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Seven Corners, Inc.

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Reviews Seven Corners, Inc.

Seven Corners, Inc. Reviews (251)

December
17, 2015Ms
*** *** Revdex.com Revdex.com of Central Indiana NDelaware StreetSuite
# Indianapolis, IN? 46204-RE: Complaint Number:? ? ***? ? ? ? ? ? Complainant(s):? ? ?
? ? ? ? ? ***
*** ***? ? ? ? ? ? ? ? ? Certificate Number:? ? ***Dear
Ms***:Thank
you for your December 14, correspondence regarding the above-noted
matter.? The complainant, *** ***
***, is requesting a refund of her airfare; however, upon review of her
file, we have confirmed that her claim is not eligible as the reason for her
trip cancellation is not a covered reason under the policyIn
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***.? Seven Corners,
Inc(“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 from NMIC.? One Travel is the Travel Provider from whom
Ms*** purchased her flight fromOur
records show that on October 24, 2015, Ms*** purchased airfare for a
scheduled trip from Pittsburgh, Pennsylvania to Manila, Philippines? Per Ms***’s claim form, she was a
no-show for her October 27, departing flight as she did not know where the
gate was located due to a language barrierUnfortunately, this reason is not a
covered perils in the event of a trip cancellation.? ? Please
refer to the pertinent policy language listed below which lists the covered
perils in the event of a trip cancellationTRIP CANCELLATIONThe 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 TripA Physician must advise to cancel the Trip on or before the Scheduled
Departure 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, Accidental
Injury or death of a non-traveling Family Member;You or a Traveling
Companion being hijacked, Quarantined, required to serve on a jury, subpoenaed,
the victim of felonious assault within ten (10) days of departure; having Your
principal place of residence made Uninhabitable by fire, flood, volcano,
earthquake, hurricane or other natural disaster; or burglary of Your principal
place of residence within ten (10) days of departure;You or a Traveling
Companion being directly involved in a traffic accident substantiated by a
police report, while en route to departure;The death or
Hospitalization of Your Host at Destination;A Terrorist Incident
that occurs in a city listed on Your Trip itinerary and within thirty (30) days
prior to Your Scheduled Departure DateThis same city must not have
experienced a Terrorist Incident within the ninety (90) days prior to the
Terrorist Incident that is causing the cancellation of Your Trip.? Benefits are not provided if the Travel
Supplier offers a substitute itineraryThis does not include flight
connections or other transportation arrangements to reach Your destination
Your Scheduled Departure Date must be no more than twelve (12) months beyond
Your Effective Date.? A Terrorist
Incident that occurs onboard an in-flight aircraft is not coveredYou, a Traveling
Companion or Family Member, who are military personnel, and are called to
emergency duty for a natural disaster; this does not include war;? ? ? ? Strike that causes
complete cessation of services for at least twenty-four (24) consecutive hours;Weather that causes
complete cessation of services of the Common Carrier for at least twenty-four
(24) consecutive hours and prevents You from reaching Your destinationThis
benefit will not apply if the potential natural disaster has been forecasted or
a storm has been named prior to purchase of this coverage;Mandatory evacuation
(or public official evacuation advisements where there is no mandatory
evacuation) issued by local government authorities at Your Trip destination due
to hurricane or other natural disasterIn order to cancel Your Trip, You must
have four (4) days or 50% of Your total Trip length or less remaining on Your
Trip at the time the mandatory evacuation ends.Unfortunately,
since Ms***’s reason for missing her flight is not covered under the
Policy, benefits are not payable under the plan.? Should
you have any further questions involving this claim matter, please contact our
companySincerely, Seven
Corners

