Berkely Group

We have reviewed [redacted]’s additional comments and are responding accordingly.  [redacted] is arguing that his temporary inability to attend his place of employment constitutes a layoff.   However, there is no evidence that at the time in question [redacted] was contacted by his employer and advised that his employment was no longer needed and he was being terminated or laid off.   Rather, from the letter which [redacted] submitted with his claim form, dated October [redacted], from the South Carolina Department of Health and Environmental Control,  at which he works, it was advised that the office was temporarily closed Octobe** [redacted] due to extensive flooding in the area.   It goes on to say that all compensation and leave time has not been approved and advises that any prior time off requests must be used to cover the days during which the office was closed.  Further, from [redacted]’s own explanation provided with his claim form, as a result of the time away from work due to this temporary office closure, the time off that he had requested for this trip now must be used to cover the days of the office closure.   He concludes by saying that because of this, as well as no longer being financially able to afford this trip, he regretfully requests cancellation.  Accordingly, the denial of [redacted]’s claim was appropriate as his reasons for cancellation, the loss of his time off requested and any subsequent financial constraints, do not qualify him for coverage under the plan.   Finally, as evidenced by the letter from [redacted]’s employer, he was neither terminated nor laid off from his employment and as such, we are unable to consider his request on such basis. With regard to [redacted]’s mention of the definition of Natural Disaster, please note that as there was no shutdown of all local airports for a period greater than 72 hours at the time of his scheduled flight, nor was [redacted]’s own home made uninhabitable at that time, we are unable to consider his request on this basis. While we certainly understand [redacted]’s disappointment with the outcome of his request for reimbursement, we must review each claim in accordance with the terms and conditions of the plan.   We trust that we have provided the requested additional clarification of the handling of this claim and this matter is now closed.  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:

[Your Answer Here] This is untrue. They have had the forms for several days now. It took me over 10 days and numerous calls, to even get them. I called them today and spoke to a supervisor name [redacted] and she verified that they have the forms, but it could several more weeks before the claim is acted on. This company has done nothing but stallll and try and find a way to keep my funds. I have attached a copy of all of the docs, that they say in the Revdex.com response they never received. I am again requesting my funds be returned to me as I do qualify under No employment/ loss of income................
 
 
 
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]

As previously advised, the plan in its entirety is made available for review prior to purchase. This includes the listing of all the specified reasons for cancellation, the notice of the 10-day Right to Examine as well as our contact information for any questions about the plan while reviewing it.
Further, as advised, the booking confirmation sent to the traveler also contains links to the full plan terms and conditions. The pdf attached is a copy of the actual claim submission of the booking confirmation that [redacted] had received from Expedia, via email, upon her purchase. The areas highlighted are the links that [redacted], as the purchaser, would have been able to use to hyperlink to the full description of coverage, a copy of which I have also attached. We would now direct your attention to the second page of said document.
On the fourth bulletin from the top of that page, it states:
  • View the complete terms and the condition of the description of coverage.
Please note that the highlighted words “description of coverage” is the first hyperlink to the plan document.
In addition, in the section below where it states:
   “You have purchased the travel protection plan. Please refer to your itinerary number when calling to ask question or file a claim.”
Once again, the highlighted words “travel protection” are the second link to the plan document itself.
Please understand that the original copy of this confirmation sent to [redacted] via email is a color document. As such, the links noted are in a contrasting color, as well as in a different font, to the remainder of the sentence text to further identify them.
As advised previously, the reason for [redacted]’s cancellation is not among the specified reasons under the plan and therefore we are unable to consider the request for reimbursement and no payment shall be forthcoming.
Should you have additional questions, please feel free to contact our office.

We have reviewed [redacted]’s complaint and we are responding accordingly. [redacted] cancelled her scheduled cruise and submitted a claim to our office indicating her reason for cancellation was that she found out she was pregnant and her doctor did not want her to travel.  She further...

