Seven Corners, Inc.

May 2, Revdex.com NDelaware Street #Indianapolis, IN? 46204- RE: Complaint ID ??" *** Seven Corners, Incis in receipt of the rebuttal response regarding Revdex.com Complaint ID Number: *** from *** ***.? We have reviewed the complaint and appreciate the opportunity to address your concerns Upon our receipt of Mr***’s concerns, Seven Corners contacted his travel provider: One TravelThe travel provider affirmed that Mr***’s initial travel itinerary (02/15/to 03/09/2015) had been cancelled and rebooked for travel later in the year: November 15th - December 14, One Travel staff also confirmed that Mr*** contacted them to cancel his secondary itinerary in December and was told at that time that the airfare was not refundable and he was not charged a cancellation fee Mr***’s travel was cancelled due to the death of a family member and based on the above information, Seven Corners has proceeded to issue claim settlement to *** *** per the trip cost limit of $1, We hope this answers Mr*** ‘s concerns regarding his recent travel claimShould you have any further questions involving this claim matter, please this office Sincerely, Seven Corners, Inc

January 28, Revdex.com of Central Indiana NDelaware Street #Indianapolis, IN? 46204- RE: Complaint ID ??" *** ? ? ? ? ? Complainant: *** *** To whom it may concern: Seven Corners, Inc(“Seven Corners”) is in receipt of complaint
*** which was filed by *** *** on January 21, 2016.? ? ? ? Upon further review of Ms***’s claim file, we have determined that the amount of $is payable based on the coverage purchased by Ms*** 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*** on January 28, 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 *** ***.? 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*** purchased her flights Ms***’s claim involves two separate travel insurance policies as she purchased two separate insurance policies for her trip:? Certificate Number was purchased on December 15, and Certificate Number 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, December 15, December 16, December 29, December 10, December 18, December 19, December 24, Ms*** cancelled her family’s trip due to the illness of her daughter, *** ***.? Medical documentation submitted reflects that Ms***’s daughter became ill on December 15, 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, *** *** was treated after the effective date of coverage, resulting in payment of $However, *** *** 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:A.Mlocal 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***’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

Revdex.com:
I have reviewed the? response made by the business in reference to complaint ID ***, and have determined that the response? would not resolve my complaint.? For your reference, details of the offer I reviewed appear below.I realize they say that I am not covered for service after the trip but how do they think I was supposed to get service in a foreign countryI attached? both pages of their insurance document provided to me prior to the tripOn page two,? close to the bottom,? section e)it says -? dental care:$for emergency dental treatment.? it does not say anything about where the service had to be doneI had the emergency on day four of my tourI toughed through the next five days of the tour.? How was I to get my tooth fixed in a foreign country? Where was I to find a dentist? Was I to just pop into a dental office and expect to get in immediately? What about my tour? Was I just to fend for myself in Europe? How would I have caught up with my tour and gotten home? Why have the insurance if it is not usable to fix the problem (my broken tooth) as soon as I could get to a dentist? Trip ended on 6/14/and I was getting my tooth crowned on 6/15/because my dental office said it was an emergencyI totally feel? left holding the bag? by this insurance company
Regards,
*** ***

*** *** Revdex.com NDelaware Street #Indianapolis, IN? 46204- RE: Complaint ID:? *** Dear *** ***:? Seven Corners, Incis in receipt of the complainant’s rebuttal to our initial response regarding complaint *** filed by *** ***.? The complainant, *** ***, has expressed concerns that she has not received a letter regarding payment for *** ***’s claim.? Payment was processed to *** *** on March 14, 2016.? The attached payment letter was also mailed.? Once processed, our system takes up to business days for the check to be printed and mailed.? Her claim check #***, in the amount of $1,865.00, was printed and mailed on March 25, 2016.? ? ? 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 ***, and have determined that the response? would not resolve my complaint.? For your reference, details of the offer I reviewed appear below.Hello,
Thank you for your consistent responsesI now understand, based on the last letter sent, the differences in company names and the rolesHowever, this is not a case of "better late than never"I? was not made aware? at the time of purchase and was therefore severely mislead.?
I read nothing? on the website of square mouth, describing about a 10day free look period and as I stated before I was not able to review the policy prior to? purchaseI only saw the large print inclusionsThere was no asterisk or fine print.? There was absolutely no mention? of the many "exclusions".? ? I did? review, the website thoroughly prior to purchase and only saw repeatedly,? the square mouth "zero complaint guarantee" which turns out to really mean nothing at all
I therefore cannot accept this answer
Regards,*** ***