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 not aware of the coverages provided by the policy at the time the policy was purchased
In order to clarify the role of the parties involved, American Modern Home Insurance Company is the insuring company of the travel insurance policy purchased*** is the website that sells travel insuranceSeven Corners is the third party administrator contracted by American Modern Home Insurance Company to provide customer service assistance and claim adjudication services for individuals who purchase the John Hancock Travel Insurance product
On September 13, 2015, *** *** purchased a short term travel insurance policy covering his trip dates November 2, to November 25, Prior to a travel insurance purchase, Mr*** had the ability to review policy coverage and compare travel insurance plansThis information is accessible on the *** ***., websiteThe Travel Insurance Policy includes a day free look period upon purchasing coverageDuring the 10-Day free look period, if the customer determined that the coverage did not meet his needs, he could have cancelled the purchased plan
This office must uphold our original decision that his claim his ineligible for paymentPolicy language which is pertinent to this matter includes the following:
“TEN-DAY FREE LOOKYou may cancel insurance under the Policy by giving Us or Our Administrator written notice within days from the Effective DateIf You do this, We will refund Your premium paid provided You have not filed a claim under the Policy.”
We are sorry we cannot respond more favorably at this timeWe hope this answers yourconcerns regarding this matterShould 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.
[Provide details of why you are not satisfied with this resolution.]
Regards,
[redacted]  The death of the family member - Insurance falsely advertised to include a rebooking the the original flight tickets November 15th - December 14, 2015 a pain to return here to rebook the ticket for later on February 15th, 2015.The terms of the insurance policy states that whatever is the least of the dates is the coverage of the ticket.I feel the label "insurance included" is a hurting me. The ticket shows the link to your insurance on the Nov 15th flight.The terms of the insurance although showing "insurance included" says a change in the itinerary in a rebooking an extra 300 dollars which I did fails the insurance for the rebooked flight even so stating "insurance included"The deceased family member is before the return date of the rebooked "insuranced included", yet the terms of the insurance does not included insurance on the rebookings for a full refund as falsely promised by the sales agents after Dec 14th, 2015.If you would again fail me a free ticket with Scandinavian Airlines, It will not be covered by your insurance for a death in the family again owing to the booking changes falsely stating the booking is the covered for within the return date of the round trip ticket. Purchased February 7th. Rebooked February 15th ticked paid in full for November 15th to December 14th check the Dec 15, 2015 ticket it is there and promised in the confirmation.I complain that even though stating on the ticket for february 15th insurance included. The Rebooking voided and nulled any future insurance including for aspergers and the unexpected event of a death and a relative. For condolences for the confusion could you pay me a future credit to One Travel or a full-refund to any mail address I stated earlier. I'm desperately at home looking for the decision letter and could not find it in the incoming mail. Did you mail the decision letter? The included forms for the doctor's information were not included promptly and there is some new information on the mailing address. There seems to be important information on the quality of the mailings the final decision did not  come from Nationwide and was written in faulty legal terms and was emailed and ever mailed?The hidden terms ended the insurance although falsely advertised on the ticket to be included. I do hope that the rebooking is truely increasing the hopes of a refund so it promised to be always "insurance included" to those having it advertised in their ticket and the terms of the end date of the insurance coverage could extend past the February 15th repaying with credit card date, for both insurance, and and I payed for an insured ticket for Nov 15th - Dec14, 2015 and the question is does the insurance show insurance included and it is shown as included for the Dec 14th, 2015 date for ending period of the coverage, the available seats on the plane.