Seven Corners, Inc.

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.My address is: [redacted] (Seven Corners typed the address wrongly. Also, the country's name is [redacted]).  Thanks. 
Regards,
[redacted]

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.Dear Sir or Madam, My name is [redacted]. I submitted a complain (ID [redacted]) against Seven Corners, Inc. (insurance company) to Revdex.com (of Central Indiana) on July 20, 2015. Through your assistance, Seven Corners, Inc. replied that they would re-mail me the check (225.91USD) again so my complaint was closed on July 24th. However, I have not yet received any mail with the check from Seven Corners so far after one month. Therefore, I file the complaint again. My address is: Miss [redacted] I think the country name on Revdex.com’s website is incorrect/confusing (Taiwan, province of China). Nowadays, people just write “TAIWAN” because it is much clear and Taiwan does not belong to (Mainland) China. I have received many mails from other countries successfully without any problem via only using “TAIWAN.” Sometimes mails, through the name the same as Revdex.com’s website, will be sent to Mainland China and disappear. Therefore, may I ask Seven Corners to mail the check to me again via only “TAIWAN” for the country name? Thank you very much for your precious assistance. Best regards, [redacted]Please re-mail me the check through the right COUNTRY NAME (TAIWAN).
Regards,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this response/resolution — specifically One Travel's agreement to issue payment to me in the amount of $1,000.00 ($500.00 per passenger) which is the cancellation fee charged by [redacted] Airlines — is satisfactory to me. I have attached that response for reference.
Regards,
[redacted]

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]

Seven Corners, Inc. is in receipt of Complaint ID Number:[redacted] and sent to the attention of Dennis W[redacted] on August 26, 2015. Thecomplaint was filed by [redacted] and we appreciate the opportunity toaddress his concerns.[redacted] purchased a Liaison International policy onApril 15, 2915,...

plan for coverage period: 4/21/2015 to 5/7/2015. On April 29,2015 and April 30, 2015, [redacted] states one of his bags was lost at thehotel he was visiting and the following day Emirates Airlines lost a piece ofhis luggage.Mr. [redacted] presented a claim(s) with Seven Cornersregarding his missing baggage. This office reviewed the presented claimsdocumentation and noted that the insured submitted a handwritten document datedMay 2, 2015 from: the Eithad Hajj Group/Fairmont Clock Tower Mecca. The hotelindicated that the insured was travelling without his baggage/luggage.The insured also submitted a claim document from EmiratesAirlines which was illegible and asked the customer to present clear documentsfor Seven Corners review. Mr. [redacted], presented additional documents,however the resolution was equally poor or worse than the original copy sentfor review. Seven Corners mailed and contacted the insured via email([redacted]) informing him of the poor resolution of the communicationfrom Emirates Airlines and if he could forward a legible copy for our review,as this office needs to confirm how his claim for his lost luggage/baggage hadbeen resolved. The customer attempted to send several copies, all equallyillegible.[redacted] later submitted to this office, an emailfrom Emirates Baggage Services dated May 10, 2015, affirming that the airlineis tracing his baggage. Mr. [redacted] noted the airline found his luggage May26, 2015. Per Mr. [redacted], he went to the Los Angeles International Airportto retrieve his property and paid $142.00 via check to Emirates BaggageServices and a $60.00 fee to customs ($202.00 total) on June 1, 2015. The customer stated in his concerns to the Revdex.com of CentralIndiana, he was seeking reimbursement in the amount of $202.00 dollars for hisout of pocket costs incurred to retrieve his baggage. Per the purchased plan,the cost to ship the customers baggage to their residence is not a coveredbenefit, however as a good-faith gesture, this office is willing to refund theinsured the $202.00.Should the customer agree with this proposed solution, SevenCorners has included a general release form for Mr. [redacted] to sign. Upon ourreceipt of that document, this office will proceed to issue payment direct to [redacted] in the amount of $202.00 and mail to his address of record.We hope this answers any outstanding questions in relationto [redacted]’s claim. If you should have any further questions or needfurther clarification of the above, please do not hesitate to contact us. Enclosure: General Release