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

March 16, Revdex.com of Central Indiana N Delaware Street #Indianapolis, IN? 46204- RE: ? ? ? ? Complaint ID:? ? ? ? *** ? ? ? ? ? ? ? ? ? ? Complainant: ? ? ? ? *** *** To Whom It May Concern: Seven Corners, Inc(“Seven Corners”) is in receipt of the rebuttal to Complaint *** which was filed by *** *** on March 11, 2016.? We have reviewed Ms***’s additional comments and our position is unchanged from our response of March 2, 2016.? We have confirmed that the claim is not eligible for trip cancellation coverage benefits As explained in our March 10, letter, trip cancellation benefits are available if the insured is prevented from taking the scheduled tripBased on the documentation presented by Ms***, she left on her trip as planned.? Since Ms*** 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 coverageUnfortunately, additional airfare expenses are not a covered expense under the trip delay benefit.? If Ms*** has any additional receipts relating to her Trip Delay, we encourage her to submit them for further review Please understand that our action at this time should not be construed as a waiver of any and all rights and defenses which Nationwide Mutual Insurance Company 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***’s concerns.? Please contact this office should you have any further questions regarding this matter Sincerely, Seven Corners, Inc

Revdex.com:
I have reviewed the? response made by the business in reference to complaint ID ***, 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.]
Regards,*** ***I followed the guidelines according to their policy; I explained the reasoning why my primary care doctor did not feel comfortable providing some of the information on their form.? She provided a letter from the department of Veterans Affairs Hospital.? On Friday, I spoke with a representative from seven corners, requested a copy of their policy to review, and was told it would be emailed to me but I have received it.? I tried to explain my health condition that comes unexpectedly and the reason why I did not go to a doctor in Europe for treatment but instead took necessary self-care for medical condition.? I was told they would review any new documents I can provide but I have to make an appointment with my VA doctor.? Since leaving the military with a disability, I use my own health insurance for most of my medical care and not the VA hospital as much because of convenience and experience

Revdex.com:
I have reviewed the? response made by the business in reference to complaint ID ***, and have determined that the response? would not resolve my complaint.? For your reference, details of the offer I reviewed appear below.? I do not think Seven Corners considered that I was covered from August to December 31, (Certificate ID: ***) at the time the symptom happened and it was physically impossible for me to immediately go to a nearest provider as I was travelling at that timeThe August to December 31, coverage is the same group coverage I had from January to February 28, (Certificate ID: ***)Both of these coverages are attached.If my claims are still denied after consideration of my coverage from August to December 2016, I will have to file a complaint against Seven Corners in the? Indiana Department of Insurance and the? Hawaii Department of Commerce
Regards,
*** ***? ***