indicates that her pregnancy was at a higher risk due to maternal age.   Please understand that 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.  More particularly, to plan allows for a cancellation due to a sickness, injury or death of a plan participant, traveling companion or immediate family member.   From the information [redacted] submitted, her cancellation was not related to a sickness, injury or death but rather to her discovery of her pregnancy.   As this is not a sickness, we were unable to consider her request for reimbursement on such basis.   Please note that, following our original determination, we were in contact with [redacted] who disputed our denial of her claim, stating that as her pregnancy was considered high risk, she should be eligible for payment.       However, please understand that the plan contains a specific exclusion to the eligibility for a cash reimbursement regarding a cancelation as a result of a pregnancy.   More particularly, the plan states:   Carnival will not waive their cancellation fee and provide a cash refund, should you cancel or interrupt your cruise vacation for any of the following reasons:… • a condition related to: elective abortion; use of alcohol or drugs other than as prescribed by a doctor; psychological disorders (unless hospitalization is required) or pregnancy (unless hospitalization is required);   However, we did agree to obtain [redacted]’s medical records to determine if she did indeed meet the plan qualifications for a cancellation.   We have now received these records and can confirm that there was no sickness for which [redacted] cancelled her trip.  Further, based on the medical documentation, there was no issue with her pregnancy which required her hospitalization.     While we can certainly appreciate the decision made by [redacted] and her physician to cancel the trip, a cancellation due to the concern for a potential medical issue is not covered under the plan and does not make one eligible for a cash reimbursement.     As such, we must reaffirm our original determination and no cash payment shall be forthcoming.  Please allow us to advise that upon the denial of her request for a cash reimbursement, the cruise line did provide [redacted] with a future cruise certificate for a future cruise.  In order to make use of such credit, [redacted] should feel free to contact the cruise line directly.   We trust we have provided sufficient information regarding this matter.   Should you have any additional questions, please feel free to contact our office.

We have reviewed [redacted] additional comments regarding the premium refund she had requested. As previously advised a premium refund in the amount of $639.00 was agreed to and was being provided by the tour operator directly. In [redacted] communication of January **, 2016, she advised she received confirmation of only a portion of such refund, in the amount of $440.00, having been provided.
Please be advised that we did reach out to the tour operator to confirm the refund provided. We have been advised that two separate refunds were processed for [redacted] on January *, 2016, both back to their original forms of payment. More particularly, one refund in the amount of $440.00, was provided to [redacted] to her credit card ending in 0020, and a second refund, in the amount of $199.00, was provided to [redacted] to her credit card ending in [redacted].
As these two refunds equal the agreed upon refund of $639.00 we trust this matter is now concluded. Should you have any further questions, please feel free to contact our office.

We have reviewed [redacted]s complaint and we are responding accordingly.  In her complaint [redacted] advises that she is dissatisfied with the payment provided to her under the Baggage and Personal Effects Benefit of the travel protection plan she purchased.    [redacted]...

submitted a claim to our office for the loss of two items from her luggage held in the overhead compartment on the plane, namely a laptop computer and a pair of sunglasses.  As was noted on the Calculation of Baggage/Personal Effects Benefit which accompanied our payment, the payment of $500.00 was the maximum amount payable under [redacted]s claim.   More particularly, while we understand the purchase price of her laptop was greater than $500, the plan contains a per article limit of $500.   Accordingly, the most we were able to reimburse [redacted] for her laptop was the $500.  Further, the plan contains specific exclusions to coverage under the Personal Effects coverage.   The plan states the following: Items Not CoveredWe will not pay for damage to or loss of:… 4.     artificial limbs or other prosthetic devices, artificial teeth, dental bridges, dentures, dental braces, retainers or other orthodontic devices, hearing aids, any type of eyeglasses, sunglasses or contact lenses;  Accordingly, as the maximum reimbursement available for the covered item, namely [redacted]s laptop, has been provided, and the second item is specifically excluded from coverage, no additional reimbursement is due to [redacted] and no further payment shall be forthcoming. 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.

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:

It wasn't that I had to "fulfill job obligations" -- the place of business was closed entirely for the week, that was beyond my control.  Furthermore the description of coverage says "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;"I was involuntarily laid off for a week, and it was not under my control.  NOWHERE does it state how long the layoff has to be for.And: "g. a Natural Disaster occurs, which causes a complete cessation of travel services at point of departure and/or destination;" -- A large part of my neighborhood was destroyed by flooding and I am still have to take detours just to get around my normal routes to and from work.This company should not be allowed to scam people out of money, this was out of my control.  I will be glad to contact any and all media to let them know that this company is trying to scam a flood victim out of insurance money.  This is disgraceful and NOT ok. 
 
 
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]

We have reviewed [redacted]’s complaint and we are responding accordingly.  In his complaint, [redacted] explains that he and his wife were unable to board the ship for their cruise as they did not have the appropriate travel documents.    In particular, as they held birth...

certificates issued in Puerto Rico prior to 2010, in order to travel using them, they were required to obtain new, valid birth certificates for use in travel.    [redacted] indicates that they were unaware of such a requirement and did not find any information related to that on the cruise line’s site.    As the reason the [redacted] did not travel was due to a lack of the necessary travel documents, such reason is not one covered under the plan and we are unable to consider their request for a cash reimbursement.  Please note that the [redacted] may be entitled to future cruise credits from the cruise line.   They may wish to contact the cruise line to see if they did indeed qualify for such future cruise credits and if so, how to make use of them.   While we cannot speak to the travel documentation information provided by the cruise line, we did note that that the cruise line’s website does indeed include notice of the need for a valid birth certificate for travelers holding a birth certificate issued in Puerto Rico prior to July *, 2010.    While we understand [redacted]’s disappointment at the outcome of this claim, we hope he can understand that we must review each request in accordance with the terms and conditions of the plan purchased.

