Seven Corners, Inc.

Seven Corners, Inc. is in receipt of Complaint ID Number: [redacted] and sent to the attention of Dennis [redacted] on September 16, 2014. The complaint was filed by [redacted] and we appreciate the opportunity to address Mr. [redacted] concerns.
In order to clarify the role of the parties involved,...

Nationwide Mutual Insurance Company (“NMIC”) is the insuring company of the travel insurance policy you purchased. One Travel is a travel provider of flight and other vacation accommodations, and Seven Corners is the third party administrator contracted by NMIC to provide customer service assistance and claim adjudication services for individuals who purchase the Nationwide Travel Insurance product.
On July 15, 2014, airfare was purchased for [redacted] and [redacted] August 13-20, 2014 trip to Tulsa, Oklahoma. Prior to the scheduled departure date, Mrs. [redacted] sought medical care for an illness/sickness which led to the cancellation of their travel plans. Seven Corners, Inc. received a trip cancellation claim due to sickness/illness on behalf of [redacted] and [redacted] on August 21, 2014.
After receipt of Mr. and Mrs. [redacted] claim documents by Seven Corners, there was a technical issue with processing the customer’s policy/claim information.  The matter was resolved on September 17, 2014 and we apologize for the delay that impeded the timely handling of Mr. and Mrs. [redacted] claim.
Seven Corners proceeded to evaluate the presented claim documentation, which included a completed physician’s statement from the client’s treating physician, Dr. [redacted], MD. Based upon that review, we have determined that Mr. and Mrs. [redacted] trip cancellation loss is not eligible for benefits and the reasoning for our decision is explained below.
Per the completed physician’s statement and claim form, [redacted] onset of sickness began on August 3, 2014.   Also on August 3, 2014, a Nationwide Travel Insurance plan was purchased by the [redacted]s. Per the trip cancellation coverage benefit, trip cancellation coverage will take effect at 12:01 AM, on the day after the required premium is received by the Company; as a result, coverage became effective on August 4, 2014.   Per the physician’s statement, Mrs. [redacted] was treated for her illness by Dr. [redacted] on August 4, 2014. Based upon the above information, the customer had no active policy at the time symptoms first manifested or were exhibited and therefore, the presented loss has no coverage.  
Policy language which is pertinent to this matter:
GENERAL PROVISIONS
The following provisions apply to all coverages:
WHEN YOUR COVERAGE BEGINS
All coverage (except Trip Cancellation) will take effect at 12:01 A.M. local time, at Your location, on the Scheduled Departure Date provided:
(a) coverage has been elected; and (b) the required premium has been paid.
Trip Cancellation coverage will take effect at 12:01 A.M. local time at Your location, on the day after the required premium for such coverage is received by the Company or its authorized representative.
BENEFITS
TRIP CANCELLATION & TRIP INTERRUPTION
The Company will pay a benefit, up to the maximum shown on the Confirmation of Coverage, if You are prevented from taking or unable to continue Your Trip due to:
(a)  Sickness, Accidental Injury or death of You, Traveling Companion, or Family Member; which results in medically imposed restrictions as certified by a Physician at the time of Loss preventing Your continued participation in the Covered Trip. A Physician must advise cancellation of the Covered Trip on or before the Scheduled Departure Date.
Pre-Existing Condition: means any injury, sickness or condition of You, or Your Traveling Companion for which within the sixty (60) day period prior to the Effective Date of Trip Cancellation coverage under the Policy (a) first manifested itself or exhibited symptoms which would have caused one to seek diagnosis, care or treatment; (b) required taking prescribed drugs or medicine, unless the condition for which the prescribed drug or medicine is taken remains controlled without any change in the required prescription; or (c) required medical treatment or treatment was recommended by a Physician.
The Pre-Existing Conditions exclusion is waived for You if You enroll in the Plan at the time You pay the deposit required for the Covered Trip (or within fourteen (14) days of the initial deposit) and You purchase the coverage under the Plan for the full cost of the Covered Trip
LIMITATIONS AND EXCLUSIONS The following exclusions apply to Trip Cancellation & Trip Interruption, Trip Delay, Missed Connection, And Accidental Death & Dismemberment:
Loss caused by or resulting from: 1. Pre-Existing Conditions, as defined in the Definitions section unless the insurance is purchased within fourteen (14) days of the initial Covered Trip deposit;
We apologize that we cannot respond more favorably at this time. This office appreciates the opportunity to respond to [redacted] concerns and should you have any further questions or concerns, please do not hesitate in contacting this office.

