Alterations Express

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, 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 matterI do not consider this issue closed and can see that *** is stuck in their decision so discussion with them seems futileSince my age group (**'s) are frequent travelers for pleasure, I will ensure that NAIC, travel agencies and travelers are aware that they must not use *** travel insurance, since *** does not follow the national law with regard to pre-existing conditions.]
Regards,
*** ***

10/18/
To whom it may concern,
Thank you for the opportunity to provide a response to Ms***’s
recent concern regarding her Trip Cancellation claim (UC81825153)
According to our records, the adjuster contacted the insured’s
mother by phone on 10/15/and explained maintaining our position on the denial
of her daughter’s claimThe appeal process was reviewed with the mother, and
it is our understanding that an appeal will be filed and reviewed by the
Quality Assurance DepartmentAfter review, the insured will be contacted
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,
*** *** (Complex Claims Adjuster)

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, 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.] Mr*** is obviously determined not to pay me for the insurance that I purchasedI will continue to provide medical proof of my physical condition and intend to report Mr***'s harassment to all social media sites as well as overview committees in an effort to receive the reimbursement that I am entitled to, as well as warn potential purchasers of Travel Guard travel insurance of the difficulty of dealing with this companyThis is a very dishonest, money grabbing business whose obvious intent is to collect money and keep it!
Regards,
*** ***

12/13/
To whom it may concern,
Thank you for the opportunity to provide a response to Ms
***’s recent concern regarding her Trip Cancellation claim (UC81857686)
To provide an update, our records show that a previous Trip
Cancellation claim (UC81810927) had been filed on
7/7/due to work
obligationsDocumentation was submitted to our office on that same day and was
reviewed by the assigned adjuster on 7/14/
The policy provides coverage for covered, named perils
listed within the policyPlease see the following 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;
(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 businessSuch 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 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 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 yearTermination must
occur following the effective date of coverageThis provision is not
applicable to temporary employment, seasonal employment, independent
contractors or self-employed persons
The following
exclusions also apply to Trip Cancellation and Trip Interruption:
Unless otherwise provided by this plan benefits will not be
provided for any loss resulting (in whole or in part) from:
(d) any business or contractual obligations of the Insured,
a Family Member, or Traveling Companion, for any reason;”
Cancellations for work obligations is not recognized as a
covered, named peril as noted in the policy wording shown aboveRather, the
reason is specifically excluded from coverageThis was communicated to Ms
*** by telephone on 7/14/2016, and a letter followed by mail
When the initial Trip Cancellation was filed on 7/7/for
work obligations, the policy was terminatedPlease see the following policy
wording:
“SECTION I
EEFFECTIVE AND
TERMINATION DATES
Termination Date:
Trip Cancellation ends on the earlier of:
(a) the cancellation of the Insured’s Trip; or
(b) the date and time the Insured starts on his/her Trip.”
Please note that claims for Trip Cancellation on this policy
cannot be filed once the policy is terminated, which was 7/7/based on the
original cancellation for work obligationsHowever, an opportunity to appeal
the determination as it related to the cancellation on 7/7/was provided
for any events which occurred prior to the trip being cancelled on 7/7/
Please note that any events or incidents which occurred after the trip was
cancelled are not covered under the policy purchased and cannot be applied to a
trip which was already cancelled before the event or incident occurred
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,
*** *** (Complex Claims Adjuster)

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, 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.]As explained previously I did not seek a doctor on the trip because none was availableI did not seek a doctor in Anchorage because it would have incurred additional costs for them and me and because it would have taken days to get an appointment when my own doctor would have been better qualifiedI think it is extremely disappointing that the company wants to stick to the letter of their fine print when I was trying to helpEspecially from a company that should know better when they claim to be in the adventure travel business
Regards,
*** ***

