For almost 12 months I have been in contact with this company for a $300-400 hospital bill. Part of my claim was rejected because their travel insurance doesn’t cover really any losses or costs (taxi, hotel, ticket modification etc) related to an illness during your trip (which would be the definition of a travel insurance), but they only cover medical expenses.
But my hospital bill is still not refunded, I don’t get real answers from their customer service, and I cannot even access my account anymore online to see progresses, documents, anything.
Please asap advise when you refund the hospital bill (i have sent all requested documents moths ago)
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 treatmentWe were told by the employee that we purchased the insurance through that our trip was coveredCome to find out we have to pay an addition to cover the other half of our tripWhy would I want to cover 50% of my trip?? [redacted]
December 17, [redacted] Revdex.com of Central Indiana NDelaware 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, Seven Corners, Incis an administrator for Certain Underwriters at Lloyd's, London (Underwriters)This response is on behalf of Seven Corner’s, Incand 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, to April 12, 2015.Seven Corner’s, Incand 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, Her admission on December 26, was determined to be due to a pre-existing medical condition, by the independent medical reviewBased upon the Policy’s Coverage Provisions specified in our December 9, 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 policyThe 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
Seven Corners, Incis in receipt of complaint ID # [redacted] and sent to the attention of Dennis W [redacted] on July 9, The complainant, [redacted] , objects tothe claim handling of her trip cancellation claim We have reviewed Ms [redacted] claim file andunfortunately, must uphold our original claim determination The reasoning behind our decision is explainedbelow.In order to clarify the role of the parties involved,Nationwide Mutual Insurance Company (“NMIC”) is the insuring company of thetravel insurance policy purchased OneTravel is a travel provider of flight and other vacation accommodations; andSeven Corners, Inc(“Seven Corners”) is the third party administratorcontracted by NMIC to provide customer service assistance and claimadjudication services for individuals who purchase travel insurance productsunderwritten by NMICOn August 7, 2014, the insured completed an online purchase onwww.onetravel.com for one wayairfare with a scheduled departure date of August 8, Per documentation from the insured, a representativefrom One Flight Travel contacted her and suggested that she purchase travelinsurance for her scheduled flight Theinsured purchased a travel insurance policy for $on August 8, According to policy provisions, tripcancellation coverage takes effect the day after the required premium isreceived; as a result, Ms [redacted] travel insurance became effective August 9,2014.Ms [redacted] stated within her complaint to the Revdex.comof Central Indiana that she purchased her travel insurance from “One FlightTravel.” Seven Corners contacted with One Travel and they confirmed the insuredparty purchased travel insurance from their online website, www.onetravel.com and the bankingstatement submitted by the customer confirms this as wellNeither, SevenCorners or One Travel has any affiliation with a company known as “One FlightTravel.”Our records show that on August 8, 2014, [redacted] and [redacted] ,the daughters of Ms [redacted] , were both treated by Dr [redacted] O [redacted] , afamily member, for food poisoning Theinsured cancelled her scheduled trip with www.onetravel.comon August 8, 2014, and she presented a trip cancellation claim to Seven Cornerson November 26, 2014.Seven Corners evaluated the presented loss and determined nocoverage was applicable Travelinsurance was purchased on August 8, 2014, and [redacted] and [redacted] illnesses were diagnosed and travel prohibited on August 8, 2014; however, thetrip cancellation coverage benefit did not become effective until 12:a.monAugust 9, There is no coverage forthis loss, as there was no active trip cancellation coverage at the time ofloss/sickness onset Policy languagewhich is pertinent to this matter includes the following:GENERAL PROVISIONSThe following provisions apply to all coverages:WHEN YOUR COVERAGE BEGINSAll coverage (except Trip Cancellation) will take effect at 12:A.Mlocaltime, at Your location, on the Scheduled Departure Date provided:(a) coverage has been elected; and (b) the required premium has beenpaid.Trip Cancellation coverage will take effect at 12:A.Mlocal time atYour location, on the day after the requiredpremium for such coverage is received by the Company or its authorizedrepresentative.BENEFITS TRIP CANCELLATION & TRIP INTERRUPTION The Company will pay a benefit, up to the maximum shown on theConfirmation of Coverage, if You are prevented from taking or unable tocontinue Your Covered Trip due to: (a) Sickness, Accidental Injury or death of You, Traveling Companion,or Family Member; which results in medically imposed restrictions as certifiedby a Physician at the time of Loss preventing Your continued participation inthe Covered TripA Physician must advise cancellation of the Covered Trip onor before the Scheduled Departure Date.TRIP CANCELLATION The Company will reimburse You for the following:Non-refundable cancellation charges imposed by the Travel Suppliers.In no event shall the amount reimbursed exceed the amount You prepaidfor the Covered Trip up to the maximum benefit shown on the Confirmation ofCoverage.SPECIAL CONDITIONS: You must advise the Travel Supplier and the Companyas soon as possible in the event of a claimThe Company will not pay benefitsfor any additional charges incurred that would not have been charged had Younotified the Travel Supplier as soon as reasonably possibleYou or Your:refers to all persons listed on the Confirmation of Coverage under the programpurchased by the Insured.GENERAL DEFINITIONSPhysician: means a licensed practitioner (including a Christian SciencePractitioner) of medical, surgical or dental services acting within the scopeof his/her licenseThe treating Physician may not be You, a TravelingCompanion or a Family Member.Sickness: means an illness or disease which is diagnosed or treatedby a Physician after the Effective Date of insurance and while You are coveredunder the PolicyWe apologize that we cannot respond more favorably at thistime and hope this answers any outstanding questions in relation to Ms[redacted] claim If you should have anyfurther questions or need further clarification of the above, please do nothesitate to contact this office