September 18, 2015  [redacted]Revdex.com151 N. Delaware Street #2020Indianapolis, IN 46204-2599 RE: Complaint ID Number: [redacted]       Certificate Number: [redacted]  Dear Ms. [redacted]: Seven Corners, Inc. is in receipt of...

Complaint ID:[redacted] and sent to the attention of Dennis W[redacted] on September 14, 2015regarding [redacted]. [redacted]. We appreciate the opportunity to address herconcerns.Upon further review of the claim documents submitted on behalf of Ms. [redacted],Seven Corners has determined the trip cancellation claim is eligiblefor payment and issued settlement in the amount of $378.00.  The settlement check was mailed to Ms. [redacted]’s addressof record: [redacted] R. [redacted] Seven Corners apologizes for any miscommunication whichoccurred during the handling of her travel claim. We hope this answers [redacted]’s concerns regarding herrecent travel claim. Should you have any further questions involving this claimmatter, please contact me at the address listed below.Sincerely, Seven Corners, Inc. Enclosure

February 23, 2016 Revdex.com of Central Indiana 151 N Delaware Street #2020 Indianapolis, IN  46204-2599 RE: Complaint ID:    [redacted]       Complainant:    [redacted] To Whom It May Concern: Seven Corners, Inc. (“Seven...

Corners”) is in receipt of Complaint [redacted] which was filed by [redacted] on February 17, 2016.     We have reviewed the complaint and the claim file and have confirmed that the claim is not eligible for trip cancellation coverage benefits.  The reasoning for our decision is explained below. In order to clarify the roles of the parties involved, Nationwide Mutual Insurance Company (“NMIC”) is the insuring company of the travel insurance policy purchased by Mr. [redacted].  Seven Corners is the third party administrator contracted by NMIC to provide customer service administration and claims adjudication services for individuals who purchase travel insurance products underwritten by NMIC.  OneTravel is the Travel Provider from whom Mr. [redacted] purchased his flights. On June 16, 2015, Mr. [redacted] purchased airfare and travel insurance for travel dates August 5-7, 2015.  Our office received Mr. [redacted]’s claim on September 10, 2015, wherein he presented a trip cancellation claim due to medical reasons.  Upon evaluation of the submitted claim, it was determined that a physician’s statement was not completed by Mr. [redacted]’s attending physician. However, a doctor’s note was submitted stating that Mr. [redacted] reported to the physician that he fell ill while on vacation and was not able to depart on his scheduled flight.  The travel insurance policy purchased by Mr. [redacted] requires evidence of medical treatment and medically imposed restrictions by a physician preventing and/or advising against travel on or before the scheduled departure date.  In addition, the nature of the medical condition should be disclosed in order to determine if any policy exclusions would apply.  To date, no medical condition has been disclosed as mandated by the terms of the policy. On September 24, 2015, a request for additional information was sent to Mr. [redacted]. Specifically, we asked for a fully completed physician’s statement, cancellation confirmation, and confirmation of the amount requested by Mr. [redacted] for reimbursement.  A follow-up letter was sent to Mr. [redacted] again advising of this request, and the necessity to submit the pertinent information for further review and consideration of his claim. On January 29, 2016, Mr. [redacted] submitted duplicate copies of the initial claim submission documents; however, in addition, there was a note from Mr. [redacted] advising that his medical condition has been present for years and that since he self-treated, there was no need to see a physician.  For this reason, his claim was subsequently denied because the documentation submitted by Mr. [redacted] did not meet the policy’s definition of sickness.  Under the travel insurance policy purchased by Mr. [redacted], “sickness” is (1) an illness that requires a physical examination and medical treatment by a physician and (2) commences while the coverage is in effect.  Due to the failure of Mr. [redacted] to present evidence to meet the definition of “sickness” under the travel insurance policy, a denial letter was mailed to Mr. [redacted] on February 10, 2016. We appreciate the opportunity to address Mr. [redacted]’s concerns.  Please contact this office should you have any further questions regarding this matter. Sincerely, Seven Corners, Inc.