5/20/To whom it may concern, Thank you for the opportunity to provide a response to Mr***’s recent concern regarding the remaining coverage under his claimAs stated previously, we have paid out under the baggage portion of Mr***’s policy, and on 5/13/16, we have made an additional payment of $under the remaining coverage. This amount represents the maximum amount allowed per day per the scheduled benefitWhile we understand the insured’s position, and sympathize with him for the situation that occurred while he was traveling, we must adjudicate the claim based on the terms and conditions of the purchased 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 rightsSincerely, *** *** (Complex Claims Adjuster)

To whom it may concern:
This is in response to the concerns raised by Ms*** regarding her Trip Cancellation claim
We understand Ms***’ frustration and concerns; however, the requested documentation is required information to finalize the Trip cancellation claim
The Claims director sent
a request to Daniel Lee to obtain the necessary information and has a reminder set for Monday, 7/20/15, to follow up with MrL** regarding the requestOnce we receive the required information, we can continue to review the claim.
We encourage Ms*** to contact the claims deptdirectly at ###-###-#### with further questions regarding her Trip cancellation claim
Thank you for the opportunity to review and respond to Ms***’ concerns
Sincerely,
Matthew F* *** ***
/**

October 2017 To Whom It May Concern, Thank you for the opportunity to provide a response to Dr*** recent concern regarding his Trip Cancellation claim (***).Payment has been requested on this case, and DrTrujillo has been notified of the forthcoming payment on October 3, 2017. 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, *** ***
Complex Claims AdjusterThis correspondence is sent by AIG Claims, Incas authorized administrator for National Union Fire Insurance Company of Pittsburgh, PA

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this does
not resolve my complaint. For your reference, details of the offer I reviewed appear below
AIG is NOT transparent about their terms and conditions. They do not give the customer an accurate assessment on what would be covered under the insurance to defraud people. AIG's terms and conditions are meaningless to me because they were not clearly stated during the purchase. The compliant is not resolved because they will not refund my money
Regards,
*** ***

To whom it
may concern:
This
response is regarding the concerns raised by Mr*** regarding his
claim.
According to the claim documentation, Mr***’ trip was cancelled
and rescheduled due to a medical condition.
We apologize for the length of
time it has taken to process the claim;
however, to determine coverage under the policy, trip and insurance verification
from Travelocity is required
Mr***’ claim has been reassigned to a new adjuster who has
contacted Travelocity on an urgent basis for the required documentationOnce we receive the necessary information from
the tour operator, we will continue to process the claim. Should Mr*** have any questions
regarding the information needed to review his claim, we welcome him to contact
the Claims Deptat ###-###-#### extension ***
Thank you for the opportunity to
review and respond to Mr***’ concerns
Sincerely,
*** *** *** ***
***

3/10/To whom it may concern, This is in response to the concern raised by Mr*** regarding his Trip Cancellation claim. According to the information provided, the trip was canceled due to severe weatherThe latest correspondence included a copy of the Description of Coverage issued under Mr***’s policy, along with a statement indicating that the information is under Trip Delay for the weather occurrence. While that is true, the claim was not processed under the Trip Delay coverage, but instead would have to be processed under Trip Cancellation, since the insured’s trip was canceled. While the Description of Coverage does list weather as a covered event under Trip Delay, the Trip Cancellation portion of the policy does not extend benefits due to a weather related reasonPlease refer to the policy wording, which states in pertinent part: Section II - Benefits TRIP CANCELLATION AND/OR 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; (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 businessSuch disability must be certified by a Physician(b) the Insured’s Primary Residence being made Uninhabitable or Inaccessible by Natural Disaster; (c) the Insured or Traveling Companion is hijacked, quarantined, subpoenaed or required to serve on a jury; (d) the Insured and/or Traveling Companion is involved in an traffic accident, substantiated by a police report, while en route to the Insured’s Destination; (e) a Terrorist Incident in a City listed on the Insured’s itinerary within days of the Insured’s scheduled arrival Based on the documentation included in your claim file, we have determined that no benefits are available 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 condition 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 purchasedThank you for the opportunity to review and respond to Mr***’s concerns. If Mr*** has any further questions related to his claim, we welcome him to contact our Claims Department at 1-866-350-Sincerely, *** *** *** *** *** 3/9/MESSAGE FROM CONSUMER: The information is under Trip DelayI had spoken to a representative of Travel Guard on 2-1-in which she said all I need was to faxed over documents that she had email me to get my claim goingShe never once said to me that weather was a issuedShe let me know that weather does play a factor on their claims and I would not have a problem