Revdex.com of Central Indiana N Delaware Street #Indianapolis, IN 46204- RE: Complaint ID #: [redacted] Complainant: [redacted] To Whom It May Concern: Seven Corners, Inc(“Seven Corners”) is in receipt of the above referenced complaint filed by [redacted] on March 22, Upon further review of Mr [redacted] ’s claim file and the circumstances surrounding this matter, trip cancellation coverage will be allowed for Mr [redacted] ’s claim Although the policy purchased by Mr [redacted] does not provide coverage for trip cancellation due to a travel ban, given the circumstances of the situation, we are issuing payment in the amount of $1,($per passenger) which is the cancellation fee charged by [redacted] AirlinesMr [redacted] will received payment under separate correspondence.We appreciate the opportunity to address Mr [redacted] ’s concerns Please contact our office at the number provided above should you have any further questions regarding this matterSincerely, Sherry O [redacted] Seven Corners, Inc
Seven Corners, Incis in receipt of Complaint ID Number: [redacted] sent to the attention of Dennis W [redacted] on 3/18/The complaint wasfiled by [redacted] , who objects to the denial of a family member’s tripcancellation claim.On February 9, 2015, [redacted] purchased airfare andtravel insurance for travel dates of February 23, to March 23, Mr[redacted] presented a trip cancellation claim to Seven Corners due to thesickness of his spouse on February 18, 2015.Upon further review of the customer’s submitted claimsdocumentation, our office has determined that trip cancellation coverage doesapply to Mr [redacted] ’s claim and our office has issued payment of $forreimbursement of the unused airline ticket Attached is a copy of the explanation ofbenefits reflecting this payment.We appreciate the opportunity to address Ms [redacted] concerns If you have further questionsregarding this matter, please feel free to contact our office
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 Hi [redacted] and Revdex.com team,It's nice to see that Seven Corners replied? Thank you Chelsi for replying.? You say that you "reviewed the file and claim" and denied all the claims due to this? "pre-existing condition." Can you please tell us what that is? what is the condition that? you are saying is "pre-existing." We have asked this over and overFor many months? we have been dealing with you guys trying to get an answer.? You say that you did a "medical review..." Can you tell us if you got the Clarification? Letters that we sent you on Dec 7, 2016? Both the Clarification Letters from the? original doctors clearly state that what was causing [redacted] to have the stabbing lower? left pain was not any pre-existing conditionDid you get the Clarification Letters? Did? you read them?? You mention "extensive communication" between me and your claims departmentYes? that is trueMostly us asking you the same questions again and again, and Kathy? H [redacted] ignoring, dodging, or replying with bad responses like, "the denial is firm..."? We ask you what the "pre-existing condition" isYou ignore usWe ask you if you? received the Clarification Letters from the doctorsThe Clarification Letters that your? claims person Kathy H [redacted] said would be nearly impossible to even getWell after? months of hard work, we got two so farWe sent them to your Claims people with a? new Appeal on Dec 7, And nothingNo reply to whether you got them or read? themWe waited weeks, and we sent you another email asking if you got the Appeal.? Also you continue to ignore our question about the "month look back period" which? applies to "pre-existing conditions." Can you respond about that question? [redacted] , can you as the Revdex.com, ask Chelsi these questions and get a reply? That would? be very appreciated.We have had to file a CA Commissioner of Insurance Complaint about Seven Corners.Hopefully Chelsi 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.? I have replied and attached the Clarification Letters from the original doctors in case you want to read them.thanks [redacted] ? ? Regards, [redacted] ***
RE: Complaint ID: [redacted] Complainant: [redacted] To Whom It May Concern: This is a follto our previous response regarding Complaint [redacted] which was filed by [redacted] on February 11, Upon further receipt and review of all the necessary documentation, we determined that payment of $1,was due under Certificate Number [redacted] and payment was issued on March 2, This payment was made as we were able to confirm that the medical condition that resulted in the cancelled trip is not pre-existingWe appreciate the opportunity to address Mr [redacted] ’s concernsPlease feel free to contact our office should you have any further questions regarding this matterSincerely, Seven Corners, Inc
December 16, [redacted] Revdex.com of Central Indiana NDelaware 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, Seven Corners, Incis an administrator for Certain Underwriters at Lloyd's, London (Underwriters)This response is on behalf of Seven Corner's, Incand 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, to March 7, 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 days, as the insured reported their occurrence to their primary carrierTo date our company has paid $9,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 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 chargesShould you have any further questions involving this claim matter, please contact our companySincerely, Seven Corners