May 25, 2016  [redacted]Revdex.com151 N Delaware Street #2020Indianapolis IN  46204-2599 RE:    Complaint ID – [redacted]          Complainant:  [redacted]...

[redacted]         Our Certificate Number [redacted] Dear Ms. [redacted], Seven Corners, Inc. is in receipt of Complaint ID Number:  [redacted] and sent to the attention of [redacted] on May 4, 2016.  The complainant, [redacted], has expressed concerns with the handling of his recent travel medical insurance claim.   This office has reviewed the file and the claims in question.  At issue was a review of his complex travel history as it applied to the eligibility provisions of the policy as well as review of his medical history as it pertained to the Pre-Existing Conditions exclusion of the policy.  It has been determined after thorough review by management that coverage for claims in the U.S. remained in effect for the dates of his treatment.  However, a medical review of the medical records received indicate that the condition in question is pre-existing based on the following definition in the policy:  The term “Pre-Existing Condition” as used in this Policy shall mean any medical condition, sickness, Injury, Illness, disease, Mental Illness or Mental Nervous Disorder, regardless of the cause including any congenital, chronic, subsequent, or recurring complications or consequences related thereto or resulting therefrom that with reasonable medical certainty existed at the time of application or any time during the 36* months prior to the effective date of coverage under this policy, whether or not previously manifested, symptomatic, known, diagnosed , treated or disclosed. This specifically includes but is not limited to any medical condition, sickness, Injury, Illness, disease , Mental Illness or Mental Nervous Disorder, for which medical advice, diagnosis, care or treatment was recommended or received or for which a reasonably prudent person would have sought treatment during the 36 month period immediately preceding the effective date of coverage under this policy. *For Insured Persons traveling outside the United States and Canada, the period is 12 months instead of 36 months.   Mr. [redacted]’s effective date under the purchased Liaison Majestic policy was March 16, 2015.  According to the medical records reviewed for his medical visit on December 11, 2015, it was stated that the insured had experienced the problem for 1 year prior to that visit.  Based on this information and the definition in the policy, the condition is pre-existing and therefore is not covered under the policy.  A letter detailing this denial is being mailed to Mr. [redacted] today.  Thank you for your time and attention to this matter and should you have questions involving this claim matter, please contact this office.   Sincerely, Seven Corners, Inc.

Seven Corners,Inc. is in receipt of complaint ID # [redacted] and sent to the attention ofDennis W[redacted] on June 29, 2015. The complainant: [redacted] objects tothe claim handling of his trip cancellation claim.On March 8, 2015,[redacted] completed an online purchase for airfare and travel...

