted]’s claim, we are held to the
terms and conditions of the policy purchased. 
The policy does not provide coverage for Pre-Existing Medical
Conditions, which are excluded from coverage. 
For this reasons, our position is maintained as the reason for loss
falls outside the scope of coverage purchased.
If the
insured has any further questions related to this claim, we welcome them to
contact our Claims Department at 1-800-826-1300.
Of course,
we reserve all rights under the policy and the law, and none of our
communications may be construed so as to waive any of those rights.
Sincerely,
 
[redacted]
Complex
Claims Adjuster

Please see attached the analyst's response regarding the above-referenced Revdex.com matter.

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.  I also want to add that without the involvement of the Revdex.com and the California Department of Insurance I suspect that this claim would not have been approved or I would have still be communicating with AIG for resolution.  I appreciate all the help from the Revdex.com and the California Department of Insurance in resolving this matter.
Regards,
[redacted]

3/23/16 To whom it may concern,  This is in response to the concern raised by ­­­­­[redacted] regarding his claim.  The latest correspondence included a statement from the insured indicating that he is now taking his concerns to the PA Attorney General’s Office among other legal avenues, however he will not pursue this avenue if his claim is paid. We understand Mr. [redacted]’s right as a consumer to pursue the above listed avenues, and will respond accordingly to the correspondence received regarding the processing of the claim ([redacted]).  Additionally, Mr. [redacted] has been notified by the assigned adjuster of the information that is required for his claim to be further processed.  We are unable to make a final determination on the claim without the required documentation.  Our adjuster has reached out to Mr. [redacted] by phone and mail correspondence.  Once the required documentation is received, we will be able to further process the claim. Thank you for the opportunity to review and respond to Mr. [redacted]’s concerns.  If Mr. [redacted] has any further questions related to his claim, we welcome him to contact our Claims Department at ###-###-####. Of course, we reserve all rights under the policy and the law, and none of our communications may be construed so as to waive any of those rights. Sincerely, Matthew [redacted]

To
whom it may concern:
 
This
is in response to the concerns raised by Ms. [redacted] regarding her Trip
Cancellation claim.
 
According to the information provided, Ms. [redacted]’ trip was
cancelled due to a medical condition.  Unfortunately,
the loss is not covered as...

the condition that prevented travel is excluded
under the terms of this policy. 
 
Please refer
to the policy wording, which states in pertinent part:
 
GENERAL
EXCLUSIONS
This plan does not cover any loss caused by or resulting from:
… 11. Mental, Nervous or Psychological Disorder; …
 
This policy defines the following:
 
Mental,
Nervous or Psychological Disorder means a Mental or Nervous health condition
including, but not limited to: anxiety, depression, neurosis, phobia,
psychosis; or any related physical manifestation.
 
It has been verified that the trip was cancelled due to a medical
condition which is excluded from coverage. 
Based on the documentation included in the claim file, we have
determined that the expenses being claimed are not covered under the terms of
your policy.  While we wish the outcome of our review could have been more
favorable, we must adjudicate each claim in accordance with the terms and
conditions of the policy purchased by our Insured.  Therefore, we must maintain the denial of
this claim as it falls outside the scope of the coverage purchased.
 
Thank you for the opportunity to review and respond to Ms. [redacted]’
concerns.  If Ms. [redacted] has any further
questions relating to her claim, we welcome her to contact our  Claims Department at ###-###-####.
 
Sincerely,
 
[redacted]
 
[redacted]

5/11/16 To whom it may concern,  This is in response to the concern raised by [redacted] regarding his claim (#[redacted]).  The correspondence included a letter from the insured expressing dissatisfaction regarding the handling of his claim regarding the baggage issue.  On...

5/10/16, the assigned adjuster made payment on Mr. [redacted]’s claim and contacted the insured regarding the payment and the processing of his other claim under the TI portion of the policy.  We acknowledge that the insured’s documentation was not reviewed timely and we apologize for any inconvenience this delay may have caused. While we understand the insured’s position, we must adjudicate the claim based on the terms and conditions of the purchased policy.  Thank you for the opportunity to review and respond to [redacted]’s concerns.  If the insured has any further questions related to this claim, we welcome them to contact our Claims Department at ###-###-####. Of course, we reserve all rights under the policy and the law, and none of our communications may be construed so as to waive any of those rights. Sincerely, [redacted] (Complex Claims Adjuster)