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, 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 meThe 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 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 ticketPurchased February 7thRebooked February 15th ticked paid in full for November 15th to December 14th check the Dec 15, ticket it is there and promised in the confirmation.I complain that even though stating on the ticket for february 15th insurance includedThe Rebooking voided and nulled any future insurance including for aspergers and the unexpected event of a death and a relativeFor condolences for the confusion could you pay me a future credit to One Travel or a full-refund to any mail address I stated earlierI'm desperately at home looking for the decision letter and could not find it in the incoming mailDid 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 addressThere 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 includedI 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, and the question is does the insurance show insurance included and it is shown as included for the Dec 14th, date for ending period of the coverage, the available seats on the plane[redacted] 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, return round trip dateI 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 flightI 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, 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, 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 flightThe 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 ticketIn this flight cancellation plan covered flight Nov 15th - Dec 14th spanning back to from the Dec 14th ending date of coverage to the months pre-flight departure coverage to coverage just to the return dateThe flight rebooking period was from February 7th, and covered year should I wish not to apply for the ticket cancellation refund and instead rebook the flightCancellation 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 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 rebookI 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 twiceOnce 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 addresssI submitted twoI was instructed by One Travel to work through Scandinavian Airlines for a full refundScandinavian 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 departureSoon after the cancellation, a relative deceasedThe two events are so differentI submitted the claim for the asperger autism and in ability to complete the trip and then resubmitted the claim for the deceased relativeThe two events are rare and occured within approved coverage periods ending to the last day in the return round trip cancelled flight planSee 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 planI did not go to the hospital owing to the asperger disorder not be serious enough for supervising the condition, but rather cancelled the tripSoon later, I found out of the relative deceased and the upcoming funteralThe death of the relative is covered by the covered flight protection plan policy and was before the cancelled return plane flight Dec 14, hence covered in the coverage beginning November 15, and ending December 2015, plus the seven months of pre flight departure allowable advanced cancellationThe 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 returnBoth 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.? ? ?
June 8, [redacted] Revdex.com NDelaware Street #Indianapolis, IN 46204-RE: Complaint ID: [redacted] Dear Ms***: Seven Corners, Incis in receipt of Complaint ID Number [redacted] sent to the attention of Dennis W [redacted] on June 7, The complainant, [redacted] , has expressed concerns with a denial of a claim for his son, [redacted] [redacted] purchased a short term travel insurance policy for his son, [redacted] , covering his trip dates June 22, – July 8, The tour package and insurance policy were purchased through EF – Educational Tours On April 4, 2016, Seven Corners received a claim for Trip Cancellation for [redacted] The reason for cancellation of the trip was due to illness of the insured Based on the completed physician’s statement form provided, the diagnosis resulting in trip cancellation was ADHD and Social Anxiety The physician indicated travel was prohibited for the patient, due to the illness This policy specifically excludes benefits for any loss caused by or resulting from a mental or nervous condition, unless hospitalized or partially hospitalized for the illness Based on the information provided to us, the insured was not hospitalized or partially hospitalized A denial letter was sent to [redacted] on April 18, 2016, explaining the reason his loss was not covered under the policy The policy language which is pertinent to this matter includes the following: “SECTION IVGENERAL EXCLUSIONS Benefits are not payable for any loss due to, arising or resulting from: a mental or nervous condition, unless hospitalized or Partially Hospitalized for that condition while the Certificate is in effect for You; SECTION IIDEFINITIONS “Hospital” means (a) a place which is licensed or recognized as a general hospital by the proper authority of the state in which it is located: (b) a place operated for the care and treatment of resident inpatients with a registered graduate nurse (RN) always on duty and with a laboratory and X-ray facility: (c) a place recognized as a general hospital by the Joint Commission on the Accreditation of Hospitals; (d) other than a residence, a place where treatment in a Hyperbaric chamber can be receivedNot included is a hospital or institution licensed or used principally: (1) for the treatment or care of drug addicts or alcoholics: or (2) as a clinic continued or extended care facility, skilled nursing facility, convalescent home, rest home, nursing home or home for the aged“Partial Hospitalization” means an outpatient program specifically designed for the diagnosis or active treatment of a serious mental disorder when there is a reasonable expectation for improvement or when it is necessary to maintain a patient’s functional level and prevent relapse or full hospitalizationPartial hospital programs are usually furnished by a hospital as distinct and organized intensive ambulatory treatment service of less than 24-hour daily care.” 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 officeSincerely, Seven Corners, Inc
Revdex.com of Central Indiana N Delaware Street #Indianapolis, IN? 46204-? RE: Complaint ID #: [redacted] ? ? ? ? ? ? Complainant: ? ? ? [redacted] ? To Whom It May Concern: Seven Corners, Inc(“Seven Corners”) is in receipt of the above referenced complaint filed by [redacted] on March 22, 2017.? Upon further review of Mr [redacted] ’s claim file and the circumstances surrounding this matter, trip cancellation coverage will be allowed for Mr [redacted] ’s claim? Although the policy purchased by Mr [redacted] does not provide coverage for trip cancellation due to a travel ban, given the circumstances of the situation, we are issuing payment in the amount of $1,($per passenger) which is the cancellation fee charged by [redacted] AirlinesMr [redacted] will received payment under separate correspondence.We appreciate the opportunity to address Mr [redacted] ’s concerns.? Please contact our office at the number provided above should you have any further questions regarding this matterSincerely, Sherry O [redacted] 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 sonThat should meet the insurance? requirement for partial hospitalizationI hope they accept it.? 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]
