Berkely Group

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me and the matter has been resolved.
Sincerely,
[redacted]

We have reviewed [redacted]’s complaint and are responding accordingly.  The plan that [redacted] purchased on May **, 2017 does indeed offer coverage for a flight cancellation in the event of a job loss.  However, the plan does specify that this coverage does not apply to “temporary...

employment, independent contractors or self-employed persons.”     Based on the information received from [redacted] and her traveling companion, [redacted], the cancellation was due to [redacted]’ job loss.  However, from the information submitted, [redacted] was a co-owner of the business that ceased operations on May **, 2017, two days after their purchase of the plan.   As [redacted] was self-employed, his and [redacted]’s reason for cancellation is specifically excluded under the terms of the plan and we are unable to consider their request for reimbursement.   Please note that the plan in its entirety is provided prior to purchase for review.  Further, the confirmation provided to [redacted] and [redacted] contained a link to the plan, including the specified reasons for cancellation as well as the contact information for our office for any questions regarding the plan.    We trust that we have responded to the issues raised in [redacted]’s complaint.  Should you have any additional questions, please feel free to contact our office.

We have reviewed [redacted]s complaint regarding the claims process with regard to his Rental Car Damage coverage claim.   Please understand that in order to fully review and finalize a claim, specified documentation is required, including but not limited to: an incident report, a...

police report, a rental agreement and a repair estimate/receipt.  When [redacted] originally submitted his claim form to our office he did not include all of the above necessary documentation. Accordingly, we sent correspondence to [redacted] on September **, 2016 requesting he forward such information and documentation.   In addition, we sent notices every 30 days following that initial correspondence, through January, **, 2017, again advising of the need for the complete information to finalize the claim.    Following receipt of this complaint, we again reviewed the information needed to finalize the claim.   Though the insured is responsible for submitting all items needed to review a claim, we did take the liberty to contact the rental company’s agent on his behalf to obtain the outstanding information.    I am pleased to advise that such information was received and payment was sent to the rental company’s agent, JNR Adjustment Co., Inc., directly on January [redacted] 2017, in the amount of $3,930.96 which sum represents the applicable covered expenses less the $250.00 plan deductible.   As this matter has now been settled under the plan terms, we have taken the liberty of closing this file.   Should you have any additional questions, please feel free to contact our office.

We have reviewed [redacted]’s complaint and we are responding accordingly.  Please note that [redacted] filed this complaint prior to initiating a claim with our office.   Further, to date, though he has now initiated a claim, no claim form or supporting documentation has been...

submitted.  Accordingly, we have not been afforded the opportunity to review and consider [redacted]’s reimbursement request.     Please note that the plan [redacted] purchased, and which was provided to him prior to such purchase, contains a listing of specified reasons making one eligible for coverage under the Trip Cancellation benefit.   One such specified reason is a cancellation due to the following:   e. your involuntary termination of employment or layoff which occurs after your effective date of coverage and was not under your control. You must have been continuously employed with the same employer for 3 years prior to the termination or layoff. This provision is not            applicable to temporary employment, independent contractors or self-employed persons;   [redacted] has indicated in his complaint that his reason for cancelation, the loss of his social security benefits, should be considered tantamount to such loss of employment.   Please note that we are more than willing to review [redacted]’s claim and contention, however, without the opportunity to review [redacted]’s information, we are unable to make a determination on his claim.     Accordingly, we kindly request [redacted] submit his completed claim form and the supporting documentation regarding the reason for his cancellation and we will be happy to review the same.   However, until such time, we are unable to consider his request for reimbursement.   We trust we have responded to the concerns raised in [redacted]’s complaint.  Should you have any further questions, please feel free to contact us.

We have reviewed [redacted]’s additional comments and we are responding accordingly.    While we can certainly appreciate [redacted]’s position, due to the number of inconsistencies previously noted, we are unable to consider this claim at this time until the requested documentation has been received and we have an opportunity to review same.     Please note that death for which [redacted] stated he had cancelled his trip occurred in mid-June 2016, as per the information he originally supplied.  However, [redacted] did not contact our office to initiate a claim until September **, 2016.   Further, there is no time limit on claim submissions.   Once [redacted] has time to gather the correct documentation for his claim submission, he should feel free to submit same for our review.   We trust this has responded to the additional comments from [redacted].   Should you have any additional questions, please feel free to contact our office.

