Alterations Express

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 submitted on Mr. [redacted]’s claim, the cancellation of the
trip was caused by Transaero’s Financial Default. The information...

submitted
also indicates that Mr. [redacted] purchased his airfare on a credit card.
The
insurance policy that Mr. [redacted] purchased with AIG Travel Guard reimburses for
non-refundable costs in the event a trip is canceled.  Before we can further process Mr. [redacted]’s
claim, he must first dispute the charges with his credit card company. Under
the Fair Credit Billing Act, under certain circumstances customers are entitled
to a refund from their credit card company for the services not rendered.  This applies to both paid and unpaid charges
on the customer’s credit card bill.
If
the credit card company credits the amount charged, this would no longer be a
non-refundable amount, therefore AIG Travel Guard would not reimburse the
airline ticket cost.  If the credit card
company does not provide reimbursement, we advise the insured to submit the
denial letter for further claim consideration.
It
is also noted that Mr. [redacted] has disputed the credit card charge for the AIG
Travel Guard insurance premium. Since the insured has disputed the charge; no claim can be made against the
policy or premium refund made on this policy. Therefore, the claim will
remain closed and all correspondence regarding the credit card dispute will be
handled by our Administrative Dept. directly with Mr. [redacted]’s credit card
company.
Thank you for the opportunity to review and respond to Mr.
[redacted]’s concerns.
Sincerely,
[redacted]
[redacted]

8/28/16
To whom it may concern, 
Thank you for the opportunity to provide a response to Ms. [redacted]’s
recent concern regarding her Trip Interruption claim (UC81792206).
To provide an update on the claim, our records indicate that
this claim was requested for payment for the...

amount of the additional
transportation expenses, which totaled $2286.14.  Our records also indicate that the assigned
adjuster called and advised of the forthcoming payment on 8/22/16, but had to
leave a message since the insured was not home at the time of the call.
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)

23
February 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]).
Per
our records a Trip Cancellation claim (UC8[redacted]) had been filed on 01/17/2017
due...

to finding out that Mr. [redacted]’s, [redacted], was pregnant and
advised not to travel due to potential exposure to the Zika virus.  Unfortunately, we are not able to extend
benefits as supervision of a Normal Pregnancy is excluded under the policy’s
General Exclusions.  The policy does not
provide coverage for the threat of obtaining an illness.   
Please
see pertinent policy wording:
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;…
 
EXCLUSIONS
AND LIMITATIONS
GENERAL
EXCLUSIONS
This
plan does not cover any loss caused by or resulting from:
… (b) Normal Pregnancy or Childbirth, other
than Unforeseen Complications of Pregnancy, or elective abortion of the
Insured, a Traveling Companion or a Family Member;…
 
DEFINITIONS
“Complications
of Pregnancy” means conditions whose diagnoses are
distinct from pregnancy but are adversely affected by pregnancy or are caused
by pregnancy. These conditions include acute nephritis, nephrosis, cardiac
decompensation, missed abortion and similar medical and surgical conditions of
comparable severity. Complications of pregnancy also include nonelective
cesarean section, ectopic pregnancy which is terminated and spontaneous termination
of pregnancy, which occurs during a period of gestation in which a viable birth
is not possible. Complications of pregnancy do not include false labor,
occasional spotting, Physician-prescribed rest during the period of pregnancy,
morning sickness, hyperemesis gravidarum, preeclampsia and similar conditions
associated with the management of a difficult pregnancy not constituting a
nosologically distinct complication of pregnancy.
at
the beginning of the Certificate.
“Sickness” means
an illness or disease diagnosed or treated by a Physician after the Insured’s
effective date of coverage under the Policy.
As the loss was due Normal Pregnancy and threat of
being exposed to the Zika virus, we are unable to extend benefits.  Unfortunately, the loss is not a covered
peril under the terms of the policy.
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

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 As mentioned in my initial complaint I can not obtain the medical certificate from my uncles doctor because he is out of the country. I do not understand what the point of this insurance is if I can not cancel when I can no longer travel. The certificate requirements are not stated on the first page that states I can cancel if a family member becomes ill.[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,
[redacted]

