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.
The business has not offered any help or settlement. I don't believe this business is even reading my emails stating a claim has been processing since September? That private medical information is being requested of a minor child nor of proof that I cancelled this insurance and my trip in the summer. Nothing was cancelled until this fall when my daughter was being treated by emergency medicine. I have sent the proof of this over to the individual previously named in an earlier email that was apparently not read. I do need to know if fraud is happening with my daughters information that has been emailed to their claims individual over and over again. I've sent a help ticket to the State of Florida and have notified the Social Security Administration of possible fraud since this insurance company cannot answer why the information has been requested as late as November 2016. I've included each persons name who responds to these communications in my report. The credit card company is also on alert since a statement was sent to this same individual. Please advise on what to do next.
Regards,
[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]’s trip was cancelled due to a medical condition.  It is noted that treatment occurred on...

02/13/2015.  The policy effective date was 08/09/2014 and the policy Departure Date was 08/13/2014.  Unfortunately, the diagnosis date was after the insured trip was to have taken place, and benefits would not be payable under Trip Cancellation.
 
Please refer to Ms. [redacted]’s policy wording, which states in pertinent part:
 
EFFECTIVE AND TERMINATION DATES
Effective Date: Trip Cancellation coverage will be effective at 12:01 a.m. Standard Time on the date following payment to the Company or the Company’s authorized representative of any required plan cost.
All other coverages will begin on the later of:
(a) 12:01 a.m. Standard Time on the scheduled Departure Date shown on the travel documents; or
(b) the date and time the Insured starts his/her Trip.
 
Termination Date: Trip Cancellation ends on the earlier of:
(a) the cancellation of the Insured’s Trip;
(b) the date and time the Insured starts on his/her Trip.
 
TRIP CANCELLATION AND INTERRUPTION
The Company will reimburse the Insured a benefit, up to the Maximum Limit shown on 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;
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) 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;
(h) a Terrorist Incident in a City listed on the Insured’s itinerary within 30 days of the Insured’s scheduled arrival.
 
Trip Cancellation Benefits: The Company will reimburse the Insured for Forfeited prepaid Trip Cost up to the Maximum Limit shown in the Schedule or Declarations Page for Trips that are canceled prior to the scheduled Departure Date due to any of the Unforeseen events shown above.
 
Treatment has been verified to have occurred 02/13/2015 for the condition causing the loss.    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. 
 
Upon review for Ms. [redacted]’s complaint, she notes on several occasions that she was advised by Travel Guard representatives that “it didn’t matter when I went to the doctor”. After receipt of the complaint, all phone call recordings associated with Ms. [redacted]’s claim were monitored. Review of the phone calls determined that Ms. [redacted] was advised that she had 1 year to submit the claim documentation; at no time was Ms. [redacted] advised that it didn’t matter when she sought medical attention or otherwise advised incorrect information regarding her claim.  We maintain that this claim has been properly adjudicated.
 
Travel Guard prides ourselves on providing outstanding customer service and apologizes if Ms. [redacted] did not receive an exceptional customer service experience during her recent phone call regarding the outcome of her claim.
 
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 F[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]. While I do not find this resolution satisfactory to me, I am moving on with grieving the untimely passing of my Son.  Thank you for your assistance.
Regards,
Jessica [redacted]

To whom it may concern:
This is in response to the concerns raised by Ms. [redacted] regarding her Trip Cancellation claim.
We understand Ms. [redacted]’ frustration and concerns; however, the requested documentation is required information to finalize the Trip cancellation claim.
The Claims director sent a follow up request to Daniel Lee on 7/15/15 to obtain the necessary information. Once we receive the required information, we can continue to review the claim. The attached information is duplicate to information already provided on Ms. [redacted]' fileand is not sufficient to finalize the claim.
We encourage Ms. [redacted] to contact the claims dept. directly at [redacted] with further questions regarding her Trip cancellation claim.
Thank you for the opportunity to review and respond to Ms. [redacted]’concerns.
Sincerely,
Matthew F[redacted]
/**
Complaint Attachments

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.]
Regards,
Stephanie [redacted]

To whom it may concern: This is in response to the concerns raised by Ms. [redacted] regarding her Trip Cancellation.  According to the information provided, Ms. [redacted]’s trip was cancelled due to the passing of a family member.  Please allow us to express our sincere condolences to Ms....