We have reviewed [redacted]’s complaint regarding the processing of her claim for trip cancellation reimbursement.  Please note that the plan [redacted] purchased does provide trip cancellation reimbursement in the event of a cancellation due to a medical reason.   However, in order...

to confirm eligibility for reimbursement, the illness or injury must meet the plan requirements and not fall under any plan exceptions.   More particularly, the plan does not cover cancellations if the condition prompting cancellation was one that first began or worsened or which necessitated the individual to seek diagnosis, care or treatment during the 60-day period prior to the purchase of the plan.     Based on the medical information submitted with the claim form, the conditions which prompted [redacted]’s cancellation appear to be ones for which she had undergone examination and received treatment as early as February **, 2017, some 10 days prior to the purchase of the plan.     However, in order to make a full assessment of the various conditions and their applicable histories, and in order to make the appropriate determination on [redacted]’s claim, it was necessary to obtain additional medical documentation from [redacted]’s physician.   To that end, we first had to request a signed authorization from [redacted], rather than the one signed by her relative and originally submitted to our office.    Upon receipt of that signed authorization from [redacted], we have been working with [redacted]’s physicians, and their records department, in order to obtain this documentation.   We anticipate receipt of this information shortly.     Upon receipt of this necessary documentation, we will be able to make a final determination and will advise [redacted] of such determination under separate cover.   Should you have any additional questions, please feel free to contact our office.

We have reviewed [redacted]’s complaint and we are responding accordingly.  In his complaint [redacted] indicates that he is displeased with the information advised to him when contacting our office regarding a request for reimbursement of items purchased while awaiting receipt of his and...

his traveling companion’s baggage.   Please allow us this opportunity to further clarify the information provided.     Please note that the plan [redacted] and his companion purchased provides coverage in the event an individual suffers a direct loss, theft, damage or destruction of their baggage during their covered trip.    [redacted] can find a description of this benefit in his plan under Part C. Baggage Protection, Baggage and Personal Effects Benefits. The plan does not include a Baggage Delay Benefit. [redacted] and his traveling companion did receive their baggage during their covered trip, though it was received several days later than their arrival at their destination.  As such, [redacted] and his companion did not experience a direct loss, theft, damage or destruction of their baggage.     Though [redacted] and his companion’s baggage was in fact delayed in its arrival at their destination, such event is not one covered under this plan.  Further, this plan does not provide coverage for reimbursement of the cost of personal effects purchased while awaiting receipt of delayed luggage.     While we certainly appreciate the situation in which [redacted] and his companion found themselves, we are unable to provide the requested reimbursement as this plan offers no such benefit.   We trust that we have addressed the concerns raised in [redacted]’s complaint and explained our position in this matter.  Should you have any further questions, please feel free to contact our office.

We have reviewed [redacted]’s complaint and we are responding accordingly. [redacted] submitted a claim form to our office advising of the cancellation his planned cruise due to a personal reason – noting that he did not feel well and needed rest.   Though he provided no medical...

documentation regarding an illness and treatment for such illness, as he seemed to indicate that his reason for cancellation was medical, we sent a letter to [redacted] on May **, 2016 requesting he submit a completed Attending Physician Statement from his treating doctor as is required under the plan.   [redacted] did not submit any further documentation prior to receipt of this complaint.   We understand from the complaint that [redacted] states the reason for his cancellation is not medical in nature.   Rather, he indicates his cancellation was due to “personal reasons”.   The plan [redacted] purchased does contain coverage for a trip cancellation due to a number of both medical and non-medical reasons specified in the plan.  However, a cancellation due to “personal reasons” is not among the specified reasons contained in the plan.   As such, we are unable to consider his request for reimbursement and we are currently sending correspondence to [redacted] advising of the denial of his claim.  Please note that though [redacted] is not eligible for a cash reimbursement, as he did purchase the plan, the cruise line will be providing [redacted] with a future cruise credit which he may use on a future trip.   To learn of the terms of the credits, and make use of them, [redacted] is directed to contact the cruise line directly.   We trust we have provided sufficient information regarding the claim submission and the current claim determination.   Should you have any additional questions, please feel free to contact our office.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:  
By going on this cruise against doctors orders would have been just stupid since my husband ended up  in the emergency room on one of those days that we would have been on the cruise.  I don’t believe companies should be able to deny refunds when we specifically purchased that insurance to prevent such occurrences.  If they need the emergency bill from the hospital and they want to pay it I will send it to them instead of the cruise reimbursement.  Doctors know when it is not possible for their patients to travel.  I still want the reimbursement of either the money paid for the insurance or the cruise reimbursement like they state that they will pay.  To take an insurance payment and then deny payment out is a scam and they are scamming a lot of people out of a lot of money 
 
[redacted]

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 and the matter has been resolved.  After issues with my address, the check arrived by [redacted] this morning (04/**/16).
Sincerely,
[redacted]

