Berkely Group

We have reviewed [redacted]’ complaint and we are responding accordingly.  In her complaint, [redacted] explains that she had to cancel her travel plans due to the medical condition of her young son.   However, [redacted] did not provide any medical verification of such illness and...

treatment, as is required under the Plan.   Please understand that in order to qualify for coverage under the plan for a cancellation as a result of a medical condition, the insured must submit verification of the examination and treatment of the patient at the time of the cancellation.   Such verification was not provided by [redacted] with her claim form submission.   Accordingly, we sent correspondence to her on January *, 2015, requesting she provide such documentation.   To date, no such documentation has been submitted. However, concurrent with receipt of this complaint, [redacted] did advise the claims personnel reviewing her claim that she will obtain such documentation from her son’s physician and submit same to us for review.   Upon receipt of this documentation, we will give [redacted]’ claim our immediate attention.   We look forward to the opportunity to continue our review of [redacted]’ claim.   Though please understand that, until such documentation is received, we will be unable to make a determination of her eligibility for reimbursement under the plan.  Should you have any additional questions regarding this matter, 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:

This complaint has not been resolved, I pick not resolved, I still dont have my...

money
 
 
[redacted]

We are in receipt of the complaint filed by [redacted] and are responding accordingly.   [redacted] cancelled her scheduled trip due to her own medical reason.   In order to determine that the reason for the cancelation meets the plan requirements, sufficient medical documentation...

is needed.   However, the original submission from [redacted] did not contain such medical documentation and we had to request she submit such additional information. I am pleased to advise that we have now completed our final review of all pertinent information submitted and are now able to make payment on the claim.   Accordingly, payment in the amount of $549.00 will shortly be sent to [redacted] directly.  As this claim is now settled we trust this will conclude this matter.   Should you have any additional questions, please feel free to contact our office.

We are in receipt of the complaint filed by [redacted] and are responding accordingly.   [redacted] initiated two separate claims on behalf of her traveling party.   One claim for her mother, [redacted], who was traveling on one itinerary, and one for herself and two others...

traveling on a separate itinerary.   [redacted] and her companions’ claim was reviewed and payment went out to them on June *, 2017.   [redacted]’s claim was reviewed and payment was sent to her on June **, 2017.   [redacted] contacted our office to advise that she and her companion on the second itinerary had not yet received our payment, having apparently been sent to an incorrect address.  We then began the process to void those checks in order to reissue new ones.     Upon approval of the void on June **, 2017, these replacement checks were requested for reissuance to [redacted] and her traveling companions and were sent on July *, 2017, the first payment issuance following such void.   We trust that [redacted] and her companions have received such payment at this time.  If there is any issue with the receipt of this payment, we request [redacted] contact us to review.   As this claim is now settled, this will conclude this matter.   Should you have any additional questions, please feel free to contact our office.

We have reviewed [redacted]s additional comments regarding this claim and are responding accordingly.   As advised previously, we show no record of the calls [redacted] contends she had with our office.   If she maintains her position, she will need to supply the requested information to allow further research.  However, at this time, as we have found no evidence to substantiate her contention, we consider that issue closed.   With regard to the documentation requested and submitted, please note that this documentation was required in the normal course of the claims process to verify the basis of the claim, and to allow payment of the claim to Ms. S[redacted] for the applicable, maximum benefit.     As advised, the appropriate and full payment of this claim has been provided to Ms. S[redacted].   The draft for said payment remains valid for a period of six months from date of issue, July *, 2017.      We trust this matter is now concluded.

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.
Sincerely,
[redacted]

We are in receipt of the complaint filed by [redacted] and are responding accordingly.   [redacted]. [redacted] began their cruise vacation but disembarked from the sailing the following day.  They submitted a claim to our office seeking reimbursement of their Trip Interruption...

benefits.  However, from the information received, it indicated that [redacted], who uses a C-Pap machine while sleeping, discovered that his machine was not functioning and the couple decided to disembark due to such mechanical issue.   Please understand that a mechanical issue with the machine alone would not be a specified reason for interruption under the plan and as such we were unable to consider the couple’s request for reimbursement.   However, based on the clarification provided in [redacted]’ complaint, as well as additional medical information regarding the circumstances surrounding the decision to end their participation on the cruise early, we were able to re-review the claim.  More particularly, we have affirmed that due to the mechanical issue with [redacted]’ C-Pap machine, he experienced an exacerbation of the underlying medical condition which requires the use of this machine.   That exacerbation was confirmed by the ship’s physician who in fact recommended the [redacted]’ disembark the cruise at the first port of call as a result of [redacted]’ medical condition.   I am pleased to advise based on the additional information reviewed, we have been able to reverse our original determination on the [redacted]’ claim.   Accordingly, on April *, 2016 we sent payment to the [redacted]es in the amount of $770.85 per person for their missed cruise portion and the additional transportation expenses for their early return.  However, additional charges incurred for a hotel stay before their return flight was not eligible for reimbursement under the terms of the plan.   As this claim is now settled we trust this will conclude this matter.   Should you have any additional questions, please feel free to contact our office.