* note the insurance included is as stated on the print of the ticket and examining the dates on the ticket shows it is indeed for the December 14, 2015 return round trip date. I think the question is, is what is written on the payment purchase is what is "included" for all the periods November 14th to December 15th flight. I would claim that the written "insurance included" on the ticket is more powerful than the insurance terms that would ever rarely null and void any insurance for a rebooking when so stated insurance inlcuded so in the billing on February 15th for theNov 15th - Dec14, 2015 flight plan on an international round trip insured itinary having been properly cancelled and given instructions by the ticket agents at One Travel to call Seven Corner's, Inc for a full-refund.After failing to board the plane owing to my illness my relative died before the end of the coverage period December 14th, 2015. My plane illness was important to describe the cancellation however the the death of the relative is the sole reason the flight plan cancellation is withing the validity period of the covered times periods ending on the last day of the return round trip plane flight. The insurance covers the total cost of the flight for the death of a relative after the date of the flight cancellation spanning to the return date. The insurance covers the total flight cost for round-trip international ticket. In this flight cancellation plan covered flight Nov 15th - Dec 14th spanning back to from the Dec 14th ending date of coverage to the 3 months pre-flight departure coverage to coverage just to the return date. The flight rebooking period was from February 7th, 2015 and covered 1 year should I wish not to apply for the ticket cancellation refund and instead rebook the flight. Cancellation are covered and backed for flight cancellation from the preflight terms of coverage to the last day of the ending flights Nov 15th flight and Dec 14th flight together making a generous time period to cancel the round trip dates for the return flight cancellation or 1 year from original purchase price for rebooking and refunding the price through the terms of the insurance should the flight traveler me, not wish to rebook. I did not wish to rebook after rebooking February 15th and asked for a refund through the seven corner's claims instructions after cancelling the ticket twice. Once cancelling for the flight on Nov 15thand a second time cancelling for the flight on Dec 15th to be extra sure each of the round trip flights on Scandinavian Airlines through One Travel had been canceled freeing up the plane seats privileding me to a refund and a check to my a client "record" address client contact addresss. I submitted two. I was instructed by One Travel to work through Scandinavian Airlines for a full refund. Scandinavian Airlines contacted me refusing the full refund or asking the sales person to contact Seven Corners to process the advertising refund on their ticket for their complementary refund conditions.The insurance covers the total cost of the flight for the death of a relative when not expecting it to occur and the validity period is the end the last date of the return round trip ticket, including the cancellation reasons for asperger autism and other mental disorders and I had not admitted oneself to the hospital, yet cancelled before the November 14th departure. Soon after the cancellation, a relative deceased. The two events are so different. I submitted the claim for the asperger autism and in ability to complete the trip and then resubmitted the claim for the deceased relative. The two events are rare and occured within approved coverage periods ending to the last day in the return round trip cancelled flight plan. See the confirmation itinerary to examine the coverable insurance flight coverage beginning and ending dates and the links on the purchase receipt click through to show the covered flight plan. I did not go to the hospital owing to the asperger disorder not be serious enough for supervising the condition, but rather cancelled the trip. Soon later, I found out of the relative deceased and the upcoming funteral. The death of the relative is covered by the covered flight protection plan policy and was before the cancelled return plane flight Dec 14, 2015 hence covered in the coverage beginning November 15, 2015 and ending December 14 2015, plus the seven months of pre flight departure allowable advanced cancellation. The coverage for the death of a relative is for all covered terms for all flight seats and the cost to the airlines free up by two cancellations one for the depature and one for the return. Both the return and the flight departing date are covered by Seven Corner's flight protection plan insurance policy on the flight itinerary, confirmation, and purchase receipt.