To whom it may concern: This response is regarding the concerns raised by Mr. [redacted] regarding his friend, Mr. [redacted]’s trip cancellation claim.   According to the claim documentation, Mr. [redacted]’s trip was cancelled due to a medical condition.  To determine coverage...

under the policy and to confirm if Mr. [redacted]’s policy is eligible for the pre-existing medical condition waiver, we need to confirm whether he was medically able to travel at the time the policy was purchased. Mr. [redacted]’s policy states, In pertinent part: Extra coverage(when coverage is purchased within 15 days of initial Trip deposit):• Pre-Existing Medical Condition Exclusion Waiver if You purchase this coverage, and You are not disabled from travel at the time You pay the cost. We have contacted Mr. [redacted]’s physician’s office to obtain the doctor’s statement; however, they require the request be submitted in writing with their own specific Medical Authorization for Release of Information form. The release form was sent to Mr. [redacted] on 6/26/15, 7/16/15, 8/25/15 and 9/14/15.  Mr. [redacted] submitted the requested form on 9/18/15 and the written request for the medical information was resent on 9/21/15. Once we receive the required physician’s statement confirming if the insured was medically able to travel when the insurance was purchased, we can continue to review the claim.  Should Mr. [redacted] have any questions regarding the information needed to review the claim, we welcome him to contact the claims analyst, Courtney Vang, at 1-800-826-7791 extension 11036.Thank you for the opportunity to review and respond to Mr. [redacted] concerns. 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.The point is no longer if I paid for the insurance or not!  If I did not pay for it and I was unaware (I had not seen the invoice), then someone should have made it known that I do not have an active policy!  When requesting information regarding cancellation, an Agent should have known that my policy is a quote?  This is something that has slipped through the cracks.  I would have been happy to pay for the insurance if this was brought to my attention.  I would like to received a full refund and or would like to have an opportunity to take a cruise of equivalent value for this inconvenience!  Thank you.
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:Thank you so much for helping me to resolve this matter. I accept the business's response to resolve this complaint. Best regards,Jane L* 
I have reviewed the response made by the business in reference to complaint ID 11744807, and find that this resolution is satisfactory to me. 
Regards,
Jane **

3/14/16 To whom it may concern,  This is in response to the concern raised by Ms. [redacted].  According to the information provided, the trip was canceled due to fear of catching the Zika Virus while traveling in Puerto Rico. The statement received from the policy holder indicated that...

they did not want to travel to Puerto Rico because of the Zika Virus outbreak.   We appreciate the opportunity to review the information presented in the policy holder’s statement.  It appears that through a conversation with our call center representative, the policy holder was informed that there was no coverage under the policy due to the fear of,  or anticipation of catching the virus while traveling. Please refer to the 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. At this time, there is no indication that a claim has been filed by the policy holder regarding the canceled trip.  Based on the limited documentation included in your statement, it would be determined that no benefits are available under the terms of your policy, because there is not a documented Sickness that was diagnosed or treated by a Physician.  While we wish the outcome of our review could have been more favorable, we must adjudicate each situation in accordance with the terms and condition of the policy purchased by our Insured.  Therefore, we are unable to consider coverage at this time, as there is no claim filed and the reason falls outside the scope of the coverage purchased. Thank you for the opportunity to review and respond to Mr. Younger’s concerns.  If Mr. Younger has any further questions related to his claim, we welcome him to contact our Claims Department at 1-866-350-3256. Sincerely, [redacted] (Claims Manager) /dr

6/25/16 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 ([redacted]). At this time, we still do not have the required documentation needed to continue to further process the insured’s claim.  We...