[redacted] for her loss. A copy of the death certificate or a physician’s letter showing cause of death has been requested since certain General Exclusions apply to the policy. Proof of loss is required in order to continue processing the trip cancellation claim. Please refer to the policy wording, which states in pertinent part: Trip Cancellation and Trip Interruption Proof of Loss. The Insured must provide Travel Guard documentation of the cancellation or interruption and proof of the expenses incurred. The Insured must provide proof of payment for the Trip such as canceled check or credit card statements, proof of refunds received, copies of applicable tour operator or Common Carrier cancellation policies, and any other information reasonably required to prove the Loss. Claims involving Loss due to Sickness, Injury, or death require signed patient (or next of kin) authorization to release medical information and an attending Physician’s statement. The Insured must provide Travel Guard with all unused air, rail, cruise or other tickets if he/she is claiming the value of those unused tickets. Once we receive the required information from Ms. [redacted], we can continue to review the claim.  Should Ms. [redacted] have any questions regarding the information needed to review her claim, we welcome her to contact the claims analyst, Nicole Niewiadomski at ###-###-####. Thank you for the opportunity to review and respond to Ms. [redacted]’s concerns.  Sincerely, Matthew [redacted]

To
Whom It May Concern:
This response is regarding the concerns raised by Ms. [redacted] regarding
her father’s claim. 
According to the claims records, Mr. [redacted] cancelled his trip
due to the illness of a family member.  A
letter of request was mailed to Mr....

[redacted] on 11/4/15 requesting the
following required information:
Sign medical authorization form by ill partyPhysician's statement providing specific diagnosis,
date of diagnosis, and dates of treatment. Please have treating physician at
the time of the diagnosis complete the Medical Certificate that was provided.
We need to have proof of reason completed by a Doctor.
Mr. [redacted]’s
policy states in pertinent part:
Trip
Cancellation and Trip Interruption Proof of Loss: The Insured
must provide Travel Guard documentation of the cancellation or interruption and
proof of the expenses incurred. The Insured must provide proof of payment for
the Trip such as canceled check or credit card statements, proof of refunds received,
copies of applicable tour operator or Common Carrier cancellation policies, and
any other information reasonably required to prove the Loss. Claims involving
Loss due to Sickness, Injury, or death require signed patient (or next of kin) authorization
to release medical information and an attending Physician’s statement. The
Insured must provide Travel Guard with all unused air, rail, Cruise, or other
tickets if he/she is claiming the value of those unused tickets.
Additionally:
FIFTEEN
DAY LOOK:
You may cancel this insurance by giving the Company or the agent written notice
within the first to occur of the following: (a) 15 days from the Effective Date
of your insurance; or (b) your Scheduled Departure Date. If you do this,
the Company
will refund your premium paid provided no insured has filed a claim under this
Certificate.
We are unable to further process the Trip Cancellation claim
without this information. Once we receive the required information, we can
continue to review the claim.  Please
note that the policy is non-refundable for 15 days after the effective to
insure the purchaser has time to review the policy purchased and request a
refund if the coverage does not meet their necessity.
Should Ms. [redacted] have any further questions regarding the
information needed to review her father’s claim, we welcome her to contact the
claims analyst, [redacted] directly at 715-345-8552.
Thank you for the opportunity to review and respond to Ms. [redacted]’s
concerns.
Sincerely,
[redacted] (Claims Manager)
/ss

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.
I understand that you are acting in accordance with your policy.  My issue is that your policy is problematic.  I had until 8/22 to cancel the policy.  But a hurricane did not hit my destination until after 8/22, creating conditions that required trip cancellation.  Your denial of a claim is unfortunate and unethical, but I get that your policy did not cover that.  The lack of refunding in such extenuating circumstances shows me the questionable ethics of your company's operation.  Your policy should reflect the pride and ethical concern for people that your CEO expresses publicly.  
Regards,
[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. 
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]I want a refund of my money spent on a trip I never got to enjoy due to a toddler getting sick, without reason or determination from his primary care provider as to why.  There was no pre-existing condition that would have prompted me to delay or cancel the planned trip.  Travel insurance is supposed to help the consumer in matters like these.  Definitions of pre-existing and prior to/ immediately preceding explain happenings before said time.  Travel insurance companies, such as Travel guard, use confusing language to make sure the purchaser of the policy does not receive any refunds for their travel. How is it only in death money will be returned.  This is not a fair practice to the consumer.  This company is swindling money from hard working citizens and essenti[redacted] leaving them out of thousands of dollars.  Furthermore, no correspondence to me indicated there were specific terms and conditions , that would only apply if this policy was purchased within a certain window. All correspondence stated you have until 17OCT2017 to purchase travel guard  policy at this rate. I do not accept this decision provided by the company.
Regards,
[redacted]