We are in receipt of the complaint submitted by [redacted] on behalf of his wife, [redacted] and are responding accordingly.   As per the information received, [redacted] cancelled her trip to Costa Rica after discovering she was pregnant and due to concerns related to the...

Zika virus.   The Plan [redacted] purchased provides a reimbursement as a result of a trip cancellation in the event of certain risks, both non-medical and medical.   One such specified medical reason is a cancellation due to a Sickness.   Sickness is defined in the Plan as follows:   Sickness means an illness or disease of the body which: 1) requires examination and treatment by a Physician, and 2) commences while the plan is in effect.   The Plan also contains specific exclusions to the eligibility for coverage.   One such exclusion states the following:  General Plan Exclusions In Parts A & B: We will not pay for any loss caused by or incurred resulting from:…          3.       normal pregnancy, except if hospitalized;From the information received, there is no indication that [redacted] was suffering from a Sickness, as defined under the Plan, at the time of her cancellation,   Rather, we understand that the reason for [redacted]’s decision to cancel her travel plans was due to her recent discovery of her pregnancy and the concerns for the potential of an illness occurring in relation to the Zika virus.  While we certainly can appreciate and empathize with [redacted]’s decision to cancel her trip, unfortunately, as her reason for such cancellation, namely her concerns for the potential of contracting an illness, is not a specified reason under the Plan, we were unable to consider her request for reimbursement.  Please note that the Plan in its entirety, including all specified reasons for cancellation, as well as all specific exclusions to the eligibility for coverage, are provided to the participant prior to and concurrent with their purchase of the plan.  In addition, our contact information is provided should a potential plan participant have any questions regarding the plan.   We trust we have addressed the issues raised in [redacted]’s complaint.  Should you have additional questions, please feel free to contact our office.

We have reviewed [redacted]’s complaint and we are responding accordingly.  In her complaint, [redacted] advised that after booking the trip, she found out that her child’s school year was starting on an earlier date than she expected and as such, she and her family would be unable to...

travel.    Unfortunately, [redacted]’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 conflict with a school schedule is not a specified reason in the plan.   As such, we are unable to consider [redacted]’s request for reimbursement.   Please note that the plan in its entirety is provided to the traveler prior to and concurrent with the purchase.   Further, the traveler must initial their understanding and acceptance of such terms in order to complete the purchase.   While we understand [redacted]’s disappointment in the outcome of her 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]’s complaint and are responding accordingly.  In her complaint, [redacted] disputes the denial of her claim, including the qualifications of the individual who reviewed her claim submission.   Please note that the plan [redacted] purchased does provide...

reimbursement for a cancellation due to a medical condition.  However, 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 Vacation is canceled; and c) in the written opinion of the treating Physician, be so disabling as to prevent you from taking your Covered Vacation.   [redacted] booked her trip and protection plan on October *, 2013 for a trip on October **, 2013, returning October **, 2013.  Accordingly, in order to qualify for consideration, the condition would have had to commence after October *, 2013 and [redacted] would have had to have been examined and treated by her physician at the time of her cancellation on or about October *, 2013.    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.  Rather, the information submitted by her physician indicated this was a condition which began while [redacted] was in her 30s and the only noted examination or treatment indicated by [redacted]’s physician was on October **, 2013, the day [redacted] had her physician complete this statement and some nine days after her cancellation of the trip.     As the information received to date indicates that [redacted] did not undergo any examination or receive any treatment from a physician for this condition at the time of her cancellation, her reason for cancellation did not meet the plan requirements and we were unable to consider her request for reimbursement.    However, should [redacted] wish to afford us the opportunity to obtain additional medical information from her physician regarding the medical condition necessitating her cancellation, we would ask that she kindly sign and return the attached Authorization for Release of Medical Information.   Please be assured that only medical information for the relevant dates pertaining to her cancellation would be requested.   Unfortunately, until we are able to consider any additional medical documentation from [redacted]’s physician regarding her reason for cancellation, we will be unable to reconsider our position.    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.

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 emailed the company to let them know that during my stay in Indiana I was with my cousin who is a physician as well as my mother who is an RN.  If the company needs documentation from a physician, I can certainly provide a letter from my cousin the PA.  
 