We have reviewed [redacted] complaint and we are responding accordingly.  Please note that we have been unable to locate a claim for [redacted], nor have we been able to locate any calls from him from the telephone numbers indicated on this complaint.  In order to allow us to research this...

matter further, we kindly request that [redacted] provide the reference number under which he indicates his claim was denied.  In addition we would ask that [redacted] provide both the telephone number from which he contacted our office as well as the telephone number he called to discuss the matter with our office.   Once we receive this information, we will be happy to further review this matter.   With regard to [redacted] contention that the plan provides reimbursement for trip interruption for any reason, please allow me to confirm that the plan in fact contains a listing of specified reasons for an interruption which would make one eligible for coverage. Please note that a complete copy of the plan is provided to all prospective insureds prior to and concurrent with their purchase.   In order to be eligible for coverage, the reason for the interruption would have to be due to one such specified reason and not fall under any of the plan exclusions contained therein.     In order to make a determination on a claim we would need to receive the supporting documentation regarding the basis of the interruption.   As we have no record of such information from [redacted], we are unable to make such a determination.  However, we have taken the liberty to initiate a claim on [redacted] behalf and have sent him a claim form via email for his completion.  [redacted] can follow the instructions on this claim form and submit the supporting documentation he has regarding his trip interruption if he has not already done so and we would be happy to review same.   However, please allow me to advise that, based on the information contained in [redacted] complaint, an interruption due to an airline’s refusal to allow a passenger to board a flight would not be among the specified reasons for interruption contained in the plan.   Should [redacted] like us to review this matter further, we ask that he provide the above-requested information regarding his reference number and the telephone numbers used for his discussions with our office.   We trust that we have responded to the issues raised in [redacted] complaint.  We look forward to providing a more substantive response once [redacted] provides the needed information to locate his communication with our office.  Should you have any additional questions, please feel free to contact us.

We have reviewed [redacted]’s further comments advising of her submission of the physician form required for further claim review.   Please note that we did indeed receive the Attending Physician Statement (“APS”) [redacted] had completed by Dr. Joycelyn D. M**.  However, rather than affirming the date of examination performed by Dr. M** and treatment provided by Dr. M**, which was noted in our prior response as being required under the plan, Dr. M** in fact simply affirmed that she had performed no such examination and had provided no such treatment to [redacted], noting on the APS under the question of examination and treatment of [redacted], “None for this condition.”   Further, Dr. M** indicates that she knows of no treatment received by [redacted] from any other physician for this condition.   As the medical documentation submitted by [redacted] affirms that she underwent no examination and treatment by a physician during the coverage period and at the time of cancellation, we must maintain our original determination on this claim.   Please note that correspondence was sent to [redacted] on October [redacted] advising of such determination.   We trust this responds to [redacted]’s further inquiry and this matter is now concluded.  Should you have any further questions regarding this matter, please feel free to contact our office.

We have reviewed [redacted]’s complaint and we are responding accordingly.  Please note that [redacted] did not initiate a claim with our office.   While [redacted] did contact our office on or about January *, 2015 to begin a claim for trip cancellation due to her job loss, she did...

not complete the initiation process.   Rather, upon being advised of the specified reasons for cancellation under the plan, in particular the coverage afforded for a cancelation as a result of a job loss of the traveler, provided the traveler was employed by such employer for a minimum of three years prior to such termination, [redacted] did not proceed with the claim initiation as she did not meet the three year requirement.   While we certainly understand [redacted]’s position, the plan language clearly states that three years of employment are required to be eligible for coverage.  Further, please understand that a complete copy of the plan was provided to [redacted] prior to and concurrent with her purchase of the plan, and such terms must be accepted in order to complete said purchase.    Though no claim has been initiated to date, should [redacted] wish to do so, she can contact our office and we would be more than happy to review any additional information she wishes to submit.   However, based on the information received to date, at this time we would be unable to consider her request for reimbursement.    We trust that we have responded to the concerns in [redacted]’s complaint.  Should you have any additional questions, please feel free to contact our office.