I will send AIG the documents they are looking for. I am working on getting them the death certificate. But please know, until the Revdex.com was involved, they did not call me or e-mail me as they stated. My cell phone records all in coming calls. There is know way that I did not answer their call. Also they would have been greeted with a voice mail that they could have left a message, or I would have seen the missed call. Only after your complaint notice did they respond to me.

To Whom It May Concern:
This response is regarding the concerns raised by Mr. [redacted] regarding his claim. 
 
According to the claims records, Mr. [redacted] interrupted his trip due to a traffic accident en route to his trip departure.  A letter of request was mailed to Mr. Olivro...

on 10/28/14 and 6/29/15 requesting the following required information:
 
·          Proof of reason for the claim.  If delayed due to traffic accident, need police report.
 
We are unable to further process the Trip Interruption claim without this information. Once we receive the required information from Mr. [redacted], we can continue to review the claim.  Should Mr. [redacted] have any further questions regarding the information needed to review his claim, we welcome him to contact the claims analyst, Jennifer Crivello at 1-800-826-7791 extension 14830.
 
Thank you for the opportunity to review and respond to Mr. [redacted]’s’s concerns.
Sincerely,
 
[redacted]
 
[redacted]

11/8/2016
To whom it may concern,
Thank you for the opportunity to provide a response to
Mr. [redacted]’s recent concern regarding his Trip Cancellation claims (UC81826367 and
UC81826388).
To provide an update on the claim, our records
indicate that the insured purchased insurance on...

6/3/2016, which became
effective on 6/4/2016, to cover travel between 8/13/2016-8/26/2016. Because of
an illness suffered by one of the insured family members, all travelers were
required to cancel the trip.
We have record that Mr. [redacted] contacted our Claims Call
Center on 7/26/2016 to initiate his claims for himself, his wife, his daughter,
and both of his parents (who are insured under separate cover). His initial
claim documentation was received in our office on 8/5/2016, which was reviewed
by the assigned adjuster on 9/13/2016. At that time, the adjuster spoke with Mr.
[redacted] via phone and explained the need for more information from the treating
physician.
Further medical information was required, as it was
noted that the condition which caused cancellation of the trip had first been
diagnosed prior to the effect of the travel insurance policies. The treatment
of the condition had been ongoing since March, 2014, per the Medical
Certificate completed by the treating physician. This means that the condition
is pre-existing. The policy specifically excludes pre-existing conditions,
unless the condition is controlled during the 180 day timeframe prior to the
purchase of the travel insurance plan.
On 9/19/2016, Dr. [redacted] had responded to the request
for medical records with a pre-payment invoice. That amount was paid to his
office directly on the same day, and the corresponding records were provided by
Dr. [redacted] on 9/27/2016.
On 10/12/2016, Dr. [redacted] had responded to the request
for medical records with a pre-payment invoice as well. That amount was paid to
his office directly on 10/19/2016. To date, those records have not been
provided. The adjuster followed up with Dr. [redacted]’s office yesterday
(11/7/2016), and it was confirmed that they could not find the check that our
office had issued. The check is in the process of being voided so that it can
be reissued to the physician. Once Dr. [redacted] receives and records our
pre-payment, the corresponding medical records will be provided to us so that
we can proceed with review of these claims.
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 Analyst)

7 March 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 (UC8[redacted]2).
Per the claim
documentation received, the trip was cancelled due to a medical condition...

of
Mr. [redacted]’s daughter.  Unfortunately, as
a Physician was not seen to certify the loss at the time that it had occurred,
we were unable to extend benefits. 
Please refer to
your policy wording, which states in pertinent part:
Part A -
TRAVEL PROTECTION
TRIP
CANCELLATION/TRIP INTERRUPTION
The Insurer
will pay a benefit, up to the maximum shown on the Schedule of Coverages and
Services, if the Insured is prevented from or unable to continue taking his/her
Trip due to the following Unforeseen events:
(a)
Sickness, Accidental Injury or death of the Insured, Traveling Companion,
Family Member or Business Partner; which results in medically imposed
restrictions as certified by a Physician at the time of Loss preventing your
continued participation in the Trip….
 