insurancefor a scheduled flight from Bordeaux, France to Miami, Florida. The traveldates were: April 16, 2015 – May 5, 2015.Due to the deathof Mr. [redacted] family member (sister-in-law), he cancelled his travel andpresented a trip cancellation claim. Seven Corners adjudicated the loss anddetermined that Mr. [redacted] claim was not eligible for payment, the reason isas follows:Per the purchasedtravel policy, there is no coverage provided under the trip cancellation benefitas Mr. [redacted] deceased relative lived/resided in France (Europe) andtherefore does not meet the policy definition of family member. The purchasedpolicy defines a family member as a person who resides in the United States, Canadaor Mexico. This office alsogave consideration to possibly provide coverage benefits for this loss underthe death of the host at destination provision, however our evaluation foundthat not applicable as Mr. [redacted] was not sharing pre-arranged accommodationsat the usual principal place of residence of his sister in law/family member.  Based upon thepresented claim documentation, this office mailed a claim denial letter to[redacted] on June 16, 2015. Upon our receiptof the concerns presented to the Revdex.com of Central Indiana, Seven Corners re-evaluatedthe presented documentation. [redacted] indicated within his complaintthat his trip cancellation claim was denied since he did not live in the UnitedStates. This is not thecase, the travel insurance policy he purchased does not provide coverage forhis presented loss: travel cancellation due to the death of a family member whoresides outside of the United States, Mexico, or Canada.Due to the aboveinformation, this office must uphold our original decision that the claim isnot eligible for payment.Policy languagewhich is pertinent to this matter:BENEFITS TRIP CANCELLATION & TRIPINTERRUPTION The Company will pay a benefit, up to themaximum shown on the Confirmation of Coverage, if You are prevented from takingor unable to continue Your Covered Trip due to: (a)Sickness, Accidental Injury or death of You, Traveling Companion, or FamilyMember; which results in medically imposed restrictions as certified by aPhysician at the time of Loss preventing Your continued participation in theCovered Trip. A Physician must advise cancellation of the Covered Trip on orbefore the Scheduled Departure Date.           (d) The death or hospitalization ofYour Host at Destination.TRIP CANCELLATION The Company willreimburse You for the following: Non-refundable cancellation charges imposed bythe Travel Suppliers.In no event shall the amount reimbursedexceed the amount You prepaid for the Covered Trip up to the maximum benefitshown on the Confirmation of Coverage.SPECIAL CONDITIONS: You must advise theTravel Supplier and the Company as soon as possible in the event of a claim.The Company will not pay benefits for any additional charges incurred thatwould not have been charged had You notified the Travel Supplier as soon asreasonably possible. You or Your: refers to all persons listed on theConfirmation of Coverage under the program purchased by the Insured.Family Member: means You or Your TravelingCompanion’s legal or common law spouse, ex-spouse, Domestic Partner, parent,legal guardian, step-parent, grandparent, parents-in-law, grandchild, naturalor adopted child, step-child, children-in-law, brother, sister, step-brother,step-sister, brother-in-law, sister-in-law, aunt, uncle, niece ornephew, or Business Partner who reside in the United States, Canada orMexico.Host at Destination: means a person withwhom You are sharing pre-arranged overnight accommodations at the host’susual principal place of residence.We apologize thatwe cannot respond more favorably at this time and hope this answers anyoutstanding questions in relation to [redacted] claim. If youshould have any further questions or need further clarification of the above,please do not hesitate to contact this office.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me. 
Regards,
[redacted] And [redacted]

July 13, 2016       [redacted] Revdex.com 151 N. Delaware Street #2020 Indianapolis, IN  46204-2599   RE: Complaint ID:  [redacted]   Dear Theresa Davis:  Seven Corners, Inc. is in receipt of the complainant’s rebuttal to our initial response regarding complaint [redacted] filed by [redacted].  The complainant, [redacted], advised new documentation was provided for further consideration of the claim submitted for Trip Cancellation for [redacted].  Our office received the appeal from the insured on June 27, 2016.  The appeal is currently under review.  The analyst is obtaining further information from the treating physician, to determine if benefits will apply under the policy.  Once that information is obtained from the physician, a letter will be sent to the insured with the final appeal decision.    We hope this answers your concerns regarding this matter.  Should you have any further concerns, please contact this office.   Sincerely,   Seven Corners, Inc.

Revdex.com:I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. No where on the website does it state that coverage takes place 24 hours after the premium is paid, and considering this was a last minute trip they should have never insured me, knowing that I wouldn't have coverage. And what family member treated my child?? They are wrong again.  The attending doctor just happened to have the same name? How common is that in the Hispanic world, EXTREMELY!!! They should have never insured me if coverage didn't start till 24 hours later, if they can't insure me, I want my $89.00 back. They are liers and scammers, absolutely no where does it say any of that on the website when you are buying ticketsRegards,[redacted]