August
To Whom It
May Concern,
Thank you
for the opportunity to provide a response to Mr***’s recent concern
regarding Ms*** ***’s Trip Cancellation claim (***)
Our
records indicate that the insured purchased insurance on
05/11/2017, which
became effective on 05/12/2017, to cover travel between 09/01/through 09/24/2017. The trip was cancelled on 07/31/due to
personal reasons. The policy purchased
provides a list of Unforeseen events that trigger coverage under the Trip
Cancellation benefit. Unfortunately, a
cancellation due to a reason not listed under these events is not covered
Please
refer to your 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 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, Business Partner or Host at
Destination;
(b) Inclement Weather causing delay
or cancellation of travel for at least consecutive hours;
(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 or Traveling
Companion is called to active military service or military leave is revoked or
reassigned;
(g) a Terrorist Incident in a City
listed on the Insured’s itinerary within 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 provided that he or she has been an active employee for the same
employer for at least yearsTermination must occur following the effective
date of coverageThis provision is not applicable to temporary employment,
seasonal employment, independent contractors or self-employed persons;
(i) 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;
(j) the Insured or Traveling
Companion has an employer initiated transfer within the same organization of
or more miles which requires the Insured's Primary Residence to be
relocated
On appeal, we
received documentation showing that Mr*** had a change in military stations
from Washington, DC to Oklahoma City, OK.
Unfortunately, the change in military station does not fall within the named,
covered perils under the Trip Cancellation benefit. Peril (f), as noted above, provides coverage
only if the Insured or Traveling Companion is called to active military
services or military leave is revoked or reassigned.
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,
***
***
Complex
Claims Adjuster
Insurance
is underwritten by National Union Fire Insurance Company. The Policy will contain reductions,
limitations, exclusions and termination provisions. All coverages may not be available in all
states

7/20/
To whom it may concern,
Thank you for the opportunity to provide a response to Ms
***’s recent concern regarding her Trip Cancellation claim (***)
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 available coverage,
which totaled $1000. Our records also
indicate that the assigned adjuster sent a letter to the insured with the
payment information on 7/11/
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,
*** *** (Complex Claims Adjuster)

6/26/
To whom it may concern,
Thank you for the opportunity to provide a response to Mrs
***’s recent concern regarding her Trip Cancellation Claim (UC8***8)
As was provided in previous communication to Mrs***,
the policy extends coverage for cancellations that meet one of the named,
covered perils outlined within the Trip Cancellation description of coverage
‘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:
…(g) the Insured or Traveling Companion is
hijacked, quarantined, subpoenaed or required to serve on a jury;’
According to the documentation submitted, Mr*** was
not allowed to take this trip due to the stipulations of this sentence, and not
because of a requirement of attending court during the insured travel datesAt
this time, no documentation has been presented which would indicate that Mr
*** was required to attend court hearings during the insured travel dates
of 4/1/2017-4/8/2017, which would meet the Subpoena peril outlined within the
policy
We must adjudicate each claim under the terms and conditions
of the policy purchasedFollowing 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,
*** *** (Complex Claims Adjuster)