December 7, 2015Ms [redacted] Revdex.com Revdex.com of Central Indiana NDelaware StreetSuite # Indianapolis, IN? 46204-RE: Complaint Number:? ? [redacted] ? ? ? ? ? ? Complainant(s):? ? ? ? ? ? ? [redacted] and [redacted] ? ? ? ? ? ? Certificate Number:? ? [redacted] Dear Ms [redacted] :Seven Corners, Incis in receipt of Complaint ID Number [redacted] , forwarded to the attention of Dennis W***, Seven Corners, Incvia email on November 24, 2015.? The complainants, ? [redacted] and [redacted] , are requesting a refund of their airfare that was purchased on April 9, Upon further review of their file, we are unable to make a final determination on their claim as we still need medical information from Mr [redacted] ’s physicianIn 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 the [redacted] s.? 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 the [redacted] s purchased their flight and other vacation accommodations fromOur records show that on April 9, 2015, the complainants purchased airfare for a scheduled trip to Washington D.Cand days later on May 22, 2015, purchased their travel insurance policy? ? The travel insurance policy purchased by the [redacted] s contains a pre-existing clause which states that if travel insurance was not purchased within days of the initial travel deposit, any claims are subject to the following:GENERAL DEFINITIONSSickness:? means an illness or disease which is diagnosed or treated by a Physician after the Effective Date of Insurance and while You are covered under the Policy.Pre-Existing Condition means an illness, disease, or other condition during the sixty (60) day period immediately prior to the Effective Date for which You, a Traveling Companion, a Family Member booked to travel with You: 1) exhibited symptoms that would have caused one to seek care or treatment; or 2) received or received a recommendation for a test, examination, or medical treatment; or 3) took or received a prescription for drugs or medicineItem (3) of this definition does not apply to a condition that is treated or controlled solely through the taking of prescription drugs or medicine and remains treated or controlled without any adjustment or change in the required prescription throughout the sixty (60) day period before the Effective Date.The Pre-Existing Conditions exclusion is waived if You (a) enroll in this Certificate at the time You pay the deposit required for Your Trip (or within fourteen (14) days of the initial Trip deposit); (b) purchase this Certificate for the full cost of Your Trip; and (c) are medically able to travel on the Effective Date.? LIMITATIONS AND EXCLUSIONSThe following exclusions apply to Trip Cancellation.Loss caused by or resulting from:1.? Pre-Existing Conditions, as defined in the Definitions section.Per their submitted trip cancellation claim form, the [redacted] s requested reimbursement in the amount of $for prepaid airfare expenses and $for the cost of the insurance coverage premium.? We have reviewed the submitted documentation but since travel insurance was not purchased within days of the initial travel deposit, this claim must be investigated for a pre-existing medical conditionOn August 28, 2015, correspondence was sent to the [redacted] s requesting the names and addresses of the physicians who may have treated Mr [redacted] during the time period of March 23, to May 22, 2015.? In addition, Seven Corners requested a copy of the [redacted] ’s trip cancellation notice with the date of cancellation, amount of any fees incurred, and the amount of any refund / credit received from their travel provider.? We have received information regarding the [redacted] ’s trip cancellation notice but as of today’s date, we have not received the names and addresses of the doctors who have treated Mr [redacted] As soon as this information is received, we will be able to continue our review of the [redacted] ’s claim.Should you have any further questions involving this claim matter, please contact our companySincerely, Seven Corners
September 30, [redacted] Revdex.com N Delaware Street #Indianapolis IN 46204-RE: Complaint ID [redacted] Customer: [redacted] Certificate # [redacted] Policy Name: Inbound Choice Claim # [redacted] Dear Ms***: Seven Corners, Incis in receipt of Complaint ID Number [redacted] and sent to the attention of Sureleen S [redacted] on September 23, The complainant, [redacted] , has expressed concerns with the handling of a recent travel medical insurance claim under the certificate # referenced aboveThis office has reviewed the file and the claim in questionWe 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 $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 $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 officeSincerely, 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 treatmentWe were told by the employee that we purchased the insurance through that our trip was coveredCome to find out we have to pay an addition to cover the other half of our tripWhy would I want to cover 50% of my trip? [redacted]
Seven Corners, Incis in receipt of Complaint ID Number: [redacted] sent to the attention of Dennis [redacted] on February 16, The complainant, [redacted] , has expressed concerns with the handling of his Trip interruption/Trip Delay claim [redacted] purchased a short term travel insurance policy covering his trip dates 11/02/to 11/25/Mr [redacted] received notification from Philippine Airlines that his scheduled flight for 11/19/2015, had been changed to 11121/This change was the result of government authority runway closures, due to the arrival and departure of APEC leadersThe change in itinerary resulted in a Trip Delay loss for Mr [redacted] On 12109/2015, Seven Corners received a claim for the additional expenses incurred as a result of the original cancelled flightThe policy purchased provides benefits for Trip Cancellation, Trip Interruption, and Trip Delay for specific named unforeseen events listed in the policyUnfortunately, the reason the flight was cancelled/delayed was not a covered peril under this policyA denial letter was sent to Mr [redacted] on 1211612015, outlining the reason his loss was not covered under the policyThe denial letter quoted Trip Cancellation or Trip Interruption Unforeseen Events On 01/11/2016, Seven Corners received an Appeal on this claimMr [redacted] requested benefits apply under the Trip Delay benefits of the policyThis policy has the same