March 30, 2016[redacted]Revdex.com151 N Delaware Street #2020Indianapolis IN  46204-2599RE:    Complaint ID – [redacted]          Complainant:  [redacted]Dear Ms. [redacted],Seven Corners, Inc. is in receipt of Complaint ID Number:  [redacted] and sent to the attention of Dennis [redacted] on March 24 2016.  The complainant, [redacted], has expressed additional concerns with the handling of his travel medical insurance claim.  The Inbound Guest policy that was purchased by Mr. [redacted] does have an overall maximum medical benefit of $45,000.00.  However, the policy does also contain a schedule of benefits that outlines specific sub-limits for benefits on various services.   The schedule of benefits specifies the following limits that are applicable to the claims filed by Mr.  [redacted]:Outpatient – Physician’s Non-Surgical/Urgent Care visits:  Up to $50/visit, 10 visits maxOutpatient – Diagnostic X-rays & Lab Services:   Up to $405 – Additional $250-One CAT scan, PET scan or MRI.  Mr. [redacted]’s claims included charges for two physician visits totaling $553.00 and diagnostic charges totaling $2,169.80.  Based on the above scheduled benefits, total payment of $505.00 was made. Thank you for your time and attention to this matter and should you have questions involving this claim matter, please contact this office.  Sincerely,Seven Corners, Inc.

March 2, 2016 Revdex.com of Central Indiana 151 N Delaware Street #2020 Indianapolis, IN  46204-2599 RE:     Complaint ID:     [redacted]            Complainant:     [redacted]...

[redacted] To Whom It May Concern: Seven Corners, Inc. (“Seven Corners”) is in receipt of Complaint [redacted] which was filed by [redacted] on February 21, 2016.  We have reviewed the complaint and the claim file and have confirmed that the claim is not eligible for trip cancellation coverage benefits.  The reasoning for our decision is explained below. In order to clarify the roles of the parties involved, Nationwide Mutual Insurance Company (“NMIC”) is the underwriter of the travel insurance policy purchased by [redacted].  Seven Corners is the third party administrator contracted by NMIC to provide customer service administration and claims adjudication services for individuals who purchase travel insurance products issued by NMIC.  One Travel is the Travel Provider from whom Ms. [redacted] purchased her flights. On November 17, 2015, Ms. [redacted] purchased a roundtrip ticket on Etihad Airways departing on January 3, 2016 from Jacksonville, FL, US (JAX) to Singapore Changi, SG (SIN) with connections at New York John F. Kennedy International Airport (JFK) and Abu Dhabi International Airport (AUH).  Ms. [redacted] was scheduled to return to Jacksonville on May 8, 2016.  On January 3, 2016, the flight from JAX to JFK was delayed and the aircraft arrived at JFK at 9:21 p.m., 51 minutes after its scheduled arrival of 8:30 p.m.  As a result, Ms. [redacted] missed her connecting flight continuing to SIN.  Etihad Airways did not have any other available flights until January 5, 2016, so Ms. [redacted] canceled her booking with Etihad Airways and purchased additional airfare with another airline to get to her final destination in time for the event she was attending.  Ms. [redacted] is claiming that trip cancellation coverage should cover the additional airline expense she incurred when booking a new flight for her travel from JFK to SIN. However, her claim was denied because the aircraft departed as scheduled.  Under the policy purchased by Ms. [redacted], Trip Cancellation benefits are available if the insured is prevented from taking the scheduled trip. Based on the documentation presented by Ms. [redacted], she left on her trip as planned.  Since Ms. [redacted] was able to depart on her trip as scheduled and only experienced a delay on the second leg of her trip, we looked to her Trip Delay benefits for coverage. Unfortunately, additional airfare expenses are not a covered expense under the Trip Delay benefit.  If Ms. [redacted] has any additional receipts relating to her Trip Delay, we encourage her to submit them for further review. Regarding the additional airfare Ms. [redacted] paid to return home, Ms. [redacted] cancelled her reservation with Etihad Airways and by doing so, would automatically void her return flight as well. Policy language which is pertinent to this matter includes the following: TRIP DELAY The Company will reimburse You for covered expenses on a one-time basis, up to the Maximum Benefit shown on the Confirmation of Coverage, if You are delayed, while coverage is in effect, en route to or from the Trip for twelve (12) or more hours due to a defined Hazard. Covered expenses: (a)             Any Additional Expenses incurred. Additional Expenses means any reasonable expenses for meals and lodging as well as local transportation and essential phone calls that were necessarily incurred as the result of a Hazard and that were not provided by the Common Carrier or other party free of charge. Please understand that our action at this time should not be construed as a waiver of any and all rights and defenses which NMIC may have under the policy in question, and any applicable statutory or common law, all of where are hereby expressly reserved. We appreciate the opportunity to address Ms. [redacted]’s concerns.  Please contact this office should you have any further questions regarding this matter. Sincerely, Seven Corners, Inc.