We have reviewed [redacted] complaint and are responding accordingly.   The plan [redacted] purchased does provide reimbursement for a cancellation due to a Sickness.   However, in order to qualify for reimbursement, the reason for cancellation must meet the plan...

requirements.   These requirements include:   The Sickness or Injury must: a) commence while your coverage is in effect under the plan; b) require the examination and treatment by a Physician at the time the Covered Trip is cancelled; and c) in the written opinion of the treating Physician, be so disabling as to prevent you from taking your Covered Trip.   However, based on the information submitted by [redacted] on March, *, 2016, he confirmed that he did not seek medical treatment and underwent no examination by his physician at the time of his cancellation.   Rather, as verification of his illness, he submitted a note from his company confirming he had not traveled on his business trip due to illness, and again confirming that [redacted] sought no medical attention for this illness.   As [redacted] underwent no examination nor received any treatment at the time he cancelled the trip, he did not meet the plan requirements and we advised him by letter on March **, 2016 that we were unable to consider his request for reimbursement.   Please note that the plan in its entirety, including all plan terms, conditions and requirements for eligibility for reimbursement, is provided prior to and concurrent with the purchase of the plan.   While the plan does provide coverage in the event of a cancellation for an illness, the plan clearly advises that the insured must meet certain criteria to be eligible for reimbursement for a cancellation due to such an illness.   As [redacted] did not meet this criteria, as indicated above, the denial of his request for reimbursement was appropriate in accordance with the plan language.   While we certainly understand [redacted] disappointment in the denial of this claim, please understand that we must consider each claim under the terms and conditions of the plan purchased.   We trust that we have responded to the issues raised in [redacted] complaint.  Should you have any additional questions, please feel free to contact our office.

We have reviewed [redacted]s complaint regarding the processing of the claim for [redacted] for Trip Cancellation benefits.  We are providing our response accordingly.    We received a claim initiation advising that [redacted] and Ms. S[redacted] were attempting to change the...

original airline ticket or cancel and repurchase a new ticket, indicating that they would advise us of the situation once they’d made their decision.  We acknowledged receipt of the claim submission and the need for such documentation once available.     [redacted] later submitted documentation indicating that the original, insured airline ticket had been cancelled and a new ticket purchased.   We then proceeded to provide the full refund of the original, cancelled, airline ticket for which the coverage had been purchased, in the amount of $233.29.  Please understand that this is the maximum benefit available under this coverage. The plan states:               In no event shall the amount reimbursed under Trip Cancellation or Trip Interruption exceed the amount you prepaid for your Flight.   While we understand that Ms. S[redacted] purchased a new airline ticket for her new travel date, please understand that there is no coverage for any additional cost of such ticket over the cost of the original ticket purchased and reimbursed.  The payment provided to Ms. S[redacted] represents the maximum benefit to which she was entitled under the plan purchased.    As full payment of this claim 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.

We have reviewed [redacted]s complaint and we are responding accordingly.  In her complaint, [redacted] states that she submitted the information needed regarding her cancellation and we have not yet provided her refund.   Please note that we spoke to [redacted] several times regarding her...

claim and advised her on September *, 2017 what information is needed in order to continue our review of her claim. We are currently awaiting such documentation.    More particularly, when [redacted] submitted her claim form to us, she did not submit a completed Attending Physician Statement from her treating physician nor note any dates of treatment.  Rather, she noted that she was an employee of a hospital and simply provided generic information regarding her medical condition  As such, we were unable to consider the claim as verification of examination and treatment by a physician at the time of the cancellation, which is required under the plan, was not provided.    As per our discussion with [redacted] on September *, 2017, we advised that in order for us to continue our review of her claim, sufficient medical documentation must be submitted to allow us to confirm that her reason for cancellation meets the plan’s terms and conditions.  At that time [redacted] advised that she would have her physician complete the Attending Physician Statement and submit same to our office.   To date we continue to await submission of this documentation.   Please understand that until sufficient medical documentation has been submitted to allow us to continue our review of the claim, we will be unable to make any further determination on [redacted]s request for reimbursement.  Upon receipt of same, we will give [redacted]s claim our immediate attention.   We trust this has addressed the concerns raised in [redacted]s correspondence.   Should you have any additional questions regarding this matter, 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:

[the hospital is still sending invoices and I don't have the final amount of how much I need to pay them. and they have transferred the case to a collection agency.  ]
 
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]

We are in receipt of the complaint filed by [redacted] and are responding accordingly.   [redacted] initiated a claim with our office seeking reimbursement for his missed return flight due to his illness.  Unfortunately, the documentation needed to process [redacted]’s claim,...

including the documentation regarding his missed flight as well as documentation regarding his rescheduled return travel were not supplied to our office with his initial submissions.   As such, we requested this additional documentation, as well as clarification from [redacted] regarding the circumstances surrounding his delayed return which occurred some two months after his originally scheduled travel date.    However, I am pleased to advise shortly before receipt of this complaint, [redacted] did submit the additional documentation requested which allowed us to finalize his claim.   Accordingly, payment in the amount of $602.97 was provided to [redacted] on May **, 2017.  Please understand that the plan fees are non-refundable.   As this claim is now settled we trust this will conclude this matter.   Should you have any additional questions, please feel free to contact our office.

We have reviewed [redacted] complaint regarding her request for a refund of the protection plan fees she paid for two separate hotel bookings she had made for travel in September and October of this year.   Please note that though [redacted] initiated claims with our office for recovery...

of these hotel expenses, she did not submit completed claim forms to allow us to review such request.    Rather, the only document received following the initiation of [redacted] claims was this complaint.   We noted in her complaint that [redacted] advised that she cancelled her planned trips due to her concerns regarding the Zika virus and her pregnancy.    Please understand that we were not afforded the opportunity to review her claim on such basis.  However, [redacted] did also advise in her complaint that she obtained full refunds of her hotel bookings from Priceline directly.   We have confirmed this information with Priceline directly.    Please note that the plan fees are non-refundable even if no penalty is assessed on a particular booking, as the risk is assumed from the date of purchase of the coverage.  However, as a courtesy, as [redacted] received a full booking refund from Priceline, we have agreed to provide the requested premium refunds.   Accordingly, these refunds, in the amounts of $10 and $15 respectively, are being provided to [redacted] at this time in the same form in which payment had been received.   We trust this shall conclude this matter.  Should you have any additional questions, please feel free to contact our office.

We have reviewed [redacted]’s complaint and are responding accordingly.  In her complaint, [redacted] disputes the denial of her claim, stating that she canceled her scheduled flight due to her own health related issues, claiming her denial was cited for post travel cancellation  ...

According to our files, [redacted] cancelled her trip some 2 weeks prior to the departure date.   In order to qualify for reimbursement under the plan, the medical condition causing the cancellation must meet certain criteria.   In particular, the illness necessitating cancellation must meet the following plan requirements: The Sickness or Injury must: a) commence while your coverage is in effect under the plan; b) require the examination and treatment by a Physician at the time the Covered Trip is canceled; and c) in the written opinion of the treating Physician, be so disabling as to prevent you from taking your Covered Trip. [redacted] purchased her airline ticket and protection plan on August **, 2014 for a trip on September **, 2014.   Accordingly, in order to qualify for consideration, the condition would have had to commence after August **, 2014 and [redacted] would have had to have been examined and treated by her physician at the time of her cancellation on or about September **, 2014.   However, based on the information received, [redacted] underwent no such examination or treatment at the time of her cancellation nor while she was covered under the plan.  In addition, the illness [redacted] cites as necessitating her cancellation was one for which she had been treated, and in fact hospitalized for, as early as August *, 2014.   As the information received confirms that [redacted]’s condition did not commence while her coverage was in effect, nor that she underwent any examination or received any treatment from any physician for this condition at the time of her cancellation, her reason for cancellation does not meet the plan requirements and we are unable to consider her request for reimbursement.   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 and we are responding accordingly.  [redacted] and her traveling companion had a scheduling conflict with the travel dates and therefore needed to cancel their planned trip.   Unfortunately, [redacted] and her traveling companion’s...

reason for cancellation is not one covered under the plan.   Please understand that the plan purchased 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 scheduling conflict is not one such specified reason.   As such, we are unable to consider their request for reimbursement. Please note that the plan in its entirety is available on [redacted].com’s website for review at any time.  Further, the confirmation provided to [redacted] and her traveling companion contains 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.  While we understand [redacted] and her traveling companion’s disappointment at the outcome of their request for reimbursement, we hope this has provided further clarification of the claim determination and understanding that we must review each request in accordance with the terms and conditions of the plan purchased.