named perils for Trip Cancellation, Trip Interruption, and Trip DelayNo benefits apply for the loss due to the runway or airport being closed by government authorityA denial of appeal letter was sent to Mr[redacted] on 02/02/The appeal analyst returned a call to Mr [redacted] on 02/16/tofurther explain the policy benefitsFollowing that conversation, Mr [redacted] was not pleased but understood that the policy did not provide benefits for his loss The policy language which is pertinent to this matter includes the following: "TRIP INTERRUPTIONWe 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 TRIP DELAYWe Will pay You for additional expenses on a one-time basis, up to the maximum shown in the Schedule of Benefits, if You are delayed en route to or from the CoverFor Trip Cancellation or Trip Interruption, Unforeseen Events Include:Accidental Injury, Sickness or death of You, Your Traveling Companion, Your Family Member, or Your Business Partner; which results in medically imposed restrictions as certified by a Physician at the time of loss preventing Your participation or continued participation in the Covered TripA Physician must advise cancellation of the Covered Trip on or before the Scheduled Departure Date.The death or hospitalization of Your Host at Destination.Inclement weather, Natural Disasters, Terrorist Attacks, or mechanical breakdown of the common carrier which results in the complete cessation of travel services at the point of departure or destination for at least consecutive hours.Adverse weather or Natural Disasters resulting in the complete cessation of travel services.Natural Disaster or documented man-made disaster at the point of departure or Your destination which renders Your primary residence or the accommodations at Your destination uninhabitable.(t) Strike that causes complete cessation of services of Your Common Carrier for at least consecutive hours.Your transfer by the employer with whom You are employed on the Effective Date of insurance which requires Your principal residence to be relocated.You or Your Traveling Companion are terminated, or laid off from employment, from aplace of employment for which You have been employed for the past consecutive years(1) Your business operations are interrupted by fire, flood, burglary, vandalism, product recall, Bankruptcy, Natural Disaster, or financial Default.If within days of Your departure, a politically motivated Terrorist Attack occurs within a mile radius of the territorial City limits of the City to be visited as shown in Youritinerary and the United States government issues a travel advisory indicating that Americans should not travel to a City named on the itinerary.Bankruptcy and/or Default of Your Travel Supplier which occurs more than days following Your Effective DateYour Scheduled Departure Date must be no more than months beyond Your Effective DateBenefits will be paid due to Bankruptcy or Default of an airline only if no alternate Transportation is availableIf alternate Transportation is available, benefits will be limited to the change fee charged to allow You to transfer to another airline in order to get to Your intended destinationThis coverage only applies if the Policy was purchased within calendar days of the initial Trip payment.(I) A documented theft of passports or visasDocumented means that You have reported the theft to the local authorities.(m) You and/or Your Traveling Companion are hijacked, quarantined, required to serve on a jury, subpoenaed, required to appear as a witness in a legal action, provided You are or Your Traveling Companion are not a party to the legal action or appearing as a law enforcement officer.SEVEN CORNERSYou and/or Your Traveling Companion are the victim of felonious assault; have Your principal place of residence made uninhabitable by fire, flood or other Natural Disaster, or burglary of Your principal place of residence within days of departure.You or Your Traveling Companion being directly involved in or delayed due to a traffic Accident substantiated by a police report, while en route to departure.You or Your Traveling Companion who are military personnel, are called to emergency duty for a disaster other than war or are called to active military duty, have their leave revoked or are reassigned for reasons other than War.A cancellation of Your Covered Trip if Your arrival on the Covered Trip is delayed and causes You to lose 51% or more of the scheduled Covered Trip duration due to the reasons covered under the Trip Delay benefit." We are sorry we cannot respond more favorably at this timeWe hope this answers your concerns regarding this matterShould you have any further concerns, please contact this office Sincerely, Seven Corners, Inc
March 20, [redacted] Revdex.com N Delaware Street #Indianapolis IN 46204-RE: Complaint ID [redacted] Customer: [redacted] Certificate [redacted] Insured: [redacted] Policy Name: [redacted] Dear Ms***: Seven Corners, Incis in receipt of the rebuttal to Complaint ID Number [redacted] and sent to the attention of Chelsi T [redacted] on March 17, The complainant, [redacted] ***, has expressed additional concerns with the handling of his wife’s travel medical insurance claims under the certificate # referenced aboveAs advised in our response of February 14, 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, and also mailed to him via U.SMail This detailed response does address the questions that Mr [redacted] has expressed in his rebuttal A copy of this response is attachedThank 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 17, [redacted] Revdex.com N Delaware Street #Indianapolis IN 46204-RE: Complaint ID [redacted] Customer: [redacted] Certificate # [redacted] Policy Name: Inbound Choice Claim # [redacted] Dear Ms***: Seven Corners, Incis in receipt of the rebuttal by [redacted] for Complaint ID Number [redacted] and sent to the attention of Sureleen S [redacted] on October 12, The complainant, [redacted] , has further disagreed with our responses to this complaintWe have reviewed our records and find that only invoices were filed for physical therapy services, one for July 5, and one for July 15, 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 officeSincerely, Seven Corners, Inc
For almost 12 months I have been in contact with this company for a $300-400 hospital bill. Part of my claim was rejected because their travel insurance doesn’t cover really any losses or costs (taxi, hotel, ticket modification etc) related to an illness during your trip (which would be the definition of a travel insurance), but they only cover medical expenses.
