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Group Medical Services Reviews (1)

Dishonoured Travel Insurance Claim[redacted] I took out a travel insurance policy with Group Medical Insurance on the March 18, 2014. The policy holds valid for a period of my travel to Pakistan and covers the trip cancellation and interruption ([redacted]).My trip was interrupted on May 09, 2014 because of my brothers wedding. I put up the claim on June 12, 2014 and it was denied by GMS agent [redacted] stating Foreign Affair and International Trade Canada's warning "avoid non-essential travel" on the dates of travel and is still active.I sent a letter appealing for the claim to be reviewed but I got the same reply referring to the same as before referring to some incident happened in Islamabad. I have clarified in my appeal letter that the warning given by Foreign Affair and International Trade Canada to "avoid non-essential travel" was just the regional warning. If it was really dangerous why did Foreign Affair and International Trade Canada not include Islamabad in the list of Regions not to travel?.Also I have mentioned in my appeal letter that how essential my travel was. The warning given by Foreign Affair and International Trade Canada states avoid non-essential travels. What basis GMS authorities are putting to justify that my travel was not an essential travel. [redacted]I wrote to GMS Ombudsman for the review of the claim but Ombudsman office [redacted] took decision in favour of GMS.Also GMS Ombudsman in his reply letter stated that "Policy does not hold valid and GMS is returning the Premium of the Travel Insurance sold with the cheque of $28"I am writing Revdex.com to question GMS authorities about:Why was the policy sold if it was invalid? Is this what Insurance is about?Is GMS getting rid of me by returning the Premium amount?I am claiming for the Insurance claim of $1100 not $28 premium.[redacted] Desired SettlementI would like GMS authorities to ask for apology for returning my Premium amount and return my claimed amount not the Premium.Business Response Mr. [redacted] purchased a Trip Cancellation & Interruptions policy. As with all insurance policies, the policy he purchased contains "Eligibility" requirements that must be met for coverage to be valid. If those eligibility criteria are not met, the policy is void.Eligibility Item #6 of the TravelStar Trip Cancellation & Interruption policy reads:"To be eligible for the Single-Trip plan you must meet the following conditions on the application date:6. On the booking date of your trip, the destination must not be deemed a country to "avoid non-essential travel" or "avoid all travel" as identified in the Foreign Affairs and International Trade Canada's travel report;"Mr. [redacted]'s trip was to a destination within Pakistan. Pakistan was on the Foreign Affairs and International Trade Canada travel report as a "avoid non-essential travel" destination at all times material to the insurance contract. As such, no trip purchased by Mr. [redacted], or anyone else, is eligible for coverage under the policy he purchased. [redacted] The mere fact that the trip was not eligible renders the contract void. No other circumstances are considered.As the contract was void from the date of purchase, we have refunded the policy premium to him. We do this to respect case law which states that where coverage is unavailable under a policy for reasons related to eligibility, premium should be returned to the person purchasing the policy.We are unable to help Mr. [redacted] further and would refer him to www.OLHI.ca, the Ombudservice for Life and Health Insurance, should he be dissatisfied with this explanation. We are aware that this explanation is similar to the one provided to him on previous occasions. Our answer cannot change based on the eligibility terms of the policy.[redacted]

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Description: Insurance - Accident & Health

Address: 2055 Albert Street, P.O. Box 1949, Regina, Saskatchewan, Canada, S4P 0E3

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