To whom it may concern:
This is in response to the concerns raised by Ms*** concerning
her travel claim
According to the information provided, Ms***’s trip was
cancelled due to personal reasons surrounding her Traveling Companion choosing
to no longer take the trip
with her. Unfortunately,
this is not recognized as a covered event under the terms of the Trip
Cancellation benefit and we are unable to extend a claim payment.
Please refer
to the policy wording, which states in pertinent part:
Section IV
EXCLUSIONS AND LIMITATIONS
The following exclusions also
apply to Trip Cancellation and Trip Interruption:
Unless
otherwise provided by this plan Benefits will not be provided for any loss
resulting (in whole or in part) from:
…(b)
changes in plans by the Insured, a Family Member or
Traveling
Companion for any reason, unless Cancel for
Any
Reason was purchased;…
Section II - Benefits
TRIP CANCELLATION AND/OR
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 careSuch 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 businessSuch disability must be certified by a Physician;
(4)
Sickness, Injury, death or hospitalization of the Insured's Host at
DestinationA 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 days following an Insured's effective
date for the Trip Cancellation or Trip Interruption BenefitsThere is no coverage
for the Financial Default of any person, organization, agency, or firm from
whom the Insured purchased travel arrangements supplied by othersThis coverage
applies only if insurance was purchased within 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 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 yearTermination must occur
following the effective date of coverageThis
provision
is not applicable to temporary employment, seasonal employment, independent
contractors or selfemployed persons;
(k)
a named hurricane causing cancellation or interruption of travel to the
Insured’s Destination that is Inaccessible or UninhabitableClaims are not
payable if a hurricane is foreseeable prior to the Insured’s effective dateA hurricane
is foreseeable on the date it becomes a named
storm
The Company will only pay the benefits for Losses occurring within 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
TripHe/she must provide proof of requirement to work, such as a notarized
statement signed by an officer of his/her employerIn 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
It has been verified that the trip
was cancelled due to personal reasons. 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
Ms*** has been provided a
new medical certificate to be completed by the treating physician. We also recommend she include a copy of her
medical records dating between 11-23-through 08-30-15; once these items are
received, we will continue to review the Trip Cancellation claim
Thank you for the opportunity to
review and respond to Ms***’s concerns.
If Ms*** has any further questions relating to her claim, we
welcome her to contact our Claims
Department at ###-###-####
Sincerely,
*** *** *** ***
***

[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 ***, and find that this resolution is satisfactory to me.
Regards,
*** ***

[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 ***, and find that this resolution is satisfactory to me. I received the check! Yeah! Thank you ever so much for your help It certainly made a difference, and I appreciate all your efforts! Thanks again!

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, 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.]My wife and I have only ever received response from Ms*** and that was the initial rejection of repaymentWhen I talked to the Costco representative I was told she was waiting to be contacted, she had not heard from TravelGuard as of yetThe reason for the cancellation was due to an infection I ended up having in my leg, not the treatment I had originally received on 6/5/The doctor sent a fax to Travel Guard stating that it was NOT pre-existing.
Regards,
*** ***

To whom it may concern:
This is in response to the concerns raised by *** *** regarding her Trip Cancellation claim
According to the information provided, *** ***’s trip was cancelled due to a family member’s medical condition. It is noted that treatment occurred on
07/03/14. The policy effective date was 10/23/14. As treatment took place and symptoms were present prior to the effective date, the condition would be considered pre-existing and benefits would not be payable under trip cancellation
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:
…(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 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
Treatment and symptoms have been verified to have occurred during the day period immediately preceding and including the policy effective date of 10/23/for the condition causing the loss. The policy purchased excludes medical conditions which meet the Pre-Existing Medical Condition Exclusion 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 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 *** ***’s concerns. If *** *** has any further questions relating to her claim, we welcome her to contact our Claims Department at ###-###-####
Sincerely,
*** *** *** ***
***

11/1/
To whom it may concern,
Thank you for the opportunity to provide a response to Mr
*** recent concern regarding his Trip Cancellation claim (UC81874678)
At this time, we do acknowledge that the documentation for
the Trip Cancellation claim was not reviewed
timelyWe 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 $300.00.
Our records indicate that the assigned adjuster called and left a
message advising of the forthcoming payment on 10/28/The adjuster also
called and spoke directly with MrMartinez with regards to the pending Claim
payment as of yesterday, 10/31/
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,
*** *** (Complex Claims Adjuster)