But my hospital bill is still not refunded, I don’t get real answers from their customer service, and I cannot even access my account anymore online to see progresses, documents, anything.
Please asap advise when you refund the hospital bill (i have sent all requested documents moths ago)
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 treatmentWe were told by the employee that we purchased the insurance through that our trip was coveredCome to find out we have to pay an addition to cover the other half of our tripWhy would I want to cover 50% of my trip?? [redacted]
December 17, [redacted] Revdex.com of Central Indiana NDelaware 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, Seven Corners, Incis an administrator for Certain Underwriters at Lloyd's, London (Underwriters)This response is on behalf of Seven Corner’s, Incand 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, to April 12, 2015.Seven Corner’s, Incand 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, Her admission on December 26, was determined to be due to a pre-existing medical condition, by the independent medical reviewBased upon the Policy’s Coverage Provisions specified in our December 9, 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 policyThe 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
Seven Corners, Incis in receipt of complaint ID # [redacted] and sent to the attention of Dennis W [redacted] on July 9, The complainant, [redacted] , objects tothe claim handling of her trip cancellation claim We have reviewed Ms [redacted] claim file andunfortunately, must uphold our original claim determination The reasoning behind our decision is explainedbelow.In order to clarify the role of the parties involved,Nationwide Mutual Insurance Company (“NMIC”) is the insuring company of thetravel insurance policy purchased OneTravel is a travel provider of flight and other vacation accommodations; andSeven Corners, Inc(“Seven Corners”) is the third party administratorcontracted by NMIC to provide customer service assistance and claimadjudication services for individuals who purchase travel insurance productsunderwritten by NMICOn August 7, 2014, the insured completed an online purchase onwww.onetravel.com for one wayairfare with a scheduled departure date of August 8, Per documentation from the insured, a representativefrom One Flight Travel contacted her and suggested that she purchase travelinsurance for her scheduled flight Theinsured purchased a travel insurance policy for $on August 8, According to policy provisions, tripcancellation coverage takes effect the day after the required premium isreceived; as a result, Ms [redacted] travel insurance became effective August 9,2014.Ms [redacted] stated within her complaint to the Revdex.comof Central Indiana that she purchased her travel insurance from “One FlightTravel.” Seven Corners contacted with One Travel and they confirmed the insuredparty purchased travel insurance from their online website, www.onetravel.com and the bankingstatement submitted by the customer confirms this as wellNeither, SevenCorners or One Travel has any affiliation with a company known as “One FlightTravel.”Our records show that on August 8, 2014, [redacted] and [redacted] ,the daughters of Ms [redacted] , were both treated by Dr [redacted] O [redacted] , afamily member, for food poisoning Theinsured cancelled her scheduled trip with www.onetravel.comon August 8, 2014, and she presented a trip cancellation claim to Seven Cornerson November 26, 2014.Seven Corners evaluated the presented loss and determined nocoverage was applicable Travelinsurance was purchased on August 8, 2014, and [redacted] and [redacted] illnesses were diagnosed and travel prohibited on August 8, 2014; however, thetrip cancellation coverage benefit did not become effective until 12:a.monAugust 9, There is no coverage forthis loss, as there was no active trip cancellation coverage at the time ofloss/sickness onset Policy languagewhich is pertinent to this matter includes the following:GENERAL PROVISIONSThe following provisions apply to all coverages:WHEN YOUR COVERAGE BEGINSAll coverage (except Trip Cancellation) will take effect at 12:A.Mlocaltime, at Your location, on the Scheduled Departure Date provided:(a) coverage has been elected; and (b) the required premium has beenpaid.Trip Cancellation coverage will take effect at 12:A.Mlocal time atYour location, on the day after the requiredpremium for such coverage is received by the Company or its authorizedrepresentative.BENEFITS TRIP CANCELLATION & TRIP INTERRUPTION The Company will pay a benefit, up to the maximum shown on theConfirmation of Coverage, if You are prevented from taking or unable tocontinue Your Covered Trip due to: (a) Sickness, Accidental Injury or death of You, Traveling Companion,or Family Member; which results in medically imposed restrictions as certifiedby a Physician at the time of Loss preventing Your continued participation inthe Covered TripA Physician must advise cancellation of the Covered Trip onor before the Scheduled Departure Date.TRIP CANCELLATION The Company will reimburse You for the following:Non-refundable cancellation charges imposed by the Travel Suppliers.In no event shall the amount reimbursed exceed the amount You prepaidfor the Covered Trip up to the maximum benefit shown on the Confirmation ofCoverage.SPECIAL CONDITIONS: You must advise the Travel Supplier and the Companyas soon as possible in the event of a claimThe Company will not pay benefitsfor any additional charges incurred that would not have been charged had Younotified the Travel Supplier as soon as reasonably possibleYou or Your:refers to all persons listed on the Confirmation of Coverage under the programpurchased by the Insured.GENERAL DEFINITIONSPhysician: means a licensed practitioner (including a Christian SciencePractitioner) of medical, surgical or dental services acting within the scopeof his/her licenseThe treating Physician may not be You, a TravelingCompanion or a Family Member.Sickness: means an illness or disease which is diagnosed or treatedby a Physician after the Effective Date of insurance and while You are coveredunder the PolicyWe apologize that we cannot respond more favorably at thistime and hope this answers any outstanding questions in relation to Ms[redacted] claim If you should have anyfurther questions or need further clarification of the above, please do nothesitate to contact this office