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.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 country. I attached both pages of their insurance document provided to me prior to the trip. On page two, close to the bottom, section e). it says - dental care:$750 for emergency dental treatment.  it does not say anything about where the service had to be done. I had the emergency on day four of my tour. I 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 6/14/16 and I was getting my tooth crowned on 6/15/16 because my dental office said it was an emergency. I totally feel left holding the bag by this insurance company.
Regards,
[redacted]

Revdex.com:I have reviewed the response made by the business in reference and today I received my check from seven corners after speaking to one of their managers.Thank you for your support on thisRegards,[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.
[Provide details of why you are not satisfied with this resolution.]I purchased the insurance in good faith. I did not make a donation to the company. People purchas insurance to cover themselves. The company did not provide any copy of their policy and coverage was assumed by me to be like any other insurance policy. Due 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 given. They did not make their policy known until I filed for a refund.
Regards,
[redacted]

October 17, 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 the rebuttal by [redacted] for Complaint ID Number [redacted] and sent to the attention of Sureleen S[redacted] on October 12, 2016.  The complainant, [redacted], has further disagreed with our responses to this complaint. We have reviewed our records and find that only 2 invoices were filed for physical therapy services, one for July 5, 2015 and one for July 15, 2016.  Physical therapy notes have also been filed for only these two visits.  In an effort to resolve this issue, we have reached out to the [redacted] to confirm if there were any invoices we were missing.  However, they have refused to provide us with any information, since they do not have authorization to discuss the insured’s account with us.     If there are additional invoices that we are missing for physical therapy services, the customer can file the fully itemized bills with our office and we will be more than happy to review them for additional benefits.  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.]
The point of my complaint is that the original date of insurance purchase was before the date of my daughter's treatment. We were told by the employee that we purchased the insurance through that our trip was covered. Come to find out we have to pay an addition 39.95 to cover the other half of our trip. Why would I want to cover 50% of my trip? 
[redacted]

February 12, 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 Complaint ID Number [redacted] and sent to the attention of Dennis W[redacted] on January 6, 2016.  The complainant, [redacted], has expressed concerns with the handling of his father’s recent travel medical insurance claim.   This office has reviewed the file and the claims in question and find that the denial of the claims under the policy exclusion for pre-existing conditions was correct based on the medical information we received.  We also find that we did receive several inquiries from Mr. [redacted] requesting more specific medical information on the determination that was made.  It appears that our responses to these inquiries did not provide the detailed information that was requested in order for Mr. [redacted] to understand our determination.   By separate letter directly to Mr. [redacted], we will respond with the medical details he has requested.    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.]
Regards,
[redacted] There was no mention of what happens to the Policy until the Expiry. Is it still in force since the cancellation is rejected?[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.
I request Dr [redacted]'s personal physician be contacted in France to give his personal report on the matter ([redacted][email protected]), as well as Dr [redacted] in Mount Forest, Ontario, Canada ([redacted]) whose report was recent and accurate, they alone can testify about her condition. I also want the detailed assessment (plus the hospital chart from Citrus Memorial Hospital, Inverness, Florida) cited by Seven Corners be sent to the above doctors, and one to myself to verify the veracity of their claim. I will not be happy before this is settled correctly and ethically. I will take further steps if necessary. I also find poor that no person responsible would sign the claim and assessment mentioned on behalf of Seven Corners. Looking forward to some prompt and solid resolution.
Regards,
[redacted]

December
17, 2015[redacted]
[redacted]Revdex.com
of Central Indiana151
N. Delaware StreetSuite
# 2020Indianapolis,
IN  46204-2599RE:  Complaint Number:  [redacted]Complainant:
[redacted]. [redacted]Our
Insured’s Name:  [redacted]Certificate
Number: [redacted]Policy:
Inbound USAUnderwriter:  Certain Underwriters at Lloyd's, LondonDear
Ms. [redacted]:We
are in receipt of your correspondence regarding the complainant’s rebuttal to
our response on the above referenced complaint. 
The rebuttal complaint was received by Seven Corners on December 16,
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
November 14, 2014 to April 12, 2015.Seven
Corner’s, Inc. and Certain Underwriters at Lloyd's, London (Underwriters) had
an independent medical review completed by Medical Review Institute of America,
Inc.; of the medical records regarding [redacted]’s condition.   The
findings of this independent medical review of the medical records revealed Ms.
[redacted] suffered from an acute manifestation of coronary artery disease and that
her coronary atherosclerosis was present for years preceding the event on
December 26, 2014.  Her admission on
December 26, 2014 was determined to be due to a pre-existing medical condition,
by the independent medical review. Based
upon the Policy’s Coverage Provisions specified in our December 9, 2015
response and the independent medical review of the medical records,
Underwriters have determined there is no coverage for the claim submitted because
the condition existed prior to the effective date of the policy. The
reasons for this denial of coverage are not limited to those stated in this
letter, and Underwriters reserve the right to supplement this letter with
further legal and factual reasons as to why there is no coverage.  Underwriters do not waive any rights under
the Policy or under applicable law.  This
response is based upon the information you provided to Underwriters and
information Underwriters have obtained during their investigation and review of
your claim.We
hope this answers any outstanding questions in relation to [redacted]’s
claim.If
you should have any further questions or need further clarification of the
above, please do not hesitate to contact us.Sincerely,Claims
DepartmentSeven
Corners, Inc.