We have reviewed [redacted] complaint and we are responding accordingly. [redacted] had filed claims with our office for Trip Interruption benefits under two separate protection plans he and his wife had purchased in connection with their scheduled European tour.   The [redacted] began their...

outbound flight to reach their tour but were unable to continue on as scheduled due to a carrier delay/cancellation.   Due to this situation, the airline was unable to re-accommodate the [redacted]’ and they returned home.      The [redacted] purchased a tour with Trafalgar and booked the airline tickets to reach the tour through Priceline.   The Edmonds purchased the travel protection plans available in conjunction with both the travel bookings made.  We processed the two claims submitted by the [redacted] in relation to the interruption of their trip.   With regard to the claim the [redacted] filed under their Trafalgar plan, the reason for the interruption of the [redacted] travel plans was indeed a specified reason under the terms and conditions of the plan.   As such, they were eligible for payment of their Trip Interruption benefits.   Accordingly, we provided the payments to the [redacted] under their Trafalgar travel plan totaling $4,048.04.  These payments were: $33.52 per person on August [redacted], for the additional expenses they incurred during the flight delay and $1,990.50 per person on August [redacted], for the full cost of their missed tour.  Apparently upon receipt of that first payment, the [redacted] believed there was no additional payment forthcoming.  We sincerely apologize for any such misunderstanding.   With regard to the coverage the Edmonds purchased in conjunction with their airline tickets booked through Priceline, however, regrettably that plan does not contain coverage for a Trip Interruption as a result of a carrier delay or cancellation.    As such, we were unable to consider the [redacted] request for reimbursement under this plan.   Please allow me to advise further that, even if the [redacted] had interrupted their travel plans for one of the specified reasons contained in the plan, the losses for which they were seeking reimbursement, namely their original, partially used airline tickets, would not be eligible for refund as there is no coverage for original airfare under the Trip Interruption benefit but rather for any new airfare expenses incurred to return home.     While we understand the [redacted] disappointment with the interruption of their travel plans, and the outcome of the claim for their airfare, we are pleased we were able to reimburse them for their missed tour.   We trust this has provided clarification of the claims handling as well as an understanding that we must review each request in accordance with the terms and conditions of the specific plan purchased.     Should you have any additional questions, please feel free to contact our office.

We have reviewed [redacted]’s complaint and are responding accordingly. Please note that [redacted] states he canceled his scheduled flight due to his own medical condition.  The plan [redacted] purchased does provide a cancellation due to a Sickness.   However, in order to qualify...

for reimbursement, the reason for cancellation must meet the plan requirements.   These requirements are as follows: The Sickness or Injury must: a) commence while your coverage is in effect under the plan; b) require the examination and treatment by a Physician at the time the Covered Trip is canceled; and c) in the written opinion of the treating Physician, be so disabling as to prevent you from taking your Covered Trip. [redacted] contacted our office on October **, 2015, to advise that he was unable to take his scheduled flight on October **, 2015, due to his own medical condition and he wished to initiate a claim for the losses associated with the cancelation or change of this ticket.   Contrary to [redacted]’s assertion that he was not advised at the time he initiated his claim that he would need to provide verification of the examination and treatment he received at the time of his cancellation, in fact this information was relayed to [redacted] during said conversation.    More particularly, a review of this conversation confirmed that our representative advised [redacted] that the claim form contained a section that would need to be completed by his treating physician.   [redacted] expressed his displeasure at this requirement as he advised it would cost him $100 to have his doctor complete the claim form. Our representative relayed her understanding of his concerns but reiterated that this was a plan requirement.  Further, please note that the plan requirements, including the requirement of an examination and treatment at the time of a trip cancellation, are noted in the plan’s description of coverage.  This description of coverage was provided to [redacted] prior to his purchase of the plan, with a link to an additional copy provided on the confirmation of his purchase.   As such, [redacted] had ample notice of the plan requirements regarding a Trip Cancellation claim for a medical illness. With respect to [redacted]’s assertion that he was not sent a claim form for a number of weeks after initiating his claim, please note that a claim form was sent to [redacted] via email, at [redacted], concurrent with the claim initiation, at 5:17pm on October **, 2015.   [redacted] then contacted our office again on November *, 2015 regarding receipt of the claim form and a second copy of the claim form was emailed to the same address at 12:07pm on November *, 2015.  Within minutes of the sending of this second claim form, [redacted] again called our office and he again requested the claim form be emailed.   A third copy of the claim form was then emailed to [redacted] at the same address at 3:19pm that same afternoon. Accordingly, every effort was made to provide [redacted] with a claim form for his completion.   Though [redacted] has not yet submitted a completed claim form, based on the information he included in his complaint, he affirmed that he in fact did not see a physician at the time of his cancellation.   As [redacted] does not meet the plan requirements indicated above, we are unable to consider his request for reimbursement and must decline coverage at this time and will notify him of this decision under separate cover. While we certainly understand [redacted]’s disappointment in the claims process, please understand that we must consider each claim under the terms and conditions of the Plan purchased. 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 and we are responding accordingly.  Please note that this complaint is the first notice we have received regarding this matter.  Please allow us to take this opportunity to advise that the plan purchased does contain a list of specified reasons...