Revdex.com of Central Indiana N Delaware Street #Indianapolis, IN 46204- RE: Complaint ID #: [redacted] Complainant: [redacted] To Whom It May Concern: Seven Corners, Inc(“Seven Corners”) is in receipt of the above referenced complaint filed by [redacted] on March 22, Upon further review of Mr [redacted] ’s claim file and the circumstances surrounding this matter, trip cancellation coverage will be allowed for Mr [redacted] ’s claim Although the policy purchased by Mr [redacted] does not provide coverage for trip cancellation due to a travel ban, given the circumstances of the situation, we are issuing payment in the amount of $1,($per passenger) which is the cancellation fee charged by [redacted] AirlinesMr [redacted] will received payment under separate correspondence.We appreciate the opportunity to address Mr [redacted] ’s concerns Please contact our office at the number provided above should you have any further questions regarding this matterSincerely, Sherry O [redacted] Seven Corners, Inc
Seven Corners, Incis in receipt of Complaint ID Number: [redacted] sent to the attention of Dennis W [redacted] on 3/18/The complaint wasfiled by [redacted] , who objects to the denial of a family member’s tripcancellation claim.On February 9, 2015, [redacted] purchased airfare andtravel insurance for travel dates of February 23, to March 23, Mr[redacted] presented a trip cancellation claim to Seven Corners due to thesickness of his spouse on February 18, 2015.Upon further review of the customer’s submitted claimsdocumentation, our office has determined that trip cancellation coverage doesapply to Mr [redacted] ’s claim and our office has issued payment of $forreimbursement of the unused airline ticket Attached is a copy of the explanation ofbenefits reflecting this payment.We appreciate the opportunity to address Ms [redacted] concerns If you have further questionsregarding this matter, please feel free to contact our office
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 Hi [redacted] and Revdex.com team,It's nice to see that Seven Corners replied? Thank you Chelsi for replying.? You say that you "reviewed the file and claim" and denied all the claims due to this? "pre-existing condition." Can you please tell us what that is? what is the condition that? you are saying is "pre-existing." We have asked this over and overFor many months? we have been dealing with you guys trying to get an answer.? You say that you did a "medical review..." Can you tell us if you got the Clarification? Letters that we sent you on Dec 7, 2016? Both the Clarification Letters from the? original doctors clearly state that what was causing [redacted] to have the stabbing lower? left pain was not any pre-existing conditionDid you get the Clarification Letters? Did? you read them?? You mention "extensive communication" between me and your claims departmentYes? that is trueMostly us asking you the same questions again and again, and Kathy? H [redacted] ignoring, dodging, or replying with bad responses like, "the denial is firm..."? We ask you what the "pre-existing condition" isYou ignore usWe ask you if you? received the Clarification Letters from the doctorsThe Clarification Letters that your? claims person Kathy H [redacted] said would be nearly impossible to even getWell after? months of hard work, we got two so farWe sent them to your Claims people with a? new Appeal on Dec 7, And nothingNo reply to whether you got them or read? themWe waited weeks, and we sent you another email asking if you got the Appeal.? Also you continue to ignore our question about the "month look back period" which? applies to "pre-existing conditions." Can you respond about that question? [redacted] , can you as the Revdex.com, ask Chelsi these questions and get a reply? That would? be very appreciated.We have had to file a CA Commissioner of Insurance Complaint about Seven Corners.Hopefully Chelsi 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.? I have replied and attached the Clarification Letters from the original doctors in case you want to read them.thanks [redacted] ? ? Regards, [redacted] ***
RE: Complaint ID: [redacted] Complainant: [redacted] To Whom It May Concern: This is a follto our previous response regarding Complaint [redacted] which was filed by [redacted] on February 11, Upon further receipt and review of all the necessary documentation, we determined that payment of $1,was due under Certificate Number [redacted] and payment was issued on March 2, This payment was made as we were able to confirm that the medical condition that resulted in the cancelled trip is not pre-existingWe appreciate the opportunity to address Mr [redacted] ’s concernsPlease feel free to contact our office should you have any further questions regarding this matterSincerely, Seven Corners, Inc
December 16, [redacted] Revdex.com of Central Indiana NDelaware 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, Seven Corners, Incis an administrator for Certain Underwriters at Lloyd's, London (Underwriters)This response is on behalf of Seven Corner's, Incand 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, to March 7, 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 days, as the insured reported their occurrence to their primary carrierTo date our company has paid $9,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 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 chargesShould you have any further questions involving this claim matter, please contact our companySincerely, Seven Corners