Dear Ms. [redacted]: Seven Corners, Inc. is in receipt of Complaint ID Number [redacted] and sent to the attention of Dennis Wood on May 18, 2016.  The complainant, [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.  This policy contains the following exclusion: Pre-existing Conditions which are excluded under this policy. This means that any claims for Pre-existing Conditions will not be covered for the duration of this policy. a) If You are a United States resident under age 70, this exclusion is waived for the first $25,000 in eligible medical expenses incurred outside the United States and Canada (for persons age 70 and over, the amount is $5,000), minus Your Deductible and selected Coinsurance option (Plan E or F). This waiver does not include coverage for known, scheduled, required, or expected medical care, drugs, or treatments existent or necessary prior to the effective date of this program. b) If you are a non-U.S. resident under age 70, this exclusion is waived for eligible medical expenses for an Acute Onset of a Pre-existing Condition(s) (as defined herein) up to $45,000 (Ages 65-69 limited to $2,000) for eligible medical expenses incurred in the United States, minus Your Deductible and selected Coinsurance option (Plan A or B). For persons age 70 and over, there is no benefit. This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs, or treatments existent or necessary prior to arrival in the United States and prior to the effective date of this program. Pre-existing Condition(s) 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. A review of the medical records by medical staff determined that based on the medical records reviewed this member’s condition could be be stated with reasonable medical certainty to have existed or is related to a condition that existed at the time of application or prior to the effective date of the policy.  This member did not present within 24 hours of acute onset of symptoms and therefore the Acute Onset Benefit would not apply for this occurrence. 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.
I just sent a letter from the doctor's office about ongoing outpatient treatment for my son. That should meet the insurance requirement for partial hospitalization. I hope they accept it. 
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.It is my understanding that, should you client seek treatment at your hospital, we would be better of collecting money up front as a self-pay patient and let your client handle insurance.
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]

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.Please re-open complaint ID [redacted] as the company did not refund the amount based on the agreement.  I have called them and no one seems to know what I am talking about. I don't think they deserve a A+ rating. Thanks [redacted]

March 20, 2017   [redacted] Revdex.com 151 N Delaware Street #2020 Indianapolis IN  46204-2509 RE:  Complaint ID [redacted]         Customer:  [redacted]         Certificate [redacted]         Insured:  [redacted]         Policy Name:  [redacted]         Dear Ms. [redacted]: Seven Corners, Inc. is in receipt of the rebuttal to Complaint ID Number [redacted] and sent to the attention of Chelsi T[redacted] on March 17, 2017.  The complainant, [redacted], has expressed additional concerns with the handling of his wife’s travel medical insurance claims under the certificate # referenced above. As advised in our response of February 14, 2017 a complete review of the file was undertaken in response to the formal complaint filed with the California Department of Insurance.  A complete, detailed response was sent to the Department of Insurance.  A detailed response was also sent to Mr. [redacted] via email on March 3, 2017 and also mailed to him via U.S. Mail.  This detailed response does address the questions that Mr. [redacted] has expressed in his rebuttal.  A copy of this response is attached. 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.]
Regards,
[redacted] Reason for my going home to the Phil. was the death of my mother

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]

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Address: 303 Congressional Boulevard, Carmel, Indiana, United States, 46032-5631

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