understand that the insured’s have appealed their originally denied claim based on the illness of a family member.  In order for us to consider this reason on the appeal, we require medical documentation regarding the family member’s illness, diagnosis, and dates of treatment for the illness.  Our office has been in contact with Mr. [redacted] to obtain this information, and the reasons why this specific information is needed.  On 6/14/16, a representative from our company sent the insured the required documentation needed to continue processing the claim, and on 6/17/16, the same representative explained to the insured “why” this specific information is required.  We will continue processing the insured’s claim once the required documentation is received regarding the medical condition of the family member. 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)

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and I adamantly reject the response from AIG.  He have positively met all of the refund requirements within the contract.  To begin with, Section II Benefits – Trip Cancellation and Interruption of the legal document states, “The company will reimburse the insured a benefit, up to the maximum limit shown in the schedule 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.”  Section II (a) (2) then goes further and states, “Sickness or injury of a family member not traveling with the insured.”  Section III Definitions says a “family member” includes a mother.  Section III then defines “sickness means an illness or disease diagnosed or treated by a physician.”  A note was given to the company that states, “[redacted] was unable to fly during February 2016 as she was assisting her mother during diagnosis and investigation of a medical illness.”  In this short sentence, from a licensed physician, you get a timeframe, which family member, and also that a medical illness was being diagnosed.  The note, in itself, addresses all requirements.Nowhere in the legal contract is there any mention of illnesses or diagnoses that are covered and illnesses or diagnoses that are exempt.  The sickness is clearly defined as an illness or diseased diagnosed or treated by a physician, therefore the diagnosis is not required to fulfill the refund requirements.  Also, the dates of the treatment are not required either.  Again “sickness means an illness or disease diagnosed or treated by a physician.”  The definition of sickness does not require any type of treatment, therefore treatment dates are futile.The request for such information is not only a complete invasion of privacy, but not required to fulfill the refund according to the contract.  We have fully met refund requirements, now it is time for AIG to fulfill their side of the legal agreement. 
Regards,
[redacted]

6/12/2017
To whom it may concern,
Thank you for the opportunity to provide a
response to Mrs. [redacted]’s recent concern regarding her Trip Cancellation claim
(UC8[redacted]8).
 
To provide an update on the claim, the
documentation was received in our office on 4/10/2017. The...