April 25, Revdex.com NDelaware Street #Indianapolis, IN? 46204- RE: Complaint ID ??" *** Dear Ms***: Seven Corners, Incis in receipt of Revdex.com Complaint ID Number: *** from *** ***.? We have reviewed the complaint and appreciate the
opportunity to address your concerns In order to clarify the role of the parties involved, One Travel is a travel provider of flight and other vacation accommodations, and Seven Corners, Inc(“Seven Corners”) is the third party administrator contracted to provide claim adjudication services for travel insurance policies issued by Nationwide Mutual Insurance Company Seven Corners evaluated the documentation submitted by Mr*** regarding a trip cancellation claimMr*** noted he cancelled his scheduled travel due to illness (autism and paranoid schizophrenia)Claim documentation presented to this office did not indicate that *** *** was hospitalized for his illnessThe purchased policy requires that for mental or emotional disorders, the client must be hospitalized to be eligible for coverage benefitsBased upon the above plan language, his claim is not eligible for reimbursement and a denial letter was mailed to his address of record on December 30, On February 16, 2016, this office received a claim appeal from the insured party disputing the initial decision and providing a different reason for cancellationMr*** indicated within his claim appeal, that his travel cancellation resulted from the death of his grandmother who passed away on December 1, The purchased policy provided plan coverage from February 15, to March 9, In order for trip cancellation coverage to be applicable the presented loss must take place after the effective date of his policyHis family member’s death occurred after his policy coverage expired and therefore is ineligible for reimbursementFurther documentation was mailed to the insured’s address of record confirming that his losses were not covered under the purchased travel insurance policy Should Mr*** provide documentation from his treating doctor that he was hospitalized for his illness during the policy effective dates, we will gladly give his claim further considerationBased upon the above information, *** ***‘s trip cancellation claim is ineligible for payment due to a policy exclusion The policy language pertinent to this matter is as follows: BENEFITS 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 non-traveling Family Member; LIMITATIONS AND EXCLUSIONS The following exclusions apply to Trip Cancellation & Trip Interruption, Trip Delay, Missed Connection, And Accidental Death & Dismemberment: Mental or emotional disorders, unless hospitalized; We hope this answers Mr*** ‘s concerns regarding his recent travel claimShould you have any further questions involving this claim matter, please contact me at the address listed below Sincerely, Seven Corners, Inc

November 29, *** *** Revdex.com NDelaware Street #Indianapolis, IN? 46204- RE:? Complaint ID:? *** ? ? ? ? ? ? Dear Ms***:? ? Seven Corners, Incis in receipt of the complainant’s rebuttal to our initial response regarding complaint *** filed by *** ***.? The complainant, *** ***, has expressed concerns that he was provided with incorrect information regarding his policy benefits In order to clarify the role of the parties involved, American Modern Home Insurance Company is the insuring company of the travel insurance purchased.? April Travel Protection is the agent that sells the travel insurance and provides customer assistance.? Seven Corners Incis the third party administrator contracted by American Modern Home Insurance Company to provide claim adjudication services.? The rebuttal response from Mr*** states he was provided with benefit information from Mabel H*** and Janet G***, and is requesting that phone records be obtained to verify any conversations.? These individuals are employed with April Travel Protection, not Seven Corners Inc., and there we are unable to verify any phone conversations with these individuals.? *** *** purchased a short term travel insurance policy on May 4, 2016, covering trip dates June 11, to June 18, 2016.? On July 19, 2016, Seven Corners received a claim from Mr***, for additional airfare incurred when two members in his party had to return home early due to the death of a family memberThe insured group had driven to their vacation destination.? Mr*** purchased two airline tickets in the amount of $for his wife and daughter to fly home following the death of the family member.? ? ? The policy purchased provides Trip Interruption benefits only for the unused, non-refundable travel arrangements prepaid to the travel supplier.? This benefit does not reimburse for additional airfare.? A denial letter was sent to Mr*** on July 22, 2016, explaining the reason the loss was not covered under the policy.? ? ? ? The policy language which is pertinent to this matter includes the following: “SECTION IVCOVERAGES TRIP INTERRUPTION We will pay a benefit, up to the maximum shown on the Schedule of Benefits, if You are prevented from continuing or resuming Your Covered Trip due to any of the Unforeseen events listed below? We will pay for the unused, non-refundable travel arrangements prepaid to the Travel Supplier(s).” ? We are sorry we cannot respond more favorably at this time.? 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 ***, 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 oneI hope it will be different this time
Regards,
*** ***