September 30, 2016   [redacted] Revdex.com 151 N Delaware Street #2020 Indianapolis IN  46204-2509 RE:  Complaint ID [redacted]         Customer:  [redacted]         Certificate # [redacted]...

        Policy Name:  Inbound Choice         Claim #[redacted] Dear Ms. [redacted]: Seven Corners, Inc. is in receipt of Complaint ID Number [redacted] and sent to the attention of Sureleen S[redacted] on September 23, 2016.  The complainant, [redacted], has expressed concerns with the handling of a recent travel medical insurance claim under the certificate # referenced above. This office has reviewed the file and the claim in question. We find that the claim in question was not processed for payment as it should have been.  We have now processed the claim for payment in the amount of $45.00 to the provider of service.   This policy contains a schedule of benefits allowing up to specified limits for medical services.  The Schedule of Benefits included in the policy contains a limit of up to $45.00 per visit for the type of service rendered.  We do regret the delay in processing this claim for benefits under the policy.  The issue has been addressed with the appropriate personnel.  Thank you for your time and attention to this matter and should you have questions involving this claim matter, please contact this office. Sincerely, Seven Corners, Inc.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
[Provide details of why you are not satisfied with this resolution.]I missed two days travelling to get to my final destination for vacation. Also I was taking my mother back home who is a senior.
Regards,
[redacted]

March 10, 2017     Revdex.com of Central Indiana 151 N Delaware Street #2020 Indianapolis, IN  46204-2599   RE: Complaint ID #: [redacted]       Complainant:    [redacted]   To Whom It May Concern:   Seven Corners,...

Inc. (“Seven Corners”) is in receipt of the above reference complaint filed by [redacted] on March 4, 2017.  We have reviewed this matter and have confirmed that, based on the documentation provided by Ms. [redacted] to date, her claim is not eligible for trip cancellation coverage benefits under the terms of the policy.  The basis for our decision is explained below. In order to clarify the roles of the parties involved, Nationwide Mutual Insurance Company (“NMIC”) is the insuring company of the travel insurance policy purchased by Ms. [redacted].  Seven Corners is the third party administrator contracted by NMIC to provide customer service administration and claims adjudication services for individuals who purchase travel insurance products underwritten by NMIC.  OneTravel is the Travel Provider from whom Ms. [redacted] purchased her flights.   On September 17, 2016, Ms. [redacted] purchased airfare and travel insurance for travel dates December 3 – 10, 2016.    On December 1, 2016, she called OneTravel and cancelled her trip.  According to claim documents received by Seven Corners on December 5, 2016, Ms. [redacted] cancelled her trip due to sickness.  In order for a trip cancellation claim based on sickness to be a covered benefit under the terms of Ms. [redacted]’s policy: (1) medical treatment must be provided by a physician while coverage is in effect; and (2) medical restrictions imposed by a physician must prevent continued participation in the trip.  Unfortunately, Ms. [redacted] did not see her physician, [redacted], MD, until December 2, 2016, which is the day after she cancelled her trip. In addition, the medical records which Ms. [redacted] provided do not indicate any restrictions regarding her ability to travel. In order to re-evaluate Ms. [redacted]’s claim, the enclosed attending physician statement must be completed by her physician or she can have her physician submit a note on letterhead, advising against/prohibiting her continued participation in her trip.                   The policy language which is pertinent to this matter is as follows:   TRIP CANCELLATION The Company will reimburse You, up to the Maximum Benefit shown on the Confirmation of Coverage, if You are prevented from taking Your Trip for any of the following reasons that are Unforeseen and takes place after the Effective Date:   Your Sickness, Accidental Injury or death that results in medically imposed restrictions as certified by a Physician at the time of Loss preventing Your participation in the Trip. A Physician must advise to cancel the Trip on or before the Scheduled Departure Date;   Sickness means an illness or disease of the body that: 1) requires a physical examination and medical treatment by a Physician and 2) commences while Your coverage is in effect. An illness or disease of the body that begins prior to the Effective Date of coverage is not a Sickness as defined herein and is not covered by this Certificate unless it suddenly worsens or becomes acute after the Effective Date.   WHEN YOUR COVERAGE ENDS - Your coverage will end at 11:59 P.M. local time on the date that is the earliest of the following: (f) the date Your Trip is cancelled   We appreciate the opportunity to address Ms. [redacted]’s concerns.  Please contact our office and the number provided above should you have any further questions regarding this matter.   Sincerely,     Sherry O[redacted] Seven Corners, Inc.