documentation was
reviewed on 4/18/2017, and at that time a final decision was made. Written
notification of denial of this claim was mailed to Mrs. [redacted] the same day,
explaining that the reason for having to cancel the trip did not meet any of
the covered, named perils outlined within the policy.
The policy purchased is a named perils
policy, which means that specific named reasons must first occur for a loss to
be covered under the terms and conditions of the policy. The Trip Cancellation
benefit provides specific, named covered perils for a loss to be covered.
Unfortunately, cancellation due to an arrest, or probation, or court ordered
denial of vacation, does not fall under one of the named, covered perils within
the Trip Cancellation benefit.  Please
see the following covered perils:
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, Business Partner or Host at Destination;
(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
continued participation in the Trip;
(2) Sickness or Injury of a Family Member
not traveling with the Insured must be because their condition is life-threatening
as certified by a Physician, or they require the Insured’s immediate care. Such
disability 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;
(4) Sickness, Injury, death or
hospitalization of the Insured's Host at Destination. A Physician must certify
the Sickness or Injury.
(b) Financial Default of an airline, Cruise
line or tour operator provided the Financial Default occurs more than 14 days following
an Insured's effective date for the Trip Cancellation or Trip Interruption
Benefits. There is no coverage for the Financial Default of any person,
organization, agency, or firm from whom the Insured purchased travel
arrangements supplied by others. This coverage applies only if insurance was
purchased within 15 days of Initial Trip Payment;
(c) Inclement Weather causing delay or
cancellation of travel;
(d) Strike causing complete cessation of
travel services at the point of departure or Destination;
(e) the Insured’s Primary Residence being
made Uninhabitable or Inaccessible by Natural Disaster, vandalism or burglary;
(f) the Insured’s Destination being made
Uninhabitable or Inaccessible by flood, tornado, earthquake, volcanic eruption,
fire, wildfire or blizzard that is due to natural causes;
(g) the Insured or Traveling Companion is
hijacked, quarantined, subpoenaed or required to serve on a jury;
(h) the Insured or Traveling Companion is
called to active military service or military leave is revoked or reassigned;
(i) a Terrorist Incident in a City listed
on the Insured’s itinerary within 30 days of the Insured’s scheduled arrival;
(j) the Insured or Traveling Companion is
involuntarily terminated or laid off through no fault of his or her own
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;
(k) a named hurricane causing cancellation
or interruption of travel to the Insured’s Destination that is Inaccessible or Uninhabitable.
Claims are not payable if a hurricane is foreseeable prior to the Insured’s
effective date. A hurricane is foreseeable on the date it becomes a named
storm. The Company will only pay the benefits for Losses occurring within 30
days after the named hurricane makes the Insured’s Destination Uninhabitable or
Inaccessible;
(l) mechanical/equipment failure of a
Common Carrier that occurs on a scheduled Trip and causes complete cessation of
the Insured’s travel and results in a Loss of 50% of the Insured’s Trip length;
(m) the Insured or Traveling Companion is
required to work during his/her scheduled Trip. He/she must provide proof of requirement
to work, such as a notarized statement signed by an officer of his/her
employer. In the situation of self-employment, proof of self-employment and a
notarized statement confirming that the Insured is unable to travel due to his
or her job obligations will be required;
(n) the Insured or Traveling Companion is
directly involved in a merger, acquisition, government required product recall
or bankruptcy proceedings and must be currently employed by the company that is
involved in said event; or
(o) the Insured’s or Traveling Companion’s
company is deemed to be unsuitable for business due to burglary or Natural Disaster
and the Insured or Traveling Companion is directly involved as a Key Employee
of the disaster recovery team.
The customer appealed immediately,
providing additional court documents which showed vacation had been
denied.  The appeal was formally
responded to on 4/28/2017, and denial was maintained as the policy does not
extend coverage for the reason the trip was cancelled.
We must adjudicate each claim under the
terms and conditions of the policy purchased. Following review, we find the
claim has been properly adjudicated; therefore, our position is maintained.
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)

9/15/16/16
To whom it may concern, 
Thank you for the opportunity to provide a response to Ms. [redacted]’s
recent concern regarding her Trip Cancellation claim (#1934595).
While we understand the position of the insured, we must
abide by the wording of the Description of Coverage.  Our records indicate that the insured
contacted our office on 8/10/15 to purchase the insurance coverage.  A copy of the policy Description of Coverage
was sent to the insured on 8/10/15.  The
Description of Coverage gives a detailed explanation of the coverages
available, and reasons for coverages to go into effect.  It also gives a list of exclusions,
definitions, and terms and conditions.
The medical condition that led to the cancellation of the
trip was considered a General Exclusion under the policy.  The policy does not cover medical conditions
which are considered pre-existing to the policy effective date, and therefore
the claim was denied.
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)

11/15/2016
To whom it may concern,
Thank you for the opportunity to provide a response to Ms.
[redacted]’s recent concern regarding her Trip Cancellation claim ([redacted]).
We appreciate the feedback provided. To provide an update on
the claim, we have received an invoice from [redacted] on behalf of
Dr. [redacted]. This physician requires that we pay for completion of the
Medical Certificate claim form in advance. Thus, the adjuster is in the process
of issuing the requested pre-payment.
Additionally, the adjuster has followed up continuously with
Dr. [redacted]’s office and has confirmed that as of today, they are in
receipt of our faxed request for completion of the Medical Certificate claim
form. A representative from the physician’s office by the name of Allie has
indicated that the form will be completed and returned to our office by fax as
soon as possible. We will continue to follow up until the completed form is
received.
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,
Erica [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.
The effective date of the travel guidance changes was already provided to the business in one of the previously requested documents. The information was disseminated 3/16/2015 A.K.A. [redacted]. Please see the attached document. Hence, there should not be any delay in providing the complete claimed value.
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
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]