February 23, Revdex.com of Central Indiana N Delaware Street #Indianapolis, IN? 46204- RE: Complaint ID:? ? ? *** ? ? ? ? ? ? Complainant:? ? ? J David *** To Whom It May Concern: Seven Corners, Inc
(“Seven Corners”) is in receipt of Complaint *** which was filed by * *** *** on February 11, 2016.? ? ? ? We have reviewed the complaint and appreciate the opportunity to address Mr***’s concerns 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***.? 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.? One Travel is the Travel Provider from whom Mr*** purchased his flights Mr***’s travel insurance policy has a Pre-Existing Conditions clause that requires a sixty day look back period from the effective date of the travel insurance policy Date trip was booked? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? November 10, Date travel insurance was purchased? ? ? ? ? ? ? January 20, Effective date of travel insurance ? ? ? ? ? ? ? ? ? ? ? ? ? January 21, Date trip was cancelled? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? March 17, While attempting to process Mr***’s claim, it was necessary to request additional medical information from Mr***’s physicians in light of the Pre-Existing Conditions clause.? We requested information from the physicians that treated Mr*** during this sixty-day look back period, which would be his primary care physician and cardiologist.? To date, we have only received information from Mr***’s primary care physician In order to appropriately evaluate Mr***’s claim, it is necessary that our office receive the outstanding medical records from his cardiologist, Dr*** ***, for dates of service November 21, ??" January 20, 2015.? Our office contacted Dr***’s office on February 17, and spoke with a representative from Dr***’s office who confirmed receipt of our medical record requests.? However, we were informed by that representative that our requests were not accepted as our medical authorization for release was not HIPAA compliant.? Unfortunately, our office was not notified of this fact prior to this telephone conversation.? As a result, we have sent Mr*** a new medical authorization release form and will forward to Dr***’s office upon receipt Policy language which is pertinent to Mr***’s claim is as follows: 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: Pre-Existing Conditions, as defined in the Definitions section unless the insurance is purchased within fourteen (14) days of the initial Covered Trip deposit 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 PhysicianThe 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 Mr*** has also requested reimbursement of the insurance premium paid for the travel insurance policy.? ? The policy purchased has a 10-day review period and insurance premiums are non-refundable once fully earned Important Note: All protection plan costs and fees are non-refundable after a day review period We appreciate the opportunity to address Mr***’s concerns and upon receipt of the medical records from Dr***, we will be able to finalize claim processing Sincerely, Seven Corners, Inc

Revdex.com:
I have reviewed the? response made by the business in reference to complaint ID ***, 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 purchased the insurance in good faithI did not make a donation to the companyPeople purchas insurance to cover themselvesThe company did not provide any copy of their policy and coverage was assumed by me to be like any other insurance policyDue to the fact they did not disclose this information prior to the travel date , I feel justified in receiving my money based on the information I was givenThey did not make their policy known until I filed for a refund
Regards,
*** ***

Revdex.com:
I have reviewed the? response made by the business in reference to complaint ID ***, and have determined that the response? would not resolve my complaint.? For your reference, details of the offer I reviewed appear below
I will not accept this offer because it is not an offerI got an health insurance covered up to and all I got back is a bill $tothat nobody wants to payI am totally broke because I wanted to be saveIf I had known that I'm only covered up to and need to pay that company on top, why would I have needed an insurance? I paid them more in the coverage time then they paid for the billThat shouldn't be right! ? I would need to go times to the hospital room in one month to even get to - totally fraud in my eyesI paid a monthly payment for that $coverage and now they have to pay for itEven the Airforce lawyer couldn't belive thatAnd I didn't go to the hospital because I like it there, I went there because I did have a serious problem.? This is a fraud and shouldn't be allowedNobody else should get into thisIf necessary, I will open more cases across the country and also write recommendations across the country about that coverageThis won't help me but it will help others since it is an immigration insurance.?
Regards,
*** ***

Revdex.com:
I have reviewed the? response made by the business in reference to complaint ID ***, and have determined that the response? would not resolve my complaint.? For your reference, details of the offer I reviewed appear below
I am still waiting for their response to my appealThey did not contact me yet
Regards,
*** ***

Revdex.com:
I have reviewed the? response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to me.? After reading this message, I understand the Seven corner's has proceeded to issue the settlement in the value $1,Could Revdex.com ensure that is it mailed as soon as possible and provide receipt that is is mailed by certifiable mail delivery and tracking number information through the USPS.** *** ***
*** *** ***Regards,
*** ***