January 28, 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 January 21, 2016.     Upon further review of Ms. [redacted]’s claim file, we have determined that the amount of $233.20 is payable based on the coverage purchased by Ms. [redacted] pursuant to Certificate Number 31919753.  This payment represents the maximum amount payable under the trip cancellation coverage provided by this certificate and payment in this amount was issued to Ms. [redacted] on January 28, 2016. 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 [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. Ms. [redacted]’s claim involves two separate travel insurance policies as she purchased two separate insurance policies for her trip:  Certificate Number 31919653 was purchased on December 15, 2015 and Certificate Number 31940395 was purchased on December 18, 2015.  The chart below provides the details surrounding each travel insurance policy. Date airfare tickets purchased via One Travel website Nationwide Travel Protection certificate number Nationwide Travel Protection certificate purchase date Policy Effective Date Travel Date December 10, 2015 31919753 December 15, 2015 December 16, 2015 December 29, 2015 December 10, 2015 31940395 December 18, 2015 December 19, 2015 December 24, 2015 Ms. [redacted] cancelled her family’s trip due to the illness of her daughter, [redacted].  Medical documentation submitted reflects that Ms. [redacted]’s daughter became ill on December 15, 2015 and received medical treatment on December 17, 2015.  Per the Nationwide Travel Protection insurance policy, when a trip is cancelled due to illness, the illness must be first diagnosed or treated by a physician after the effective date of insurance coverage and while coverage under the policy is still in[SO1] effect.  Under Certificate 31919753, [redacted] was treated after the effective date of coverage, resulting in payment of $233.20. However, [redacted] was treated prior to the effective date of coverage under Certificate 31940395, and as a result, the claim is not eligible for payment under this policy.  Policy language which is pertinent to this matter includes the following; 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: Sickness, Accidental Injury or death of a Family Member or Traveling Companion, booked to travel with You, that results in medically imposed restrictions as certified  by a Physician preventing that person’s participation in the Trip; 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 is suddenly worsens or becomes acute after the Effective Date. Effective Date means 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. 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.  [SO1]…and while coverage under the policy is still in effect

March 18, 2016Revdex.com of Central Indiana 151 N Delaware Street #2020 Indianapolis, IN  46204-2599RE: Inquiry ID:    [redacted]       Complainant:    [redacted]To Whom It May Concern:Seven Corners, Inc. (“Seven Corners”)...

is in receipt of Inquiry [redacted] which was filed by [redacted] on March 10, 2016.  Ms. [redacted] purchased the Nationwide Travel Protection Plan under Certificate Number [redacted], for her July 14, 2015 – August 2, 2015 trip.  We have reviewed the inquiry and the claim file and have confirmed that all eligible expenses have been reimbursed according to the trip delay benefit listed in the policy. Payment was issued to Ms. [redacted] on November 19, 2015 and we will explain below how this benefit was calculated. 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. Ms. [redacted] submitted a claim for her travel, which was received by Seven Corners on October 29, 2015.    On the claim form submitted, Ms. [redacted] did not clearly indicate the amount she was seeking for reimbursement and did not submit any receipts to support her claim. On November 5, 2015, a request was sent to Ms. [redacted] requesting the following information:Original receipts for expenses incurred due to the delay;Confirmation of the amount being sought for reimbursement, and;Other insurance information, if applicable. According to the documentation provided by Ms. [redacted], Ms. [redacted] incurred approximately $20.00 in out of pocket expenses. Under the Nationwide Travel Protection Plan, the trip delay benefit reimburses for meal, lodging, local transportation, and essential phone call expenses incurred due to the delay.  If these items are provided by the airlines free of charge, they are not subject to reimbursement under the Travel Protection Plan.  As a result, payment of $20.00 was issued to Ms. [redacted], since American Airlines did not cover this expense.  In her inquiry, Ms. [redacted] mentioned that she should be reimbursed more than $20.00 and on the claim form she submitted, she indicated reimbursement of $1,500.00 was appropriate because of several appointments she missed as a result of the trip delay.  While it was unfortunate that Ms. [redacted] was inconvenienced due to the trip delay, the Nationwide Travel Protection Plan does not provide compensation for loss of time.  As of this date, Ms. [redacted] mentioned that she has not received our $20.00 check and this could be attributed to her address outside of the United States. In order to get the funds to her as quickly as possible, we encourage Ms. [redacted] to complete the attached Payment Authorization Form so payment can be wired to her bank.  Ms. [redacted] should send the completed form to the following email for prompt handling: [email protected] language that is pertinent to this matter is as follows: TRIP DELAY 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.We appreciate the opportunity to address Ms. [redacted]’ concerns.  Please contact this office should you have any further questions regarding this matter.Sincerely,Seven Corners, Inc.