To whom it may concern:
This is in response to the concerns raised by Ms. [redacted] regarding her
Trip Interruption claim.
According to the information
provided, the trip was interrupted due to a technical (mechanical and/or electrical)
reason with the airplane.  Unfortunately...

this
does not fall within the scope of coverage and benefits would not be payable
under the Trip Interruption benefit.
Please refer to the policy wording,
which states in pertinent part:
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
continued participation in the Trip;
(2) Sickness or Injury of a Family Member not
traveling with the Insured must be because their condition is life-threatening
as certified by a Physician, or they require the Insured’s immediate care. Such
disability 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) Financial Default of an airline, Cruise line or
tour operator provided the Financial Default occurs more than 14 days following
an Insured's effective date for the Trip Cancellation or Trip Interruption
Benefits. There is no coverage for the Financial Default of any person,
organization, agency, or firm from whom
the Insured purchased travel arrangements supplied by others. This coverage
applies only if insurance was purchased within 15 days of Initial Trip Payment;
(c) Inclement Weather causing delay or cancellation
of travel for at least 24 consecutive hours;
(d)
Strike causing complete cessation of travel services at the point of departure
or Destination;
(e)
the Insured’s Primary Residence being made Uninhabitable or Inaccessible by
Natural Disaster, vandalism or burglary;
(f)
the Insured’s Destination being made Uninhabitable or Inaccessible by flood,
tornado, earthquake, volcanic eruption, fire, wildfire or blizzard that is due
to natural causes;
(g)
the Insured or Traveling Companion is hijacked, quarantined, subpoenaed or
required to serve on a jury;
(h)
the Insured or Traveling Companion is called to active military service or
military leave is revoked or reassigned;
(i)
a Terrorist Incident in a City listed on the Insured’s itinerary within 30 days
of the Insured’s scheduled arrival;
(j)
the Insured or Traveling Companion is involuntarily terminated or laid off
through no fault of his or her own 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;
(k)
a named hurricane causing cancellation or interruption of travel to the
Insured’s Destination that is Inaccessible or Uninhabitable. Claims are not
payable if a hurricane is foreseeable prior to the Insured’s effective date. A
hurricane is foreseeable on the date it becomes a named storm. The Company will
only pay the benefits for Losses occurring within 30 days after the named
hurricane makes the Insured’s Destination Uninhabitable or Inaccessible.
Upon review of the documentation
included in the claim file, we have determined that the
reason for the trip Interruption is not a covered loss; therefore, we find that the claim has been properly
adjudicated under the terms and conditions of the policy purchased.
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 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,
[redacted]

I have reviewed the response made by the Travel Guard in reference to complaint ID [redacted], and have determined that it does not resolve my complaint.  Thank you.
[redacted]

5/23/16 To whom it may concern,  Thank you for the opportunity to provide a response to Ms. [redacted]’s recent concern regarding her Trip Cancellation claim (UC81731326). At this time, we do acknowledge that the documentation for the Trip Cancellation claim was not reviewed timely, and that our...

request for the additional documentation was not done so on a timely basis.  We do apologize for this delay, and any inconvenience this delay has caused. To provide an update on the claim, our records indicate that this claim was requested for payment for the full amount of charged cancellation penalties, which totaled $4078.  Our records also indicate that the assigned adjuster called and advised of the forthcoming payment on 5/20/16. 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)

24
October 2017
 
To
Whom It May Concern,
 
Thank
you for the opportunity to provide a response to Mr. [redacted] recent concern
regarding his Trip Cancellation claim ([redacted]).
According
to the information provided, the trip was cancelled due to flooding,...