September 18, 2015? ? *** ***Revdex.comNDelaware Street #2020Indianapolis, IN? 46204-2599? RE: Complaint ID Number: ***? ? ? ? ? ? Certificate Number: ***? ? Dear Ms***:? Seven Corners, Incis in receipt of
Complaint ID:*** and sent to the attention of Dennis W*** on September 14, 2015regarding *** ***We appreciate the opportunity to address herconcerns.Upon further review of the claim documents submitted on behalf of Ms***,Seven Corners has determined the trip cancellation claim is eligiblefor payment and issued settlement in the amount of $? The settlement check was mailed to Ms***’s addressof record:? *** R*** *** *** *** ** ***? Seven Corners apologizes for any miscommunication whichoccurred during the handling of her travel claim.? We hope this answers *** ***’s concerns regarding herrecent travel claimShould you have any further questions involving this claimmatter, please contact me at the address listed below.Sincerely,? Seven Corners, Inc.? Enclosure

February 14, ? *** *** Revdex.com N Delaware Street #Indianapolis IN? 46204-RE:? Complaint ID *** ? ? ? ? ? ? ? Customer:? *** *** ? ? ? ? ? ? ? Certificate *** ? ? ? ? ? ? ? Insured:? *** *** ? ? ? ? ? ? ? Policy Name:? *** *** ? ? ? ? ? ? ? Dear Ms***: Seven Corners, Incis in receipt of Complaint ID Number *** and sent to the attention of Chelsi T*** on February 1, 2017.? The complainant, *** ***, has expressed concerns with the handling of his wife’s travel medical insurance claims under the certificate # referenced aboveThis office has reviewed the file and the claim in question.? The claims were denied under the exclusion in the policy for pre-existing conditions.? This decision was made after medical review of the medical records received in connection with *** ***’s illness.? We regret that Mr*** is not happy with our customer service or claim handling.? However, our records reflect extensive communications between our company and Mr*** in efforts to explain our denial and assist him with his concerns.? Please be advised that in response to this complaint, as well as a formal complaint that has been filed by Mr*** with the California Department of Insurance, we will be undertaking a complete review of this file.? Complete, detailed response to Mr***’s complaint with documentation will be sent to the California Department of Insurance by their deadline of March 1, 2016.? Thank you for your time and attention to this matter and should you have questions involving this claim matter, please contact this officeSincerely, Seven Corners, Inc.? ? ? ? ?

October 10, ? *** *** Revdex.com N Delaware Street #Indianapolis IN? 46204-RE:? Complaint ID *** ? ? ? ? ? ? ? Customer:? *** *** ? ? ? ? ? ? ? Certificate # *** ? ? ? ? ? ? ? Policy Name:? Inbound Choice ? ? ? ? ? ? ? Claim #*** Dear Ms***: Seven Corners, Incis in receipt of the rebuttal by *** *** for Complaint ID Number *** and sent to the attention of Chelsi T*** on October 4, 2016.? The complainant, *** ***, has disagreed with our response to this complaintThe Inbound Choice policy purchased by the insured is a limited benefit Travel Medical policy.? As explained previously, this policy contains a schedule of benefits allowing up to specified limits for medical services.? The service provided on August for which Mr*** paid $was for three physical therapy treatments during the same visit.? The Schedule of Benefits included in the policy contains a limit of up to $per visit for physical therapy.? This is the maximum amount that can be allowed for this medical service under the policy provisions.? We do find that our statement that the benefit would be paid to the provider of service to be a mistake.? The benefit payment was made to *** *** since he had already made payment to the provider.? We regret that Mr*** is not satisfied with the payment under the policy for the claim in question.? However, we are contractually required to process claims in accordance with the terms and limitations of the policy.? At this time we do not find any additional benefit due for this claim.? Thank you for your time and attention to this matter and should you have questions involving this claim matter, please contact this officeSincerely, Seven Corners, Inc.? ?