Seven Corners, Inc. is in receipt of the rebuttal response to Complaint ID Number: [redacted] and sent to the attention of [redacted] on September 8, 2014. The complainant: [redacted] submitted copy of cancellation notice she received from travel provider: [redacted] on August 7, 2014 regarding the cancelled airfare reservations for [redacted] and [redacted].
Per the complainant, Ms. [redacted] sent copy of cancellation notice to Seven Corners, Inc. on August 7, 2014. This was not the case; Seven Corners, Inc. received a copy of the cancellation document within the correspondence from the Revdex.com of Central Indiana on September 8, 2014. The document sender was: service@[redacted]customercare.com and the recipients were listed as: [redacted]@msn.com; and [redacted]@tinleg.com. 
Upon this office receiving the requested cancellation notice; claim payments have been processed for both insured parties. [redacted] will receive settlement in the amount of $1,142.00 for claim number: [redacted] will receive settlement in the amount of $1,142.00 for claim number [redacted]. We trust that this proposed action will resolve Complaint ID Number: [redacted].
We appreciate the opportunity to address the concerns of [redacted]. Please contact this office should you have any further questions regarding this matter.

June 24, 2016   [redacted] Revdex.com 151 N Delaware Street #2020 Indianapolis IN  46204-2509   RE:  Complaint ID [redacted]         Customer:  [redacted]l         Certificate #[redacted] Dear Ms. Davis: Seven Corners, Inc. is in receipt of the rebuttal to Complaint ID Number [redacted] and sent to the attention of Sureleen S[redacted] on June 21, 2016.  We have again reviewed the file, which included a medical review of the complete medical records received from [redacted].  As stated in our earlier response, the initial treatment was on July 23, 2015 and showed no acute injury or onset resulting in the visit.  Additional visits on August 13, September 22 and October 20, 2015 were all shown as being follow-up care, with no indication on any of the visits that there was any onset of new, acute symptoms involving the condition.  Based on the medical records and the provisions and definitions contained in the policy, we can find no basis for allowing these claims under the Acute Onset of Pre-Existing Conditions benefit.  Therefore, we must uphold our denial of these claims in accordance with the provisions of 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.