road
closures and damages caused by Hurricane Harvey.  Hurricane Harvey became a named storm on
08/24/2017.  The insurance policy was
purchased on 08/29/2017 becoming effective on 08/30/2017.  As Hurricane Harvey became a named storm
prior to the purchase of the policy, the loss is not Unforeseen and is excluded
from coverage.
Please
refer to your policy wording, which states in pertinent part (emphasis added):
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,
Business Partner or Host at Destination;
(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 continued participation
in the Trip;
(2)
Sickness or Injury of a Family Member not traveling with the Insured must be because
their condition is life threatening as certified by a Physician, or they
require the Insured’s immediate care. Such disability 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;
(4) Sickness, Injury, death or hospitalization
of the Insured's Host at Destination. A Physician must certify the Sickness or
Injury.
(b) Financial Default of an airline,
Cruise line or tour operator provided the Financial Default occurs more than 14
days following an Insured's effective date for the Trip Cancellation or Trip
Interruption Benefits. There is no coverage for the Financial Default of any
person, organization, agency, or firm from whom the Insured purchased travel
arrangements supplied by others. This coverage applies only if insurance was
purchased within 15 days of Initial Trip Payment;
(c) Inclement Weather causing delay
or cancellation of travel;
(d) Strike causing complete cessation
of travel services at the point of departure or Destination;
(e) the Insured’s Primary Residence
being made Uninhabitable or Inaccessible by Natural Disaster, vandalism or
burglary;
(f) the Insured’s Destination being
made Uninhabitable or Inaccessible by flood, tornado, earthquake, volcanic
eruption, fire, wildfire or blizzard that is due to natural causes;
(g) the Insured or Traveling Companion
is hijacked, quarantined, subpoenaed or required to serve on a jury;
(h) the Insured or Traveling
Companion is called to active military service or military leave is revoked or
reassigned;
(i) a Terrorist Incident in a City
listed on the Insured’s itinerary within 30 days of the Insured’s scheduled
arrival;
(j) the Insured or Traveling Companion
is involuntarily terminated or laid off through no fault of his or her own
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;
(k) a named hurricane causing cancellation
or interruption of travel to the Insured’s Destination that is Inaccessible or Uninhabitable.
Claims are not payable if a hurricane is foreseeable prior to the Insured’s
effective date. A hurricane is foreseeable on the date it becomes a named
storm. The Company will only pay the benefits for Losses occurring within 30
days after the named hurricane makes the Insured’s Destination Uninhabitable or
Inaccessible;
(l) mechanical/equipment failure of
a Common Carrier that occurs on a scheduled Trip and causes complete cessation
of the Insured’s travel and results in a Loss of 50% of the Insured’s Trip
length;
(m) the Insured or Traveling Companion
is required to work during his/her scheduled Trip. He/she must provide proof of
requirement to work, such as a notarized statement signed by an officer of
his/her employer. In the situation of self-employment, proof of self-employment and a
notarized statement confirming that the Insured is unable to travel due to his
or her job obligations will be required;
(n)
the Insured or Traveling Companion is directly involved in a merger,
acquisition, government required product recall or bankruptcy proceedings and
must be currently employed by the company that is involved in said event; or
(o)
the Insured’s or Traveling Companion’s company is deemed to be unsuitable for
business due to burglary or Natural Disaster and the Insured or Traveling
Companion is directly involved as a Key Employee of the disaster recovery team.
 
Section
III
DEFINITIONS
“Unforeseen” means not anticipated
or expected and occurring after the effective date of coverage.
 
Section
IV
EXCLUSIONS
AND LIMITATIONS
GENERAL
EXCLUSIONS
This
plan does not cover any loss caused by or resulting from:
…(l)
any loss that occurs at a time when this coverage is not in effect;…
 
Unfortunately, we were not able to extend benefits
as Hurricane Harvey and its projected path were known prior to the policy
effective date of 08/30/2017.  We must
adjudicate the claim based on the terms and conditions outlined in the policy.
 
A request may be made in writing to [email protected] for further information
on a premium refund.   Once we have received a request in writing,
our administration team will review and respond with further details.  At this time, we cannot make any guarantees
that a premium refund will be available.   
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

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.
At this time I will get a legal opinion regarding this claim.  If the legal opinion supports my position as I suspect it will I will send that information along with a letter stating my dissatisfaction with the company.  Since the amount of money is not large I do not intend to pursue anything further as any legal costs would likely exceed any settlement.  I then intend to be a dissatisfied customer.
Regards,
[redacted]