DEFINITIONS
“Sickness” means illness or disease which is
diagnosed or treated by a Physician after the Effective Date of insurance and while
the Insured is covered under the Policy.
 
The policy
requires a Physician to certify the loss at the time it occurs as proof of loss
for the claim.  As a Physician was not seen,
we were unable to extend benefits since the condition does not meet the policy
definition of a Sickness.
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

The information is under Trip Delay. I had spoken to a representative of Travel Guard on 2-1-2016 in which she said all I need was to faxed over documents that she had email me to get my claim going. She never once said to me that weather was a issued. She let me know that weather does play a factor on their claims and I would not have a problem.

Good Afternoon, I hope this email finds you well. Please accept this letter from National Union Fire Insurance Company of Pittsburgh, Pa. as confirmation that the Consumer Complaints Division received your letter of complaint dated 3/7/2018 and submitted on behalf of [redacted]. Thank...

you. Best, [redacted] 
AIGAdministrative AssistantConsumer Complaints Division80 Pine Street 13th Floor, New York, NY 10038Telephone – (212) [email protected] | www.aig.com

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.AIG has yet to provide an itemized list of accepted and rejected elements of the claim which were used to determine the final total. The current proposed compensation remains a random number unless proof is provided[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,
[redacted]

30
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/Trip Interruption/Medical Expense claim (UC88[redacted]).
As previously
advised, our management team was able to have the sales call listened to in
order to verify what was advised during the purchase of the policy on
05/03/2017. It was confirmed that our Customer Service Representative (CSR)
gathered trip details and went over general policy information.  Our CSR and Mr. [redacted] had discussed coverage
in regards to potential cancellation of the trip should his daughter become
ill.   
The
consumer has the opportunity to review the full Description of Coverage for the
policy prior to, during and after the purchase of a policy.  The insurance information was emailed to Mr.
[redacted] on 05/03/2017.  The email would
have provided complete access to the full terms and conditions of the policy
for review. 
In regards
to the Medical Expense portion of the claim, we are still in need of a copy of
the explanation of benefits from the insured’s primary medical insurer.  Once this documentation is received, we will
be able to further review this portion of the claim.  We have already issued reimbursement to Mr.
[redacted] for the additional airfare to return home under the Trip Interruption benefit.
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]
[redacted]
Complex
Claims Adjuster

10/20/2016
To whom it may concern,
Thank you for the opportunity to provide a response to
[redacted] recent concern regarding his Trip Interruption claim
(UC81871267).
To provide an update on the claim, our records indicate that
the insured purchased insurance on 8/3/2016,...

which became effective on
8/4/2016, to cover travel between 9/7/2016-9/23/2016. Because of a death in the
family, Mr. and Mrs. [redacted] were required to return home earlier than
expected, incurring additional transportation expenses as the result.
We have record that Mr. [redacted] contacted our Service Center
on 9/27/2016 via our website and requested that someone reach out to him to
provide an update on the claim. There was difficulty with getting his documents
to submit via our online claims filing portal. One of our Claims
Representatives attempted to reach Mr. [redacted] on 9/28/2016 by telephone, but
there was no answer. The representative followed up with an email to the
customer that same day and explained that Mr. [redacted] could submit his claim
documents by email alternatively. 
Documentation from the customer was forwarded to our office by email on
9/29/2016, and the claim was assigned to an analyst.
When documentation is received, the analyst is assigned to
the case within 24-48 hours. However, the full Claims process can take
approximately 4 weeks for completion.  The
analyst did review the claim on 10/18/2016 and attempted calling the [redacted]’s
that same day. However, there was no answer. More documentation is required by
the analyst, and correspondence was sent to this effect to the insured by email
that same day, as well.
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 Analyst)

To whom it may concern:In response to Ms. [redacted] concerns; an email was sent to [redacted] on 12/31/15 14:28 from [redacted] which included an attachment and link where Ms. [redacted] could view her policy and description of coverage(DOC) in its entirety. The DOC explains the insurance coverage, including the policy effective date and termination date, in detail.Based on the effective date wording of the policies; coverage can only be purchased up to the day prior to departure.Thank you for the opportunity to response to Ms. [redacted]' additional concerns.Sincerely, Matthew [redacted]