August 15, 2016   [redacted] Revdex.com 151 N Delaware Street #2020 Indianapolis IN  46204-2509 RE:  Complaint ID [redacted]         Customer:  [redacted]         Certificate...

#[redacted]         Policy Name:  Inbound Immigrant         Claim #[redacted] Dear Ms. [redacted]: Seven Corners, Inc. is in receipt of Complaint ID Number [redacted] and sent to the attention of Chelsi T[redacted] on August 10, 2016.  The complainant, [redacted], has expressed concerns with the handling of her recent travel medical insurance claim under the certificate # referenced above. This office has reviewed the file and the claim in question.  This policy contains a schedule of benefits allowing up to specified limits for medical services.  The Schedule of Benefits included in the policy contains a limit of up to $200.00 for “Hospital Emergency Room (all expenses incurred therein)”.  All services billed for by the hospital for services during an emergency room visit are payable under this benefit and are subject to the $200.00 limit.  Since the maximum benefit payable under the policy has been paid, no additional benefit can be paid under the policy to the hospital for this visit.  We do regret if there was any misunderstanding by Ms. [redacted] concerning the coverage allowances under the policy.  However, we are unable to allow benefits exceeding the maximum amount payable stated in the policy.  Thank you for your time and attention to this matter and should you have questions involving this claim matter, please contact this office. Sincerely, Seven Corners, Inc.

May 26, 2016   [redacted] Revdex.com 151 N Delaware Street #2020 Indianapolis IN  46204-2509 RE:  Complaint ID [redacted]         Customer:  Russell S. Rambert         Certificate #9LCL15-107039 Dear Ms. [redacted]: Seven Corners, Inc. is in receipt of the rebuttal regarding Complaint ID Number [redacted], sent to the attention of Dennis W[redacted] on May 23, 2016.  The complainant, [redacted], has expressed disagreement with the handling of recent travel medical insurance claims for insured [redacted] under the certificate # referenced above. The original decision was made on the file based on a medical review of the records received and the definition in the policy.  Due the continued dissatisfaction of the complainant with the decision, we did submit the file for an additional Independent Medical Review.  This review has been returned with the determination that the insured’s illness was NOT the result of a pre-existing condition. Therefore, based on this new review, we are pleased to advise that we have overturned our denial of these claims and they will be processed according to the benefits allowed under the policy.  Thank you for your time and attention to this matter and should you have questions involving this claim matter, please contact this office. Sincerely, Seven Corners, Inc.

December 16, 2015[redacted]Revdex.com of Central Indiana 151 N. Delaware StreetSuite # 2020Indianapolis, IN  46204-2599RE:  Complaint Number:  [redacted]Complainant: [redacted] and [redacted]  Our Insured's Name:  [redacted]Certificate Number:  ...