We have reviewed [redacted]’s remarks to our response and we welcome this opportunity to further clarify our position. [redacted] advises in her remarks that we are confused with regard to the basis of her and her companion’s reason for cancellation, noting it was not a scheduling conflict but rather due to a death in his congregation and his need to attend to the congregation’s needs.    Please note, when the claim was originally submitted, [redacted] indicated that he learned of the death of a congregant and, as his Associate Pastor, the only other one able to handle the situation in his absence, was unavailable, he felt the need to cancel the trip to attend to his congregants.  If [redacted] felt our noting the situation as simply a scheduling conflict seemed too limiting, we apologize.   However, please be assured that we are fully cognizant of the reason behind the decision to cancel the planned trip.   Further, while we certainly can appreciate the decision [redacted] made, please understand that such reason for cancellation is not one covered under this plan. Please allow us to confirm to you that the specified reasons contained in the plan apply to any individual purchasing said plan.  There is no variation in the terms of the plan based on the profession of the individual traveler. As [redacted] and [redacted] cancelled their travel plans so [redacted] could remain at home to attend to his congregation, and such reason is not one specified in the plan, we are unable to consider their request for a refund.    We hope this shall provide additional clarification regarding the basis under which this claim was adjudicated.  Should you have any additional questions, please feel free to contact our office.

We have reviewed [redacted]’s complaint and we are responding accordingly.   Based on the information received, [redacted] cancelled his family’s scheduled trip as the purpose of the trip was to visit his son prior to his deployment but his son received a change in his orders and was no...

longer going to be at the destination to which the [redacted] were planning to fly.  As their son was no longer going to be there to visit with, the [redacted] advised they no longer had a need to travel.    Please understand that the plan provides reimbursement in the event of a cancellation due to a number of both medical and non-medical reasons as specified in the plan.  However a change in plans, as a result of an insured no longer choosing to travel due to the unavailability of their son with whom to visit, is not one of the covered reasons under the plan.  As such we were unable to consider the request for reimbursement.  Please note that this is a named-peril policy, and as such, only cancellations due to one of the specified reasons contained in the plan would make an insured eligible for benefits.   Please note that the plan in its entirety is provided prior to purchase for review.  Further, the confirmation provided to [redacted] contained a link to the plan, including the specified reasons for cancellation and the contact information for our office for any questions regarding the plan as well as a notice of a 10 day right to examine the plan to determine if it meets with the insured’s needs.   We truly empathize with [redacted] and his family in the disappointment of the cancelled visit and in the denial of their claim.  However, we must review each claim in keeping with the terms and conditions of the plan purchased.    We trust that we have addressed the concerns raised in [redacted]’s complaint.   Should you have any additional questions, please feel free to contact us.

We have reviewed [redacted]’s complaint regarding the denial of her claim for Trip Cancellation benefits and are responding accordingly.     Please note that the plan [redacted] purchased provides reimbursement for cancellations due to certain specified reasons, both medical and...

non-medical.   However, should an individual’s reason for cancellation not be amongst those specified in the plan, we would be unable to consider their request for reimbursement.   [redacted] canceled her hotel booking when one of her one-day job assignments, which required her overnight stay for commuting purposes, was canceled, thus negating her need for the overnight stay.  Therefore, she cancelled the booking and submitted a claim to our office for reimbursement of that hotel charge.   [redacted] has submitted her claim to our office on the basis that the cancellation of one of her one-day job assignments constitutes a “termination of employment or lay-off”, under the plan.   Please note that the plan [redacted] purchased does indeed afford an insured coverage for a cancellation due to the following:...e. your involuntary termination of employment or layoff which occurs after your effective date of coverage and was not under your control. You must have been continuously employed with the same employer for 3 years prior to the termination or layoff. This provision is not applicable to temporary employment, independent contractors or self-employed persons;   However, please understand that [redacted]’s situation does not fall under this coverage.   More particularly, the cancellation of one of [redacted]’s one-day assignments was neither a termination of employment nor a layoff.   Rather, [redacted] is still employed with the same company, the company from whom she receives these one- or multi-day outside assignments.   As such, the cancellation of [redacted]’s one-day assignment does not qualify her for coverage under the plan as a termination or layoff.  Further, please note that, as the assignment in question was a short-term, temporary assignment, its cancellation would also not have qualified [redacted] for coverage as the coverage does not extend to temporary employment.    As [redacted] notes in her complaint, she reviewed the plan prior to purchasing it.   Please understand that the complete plan, including the coverage terms and conditions listed above, are provided to each prospective insured prior to their purchase of the plan.  Further, in order to finalize the purchase of the plan, they must initial their agreement with such terms and conditions.    Based on the above, we are unable to consider [redacted]’s cancelled one-day, temporary assignment as a covered reason for Trip Cancellation under the Plan and no reimbursement shall be forthcoming.   We trust that we have responded to the items raised in [redacted]’s complaint and appreciate this opportunity to provide further clarification regarding the basis for the denial of her claim.  Should you have any additional questions, please feel free to contact our office.