for cancellation, both medical and non-medical, which would make one eligible for reimbursement.  In order to qualify for coverage, the plan participant’s reason for cancellation must fall within the terms and conditions of the plan and the appropriate supporting documentation must be submitted for our review and determination.  The list of specified, non-medical reasons for cancellation are contained in the plan under Other Covered Events, and read as follows: Other Covered Events means only the following unforeseeable events or their   consequences which occur while coverage is in effect under this Policy: a change in plans by you, an Immediate Family Member traveling with you, or Traveling Companion resulting from one of the following events which occurs while coverage is in effect under this Policy: (a) being directly involved in a documented traffic accident while en route to departure; (b) being hijacked, Quarantined, required to serve on a jury, or required by a court order to appear as a witness in a legal action, provided you, an Immediate Family Member traveling with you or a Traveling Companion is not: 1) a party to the legal action, or 2) appearing as a law enforcement officer; (c) having your Home made uninhabitable by fire, flood, volcano, earthquake, hurricane or other natural disaster; (d) Your involuntary termination of employment or layoff which occurs after your effective date of coverage. You must have been continuously employed with the same employer for 1 year prior to the termination or layoff. This provision is not applicable to temporary employment, independent contractors or self- employed persons. In order to be eligible for coverage under the Plan, the non-medical reason for a cancellation must meet one of the above specified reasons.   Without a claim being initiated, we are unable to speak to any coverage to which [redacted] may have been entitled upon the cancellation/change of his original travel plans.   However, as [redacted] notes, the plan purchased does also contain an [redacted] Vacation Waiver which allows a plan participant to cancel or change their scheduled plans, on a one time basis, for any reason, and receive reimbursement of any change fees applied by the airline.  From [redacted]’s complaint, we understand that he did make an initial change to his original scheduled travel plans and he has indicated that for this he was charged a $200 per person change fee for which he requested reimbursement from [redacted] directly, under the terms of this Waiver.   It is our understanding that [redacted] subsequently made a second change to his itinerary for an additional fee but does understand that the Waiver applies only to the initial change made.   As such, he has indicated that he is seeking recovery of only the $200 per person change fee imposed on the initial change. As indicated above, such recovery under the Waiver is handled by [redacted] directly.  Accordingly, we did reach out to [redacted] to determine the status of such request.   We have confirmed with [redacted] that the applicable refund of the fees charged to [redacted] upon the initial change of his travel plans has been processed by [redacted].   Such refund should be visible to [redacted] shortly with his credit card company.   As the requested refund has been provided by [redacted], we have taken the liberty of closing this matter at this time.  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 complaint and we are responding accordingly.  Please note that, though [redacted] did contact our office regarding his need to cancel his scheduled flight for personal reasons, when advised that there were specified reasons for cancellation under the plan that...

made one eligible for reimbursement, [redacted] refused to provide more information and chose not to initiate the claim.   Please understand that the full terms and conditions of the plan are provided to each prospective participant prior to their purchase and they must confirm their acceptance of such terms in order to finalize that purchase.   In order for us to determine if an individual’s reason for cancellation falls within the plan’s guidelines, a claim must be initiated and sufficient documentation regarding the reason for cancelation must be submitted.   Please note that [redacted] is welcome to initiate a claim with our office and we would be happy to review any documentation he submits regarding his reason for cancellation.  However, with no claim having been initiated, and with no opportunity to determine whether [redacted]s reason for cancelation falls within the plan’s terms and conditions, we are unable to consider his request for reimbursement.    Should [redacted] wish to initiate a claim with us he can certainly do so at our toll free number, ###-###-#### and submit the necessary documentation to allow us to review his claim under the terms of the plan.

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 feel this advertising is intentionally misleading. You call it travel insurance. I question the ethics of your business practices. It seems you advertise this was for one reason, and that is to trick people into believing you can cancel or reschedule without penalty!
If you will not make this right I will have only one option to escalate this to the next level. I want my $144 back. I don't have the money to give to your company for nothing. I hope you will resolve this issue so we won't have to go that route.
 
 
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]