[redacted]Policy: United Methodist Volunteers in MissionUnderwriter: Certain Underwriters at Lloyd's, LondonDear Ms. [redacted]: We are in receipt of your correspondence regarding the above referenced complaint.  The complaint was received by Seven Corners on December 14, 2015.  Seven Corners, Inc. is an administrator for Certain Underwriters at Lloyd's, London (Underwriters). This response is on behalf of Seven Corner's, Inc. and Certain Underwriters at Lloyd's, London (Underwriters) subscribing to the above referenced policy.Our records show that the effective dates of the above captioned policy were from March 1, 2015 to March 7, 2015.  Only medical care charges resulting from this accident and incurred within this policy period would be considered.  Our company is willing to waive the required Timely Filing within 90 days, as the insured reported their occurrence to their primary carrier. To date our company has paid $9,670.70 in medical expenses as the secondary provider.  The complaint did not specify the outstanding incurred charges that the complainants were indicating were unpaid.  In order for our company to consider reimbursement of any outstanding charges, we need the complainants to provide the following documented information. 1.  Copies of the medical records and itemized medical bills for the claimed charges.Upon receipt of the above specified information, our company will review the presented claim(s) for afforded Coverage Benefits per the Policy's Conditions and Provisions for additional payable charges. Should you have any further questions involving this claim matter, please contact our company. Sincerely, Seven Corners

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me as soon I receive the payment. I had been told by the company on several occasions about them sending me letters by mail, but actually never got one. I hope it will be different this time.
Regards,
[redacted]

April 20, 2016 [redacted] Revdex.com 151 N Delaware Street #2020 Indianapolis IN  46204-2599 RE:    Complaint ID – [redacted]                Complainant:  [redacted]       Dear Ms. [redacted], Seven Corners, Inc. is in receipt of the additional correspondence concerning Complaint ID Number:  [redacted] and sent to the attention of Dennis [redacted] on April 18, 2016.  The complainant, [redacted], has requested additional clarification concerning our original response.  Please be advised that the policy in question remains in effect until September 26, 2016, the original termination date requested at the time of purchase.  Thank you for your time and attention to this matter and should you have questions involving this claim matter, please contact this office.  Sincerely, Seven Corners, Inc.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
To Whom It May Concern,I am not in agreement with this settlement offer.  The denial of this claim is based on my missed flight due to a delay on the way to my destination. I purchased another ticket for $946.40 to get to my school in a timely manner, which I do not expect to be reimbursed for. I was not able to stay at the JFK airport for two days, which was required if I was to utilize my Etihad Airline ticket. I have already agreed to give up one half of my ticket cost of $948.00 (one half of the original ticket price of $1896.86 ) based on the insurance company’s delay criteria. My settlement claim for $948.00 fits into the category of cancellation ( not delay ). The Etihad airline CANCELLED my return flight that I already paid for on 11/20/15. This was beyond my control and I was forced to purchase a new return ticket for $948.00.  It is only fair and just that the travel insurance that I purchased in good faith cover this CANCELLED flight by the airline.  The reason I bought the flight cancellation insurance, was to protect me in this type of situation.
Regards,
[redacted]

October 2, 2015 [redacted]Revdex.com151 N. Delaware Street #2020Indianapolis, IN 46204-2599 RE: Complaint ID – [redacted]Insured: [redacted] Dear Ms. [redacted]: Seven Corners, Inc. acknowledges receiving furthercorrespondence on compliant ID [redacted], regarding [redacted].  This office has issued a claim benefit payment in theamount of $225.91 USD to Ms. [redacted] on two prior occasions; however the insuredparty has not received either payment at her address of record in Taiwan.  Seven Corners had proposed that we send a wire transferpayment to Ms. [redacted], however she declined that course of action and stated shewould prefer a check as a form of settlement. On September 30, 2015, Seven Corners reissued claim settlementto Ms. [redacted] as requested and shipped the claim payment via United StatesCertified Mail to her address of record: [redacted] Taiwan Please note the USPS Tracking Number: [redacted] for tracking purposes. We hope this will resolve [redacted]’s concernsregarding her recent claim. If you should have any further questions or needfurther clarification of the above, please do not hesitate to contact us. Sincerely, Seven Corners, Inc.  Tell us why here...