We have reviewed [redacted]’s complaint and we are responding accordingly.    In his complaint, [redacted] states that he has been unable to proceed with his claim, alleging that we have refused to send the Attending Physician Statement to him for completion while he is currently in the...

hospital.   Please note that we originally sent the required form on 2/**/17 via email, shortly after [redacted] had initiated the claim earlier that afternoon.  [redacted] emailed us back that evening to inquire what other information was needed.   We replied to him on 2/**/17, explaining the letter sent to him the prior day and attaching an additional copy of the letter with that email.     The response received from [redacted], on 2/**/17, was simply an inquiry as to the status of his claim, without submission of the completed form, as requested.   We responded to [redacted] later that day to again advise of the additional information needed, and we provided an additional copy of the letter sent to him on 2/**/17.   Shortly thereafter, later on 2/**/17, [redacted] sent a responding email, demanding his refund but again, not providing the requested documentation.   Concurrent with sending this email, [redacted] also called our office, advising he is in the hospital and does not have a printer and cannot get mail.  At that time we offered to fax the form to the hospital if he could receive a fax through them and provide us with a fax number.  [redacted] provided a fax number and the form was faxed out accordingly, with a fax delivery confirmation received.     Upon receipt of this complaint we have made numerous attempts to reach [redacted] at the telephone numbers he had previously provided.   We attempted to reach him on 3/*/17, 3/*/17, 3/*/17 and 3/*/17.   To date, we have received no return call from [redacted].     As previously advised to [redacted], the completed Attending Physician Statement is required in order for us to continue our review of his claim.   Should he still be in need of a copy of this form, we ask that [redacted] call our office and provide a current fax number or email address for us to use.   We trust this has provided the necessary clarification and time frame regarding our efforts in assisting [redacted].   Should you have any additional questions, please feel free to contact us.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

[Your Answer Here]
 I am deeply disturbed by the Berkely Group's response to my complaint, particularly over the fact that they would never have reimbursed the air travel regardless of how well we met their unreasonably strict and confusing criteria. This is also directly contrary to what a Berkely group employee [redacted] - reference number [redacted] and what a [redacted] employee told me whose name is [redacted].  [redacted] went as far as to offer me partial compensation over the phone for my tickets but encouraged me to submit a claim with Berkely group as he was confident that I would receive full compensation by Berkely.  Furthermore no one said that my claim would not be considered if my children did not immediately receive medical attention.  My children have special needs and they do not do well with unfamiliar doctors.  I had every intention of bringing them in to our Pediatrcian but by the next day they were doing substantially better. If this travel insurance doesn't even cover the cost of a flight when you get sick what is the point of having it?  Why would [redacted] and [redacted] both mislead me? Why did I even bother submitting a claim in the first place if no one was going to even consider it as Berkely group says.  I was deceived by Berkely group and [redacted] and feel I am entitled to compensation.  The plane tickets were about $1000 one way for four people for a very short flight.  I am sure that these were full fair tickets or close to it and that any reputable airline would have offered some compensation if not a full refund.  I am certain that either Berkely group or [redacted] received some refund for these canceled tickets which they have yet to reimburse me for. Berkely group is clearly utilizing deceptive business practices and misleading consumers.  I haven't been able to find a single website online that gives Berkely group more than a few stars out ten.  I was not the first to be unfairly treated by them and I'm sure I won't be the last.  People need to know the truth about this company.
 
 
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

I absolutely protest this email response to me--the first I have received right now, today, the [redacted]!  because it is completely false.  Yes, I had initially submitted insufficient evidence this company said, but then I sent additional documents that were NOT from the attorney but from the court.  I also sent copies to you too--so frankly I suspect you are simply covering up the fraud for your neighborhood homies.   maybe Tony Soprano told you to do so. IF New York Revdex.com is an honest consumer agency, like they are in other parts of the U.S., please follow-up.  I do not agree with your email.  This was the first I have heard ANYTHING from you--you are not telling the truth and this company is not telling the truth.  plus, my elderly widowed mother, is now recovering or trying to from Harvey.  I know I know, to New Yorkers you probably just laugh, right?Sincerely,[redacted]

We have reviewed [redacted]’s complaint regarding the processing of her claim for Trip Cancellation benefits.  We are providing our response accordingly.    We received [redacted]’s claim submission on December **, 2016.  As advised, on average it takes 7 – 10 business days for...

the review of a claim.   Shortly before receipt of this complaint on January *, 2017, 8 days after receipt of the claim submission, this claim was approved for payment.  Payment in the amount of $575.70 per person was sent to [redacted] and her husband on January *, 2017.    As payment has been provided we have closed this matter. We trust that we have sufficiently responded to the concerns contained in [redacted]’s complaint. Should you have any additional questions, please feel free to contact our office.