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.
[redacted]/Revdex.com team,   Thank you for getting a reply from Jennifer/ Seven CornersJennifer/Seven Corners,We can confirm that we got Jennifer's letter in reply to the Complaint that we had to file with the CA Commissioner. And thank you for finally replying to our Revdex.com reply from Feb 15 2017. Seems like a very very long time to wait for a reply from you guys. Unfortunately you still have not answered the questions.In our Revdex.com Message from Feb 15 2017, we asked you very specific questions. We were hoping that you would have answered them in this new message from you that we got on March 20 2017. You state below that your letter replying to our CA Commissioner Complaint addresses the questions. That is not true. Your letter did not address or answer the questions.We got your March 2 2017 letter replying to the CA Commissioner investigation.Thanks for apologizing for not replying to the many many questions that we asked Kathy H[redacted] over the past 9 months. I guess you are also apologizing for you and Chelsi T[redacted] not answering our questions to you directly to you, via the Revdex.com Complaint, and via the CA Insurance Commissioner. The irony is that even though you are apologizing for not answering the questions, it seems like you are still not answering the questions.Lets just focus on just one or two questions:First Question:The biggest question you still have not answered is, what is the "pre-existing condition"? Can you reply to this? What is this "pre-existing condition" that apparently [redacted] has? And also what medical certainty do you have that she had this "pre-existing condition" during the look-back period? This look-back period seems pretty important, as it basically means that if someone once upon a time had some "pre-existing condition" but was stable (meaning: had no new medical condition and no prescription medication changes) during the look-back period, then a denial based on a "pre-existing condition" can't be used. In this new reply letter from March 2 2017, you say "...[redacted]'s illnesses were pre-existing" Can you please tell us what these "illnesses" are? Since you are telling us that with "medical certainty" they are "pre-existing," you should be able to tell us what they are. Also please can you provide the evidence you are using to determine that the "illnesses" are "pre-existing". That would be quite helpful. For instance, what information, facts, or evidence are you using to determine that [redacted]'s ovarian cyst was "pre-existing." ? Second Question:Also can you confirm that you got the Clarification Letters that we sent you directly in December 2016. Did you read them? We also attached them to the Revdex.com reply on Feb 15 2017.If you read Tina B[redacted]'s original office visit report and her Clarification Letter you asked for, Tina B[redacted] clearly states that:"Her non-chronic more recent change in abdominal pain and menses required further evaluation to address her complaint." and "The more acute problem including diagnosis or irregular menstrual cycle (N92.6,) female pelvic pain (N94.9) required further evaluation and was not chronic in nature." If you read Rahul C[redacted]'s Clarification letter he clearly states:"...acute onset abdominal pain and heartburn. This was the first time she had experienced such pain and heartburn and so came to see me for consultation." he continues ... "While her bloating was a pre-existing condition, her abdominal pain and heartburn were new medical problems that led to her seek Gl consultation. In my professional opinion, her abdominal pain and heartburn were not pre-existing conditions and not related to her prior history of bloating..." Lets start with that, and hopefully a reply from you will come faster than the 35 days we have waited patiently for basically a non reply. Hopefully Chelsi or Jennifer and the Seven Corners people decide to stop denying the claims, and reimburse [redacted] for the bills she has already had to pay to stop them from going to collections, as well as pay the current claims.Regards,[redacted]
Regards,
[redacted]

June 10, 2016   [redacted] Revdex.com 151 N Delaware Street #2020 Indianapolis IN  46204-2509 RE:  Complaint ID [redacted]         Customer:  [redacted]         Certificate #[redacted]...

        Insured:  [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 June 8, 2016.  The complainant, [redacted] with [redacted], has expressed concerns with the handling of recent travel medical insurance claims for insured [redacted] under the certificate # referenced above. This office has reviewed the file and the claims in question.    The insured is covered under a Travel Medical policy which provides coverage for individuals traveling outside their home country.  Seven Corners received the complainant’s claim on March 2, 2016, for services that were provided to the insured on February 16, 2016.  In order to determine if benefits were payable under the policy, we required medical records from the hospital, as well as a Proof of Loss form fully completed by the insured and copy of the insured’s passport to verify eligibility under the policy.   This information was requested on March 11, 2016.  We did receive the copies of the requested medical records from the hospital, as well as a copy of the passport also provided by the hospital.  However, we have received no response from the insured to our request for completed Proof of Loss form. We have checked our records and can find no record of any call from the complainant on the dates indicated in the complaint.  Until the required Proof of Loss form is received from the insured, we will be unable to complete the processing of the claims.  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.