 
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]

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 have advised [redacted] several times what information is needed in order to continue our review of her claim.     When [redacted] submitted her claim form to us, she did not complete Section III, the Patient Medical Information, nor did she submit a completed Attending Physician Statement and a signed authorization.   As has been explained to [redacted], in order to 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.    As well as this documentation having been requested on the claim form, which [redacted] did not complete, we also requested this information by letter on January *, 2017 and sent follow up written requests on February [redacted] and March [redacted].  In addition, we discussed what information was needed with [redacted] during a telephone call with her on January [redacted].     Please note, in addition to our direct contact with [redacted], we did affirm to the representatives from the travel suppliers she had contact us on her behalf that this medical documentation was needed to continue the claims process.  Based on our discussion with the travel supplier’s representative on March [redacted], [redacted] indicated she would be sending in a letter from her doctor regarding the consultation she had due to her illness.     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 determination on [redacted]’ request for reimbursement.    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.

We have reviewed [redacted]’s complaint and we are responding accordingly.  In her complaint, [redacted] advised that she cancelled her scheduled trip due to her temporary job relocation.  Unfortunately, [redacted]’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 job relocation is not a specified reason in the plan.   As such, we are unable to consider [redacted]’s request for reimbursement.Please note that the plan in its entirety, including the full listing of all specified reasons making one eligible for reimbursement is provided to the traveler prior to and concurrent with the purchase.   While we understand [redacted]’s disappointment in the outcome of her 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]’s complaint regarding his request for a premium refund for his and his party’s cancelled airline tickets.  Please be advised that upon receipt of the complaint, we did confirm that [redacted]’s premium refund request was received in our office.  Such request was...

approved and sent to Expedia for processing.     We have confirmed that [redacted] was refunded for the full $96.00 on June **, 2015.   Such refund was made back to the original form of payment.  Should [redacted] have any further questions regarding this refund, he should feel free to contact our office   As [redacted]’s premium refund has been processed we trust this matter is concluded.  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 find that this resolution is satisfactory to me and the matter has been resolved.
Sincerely,
[redacted]
  P.S. I do strongly recommend putting the author of the reply through a remedial computer course, seeing that there is a repeated mistake of an "s" where there should be an "r", as in "Ms" instead of the appropriate "Mr". Seeing that there is an inability to read, I hope this same negligence isn't present with other clients.

We have reviewed [redacted] complaint and we are responding accordingly.  In his complaint, [redacted] advised that he cancelled his travel plans because the appointment he had in Virginia for which he had booked this trip was cancelled.  As such, he no longer needed to travel to...

Virginia and submitted his claim seeking reimbursement of his trip cost.   Unfortunately, [redacted] 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, the cancellation of a scheduled appointment for which the plan participant booked the trip, is not one such specified reason.   As such, we are unable to consider his request for reimbursement on such basis.   Please note that, prior to purchase, the plan in its entirety, including the complete listing of the specified reasons for eligibility for coverage, is provided to each prospective insured.   As such, [redacted] was advised of the full terms and conditions of the plan prior to his purchase.   While we understand [redacted] disappointment at the outcome of his request for reimbursement, we hope this has provided further clarification of the claim determination made and understanding that each request must be considered in accordance with the terms and conditions of the plan purchased.

We have reviewed [redacted] complaint and we are responding accordingly.  In his complaint [redacted] advises that he submitted his claim for medical expenses to our office pursuant to the Medical Expense Benefit contained in the Total Protection Plan (“Plan”) that he purchased for his trip in...

December and January and to date has not received payment.    Please understand that such Medical Expense benefits are excess to any primary and supplemental medical coverage the insured may have at the time of such loss.   Further, as this is a reimbursement policy, we must confirm the amounts outstanding for the care received.     I am pleased to advise that we have received the information needed to finalize [redacted] claim and payment is presently being sent to [redacted] in the amount of $1,871.75 for the emergency medical care he received in December and for which he submitted receipts to our office for reimbursement.  An additional charge noted on [redacted] claim form in the amount of $526.00 requires a copy of the bill received.   Under separate cover we have requested a copy of this from [redacted] and will further review this item once it is submitted.     We trust that this information responds to the concerns raised in [redacted] complaint.  Should you have any further 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 find that this resolution is satisfactory to me and the matter has been resolved.
[redacted] 
[redacted]...

**
[redacted]HelloMy complaint was resolved by the AON insurance company and can be closed.Thank you so much for your help!Sent from my iPad

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 was only refunded $250 by [redacted] last week.  Why not the $400 ($200/passenger)?  
 
 
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]