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, 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 meThe 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 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 ticketPurchased February 7thRebooked February 15th ticked paid in full for November 15th to December 14th check the Dec 15, ticket it is there and promised in the confirmation.I complain that even though stating on the ticket for february 15th insurance includedThe Rebooking voided and nulled any future insurance including for aspergers and the unexpected event of a death and a relativeFor condolences for the confusion could you pay me a future credit to One Travel or a full-refund to any mail address I stated earlierI'm desperately at home looking for the decision letter and could not find it in the incoming mailDid 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 addressThere 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 includedI 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, and the question is does the insurance show insurance included and it is shown as included for the Dec 14th, date for ending period of the coverage, the available seats on the plane[redacted] 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, return round trip dateI 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 flightI 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, 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, 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 flightThe 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 ticketIn this flight cancellation plan covered flight Nov 15th - Dec 14th spanning back to from the Dec 14th ending date of coverage to the months pre-flight departure coverage to coverage just to the return dateThe flight rebooking period was from February 7th, and covered year should I wish not to apply for the ticket cancellation refund and instead rebook the flightCancellation 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 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 rebookI 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 twiceOnce 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 addresssI submitted twoI was instructed by One Travel to work through Scandinavian Airlines for a full refundScandinavian 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 departureSoon after the cancellation, a relative deceasedThe two events are so differentI submitted the claim for the asperger autism and in ability to complete the trip and then resubmitted the claim for the deceased relativeThe two events are rare and occured within approved coverage periods ending to the last day in the return round trip cancelled flight planSee 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 planI did not go to the hospital owing to the asperger disorder not be serious enough for supervising the condition, but rather cancelled the tripSoon later, I found out of the relative deceased and the upcoming funteralThe death of the relative is covered by the covered flight protection plan policy and was before the cancelled return plane flight Dec 14, hence covered in the coverage beginning November 15, and ending December 2015, plus the seven months of pre flight departure allowable advanced cancellationThe 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 returnBoth 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.? ? ?
June 8, [redacted] Revdex.com NDelaware Street #Indianapolis, IN 46204-RE: Complaint ID: [redacted] Dear Ms***: Seven Corners, Incis in receipt of Complaint ID Number [redacted] sent to the attention of Dennis W [redacted] on June 7, The complainant, [redacted] , has expressed concerns with a denial of a claim for his son, [redacted] [redacted] purchased a short term travel insurance policy for his son, [redacted] , covering his trip dates June 22, – July 8, The tour package and insurance policy were purchased through EF – Educational Tours On April 4, 2016, Seven Corners received a claim for Trip Cancellation for [redacted] The reason for cancellation of the trip was due to illness of the insured Based on the completed physician’s statement form provided, the diagnosis resulting in trip cancellation was ADHD and Social Anxiety The physician indicated travel was prohibited for the patient, due to the illness This policy specifically excludes benefits for any loss caused by or resulting from a mental or nervous condition, unless hospitalized or partially hospitalized for the illness Based on the information provided to us, the insured was not hospitalized or partially hospitalized A denial letter was sent to [redacted] on April 18, 2016, explaining the reason his loss was not covered under the policy The policy language which is pertinent to this matter includes the following: “SECTION IVGENERAL EXCLUSIONS Benefits are not payable for any loss due to, arising or resulting from: a mental or nervous condition, unless hospitalized or Partially Hospitalized for that condition while the Certificate is in effect for You; SECTION IIDEFINITIONS “Hospital” means (a) a place which is licensed or recognized as a general hospital by the proper authority of the state in which it is located: (b) a place operated for the care and treatment of resident inpatients with a registered graduate nurse (RN) always on duty and with a laboratory and X-ray facility: (c) a place recognized as a general hospital by the Joint Commission on the Accreditation of Hospitals; (d) other than a residence, a place where treatment in a Hyperbaric chamber can be receivedNot included is a hospital or institution licensed or used principally: (1) for the treatment or care of drug addicts or alcoholics: or (2) as a clinic continued or extended care facility, skilled nursing facility, convalescent home, rest home, nursing home or home for the aged“Partial Hospitalization” means an outpatient program specifically designed for the diagnosis or active treatment of a serious mental disorder when there is a reasonable expectation for improvement or when it is necessary to maintain a patient’s functional level and prevent relapse or full hospitalizationPartial hospital programs are usually furnished by a hospital as distinct and organized intensive ambulatory treatment service of less than 24-hour daily care.” 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 officeSincerely, Seven Corners, Inc
Revdex.com of Central Indiana N Delaware Street #Indianapolis, IN? 46204-? RE: Complaint ID #: [redacted] ? ? ? ? ? ? Complainant: ? ? ? [redacted] ? To Whom It May Concern: Seven Corners, Inc(“Seven Corners”) is in receipt of the above referenced complaint filed by [redacted] on March 22, 2017.? Upon further review of Mr [redacted] ’s claim file and the circumstances surrounding this matter, trip cancellation coverage will be allowed for Mr [redacted] ’s claim? Although the policy purchased by Mr [redacted] does not provide coverage for trip cancellation due to a travel ban, given the circumstances of the situation, we are issuing payment in the amount of $1,($per passenger) which is the cancellation fee charged by [redacted] AirlinesMr [redacted] will received payment under separate correspondence.We appreciate the opportunity to address Mr [redacted] ’s concerns.? Please contact our office at the number provided above should you have any further questions regarding this matterSincerely, Sherry O [redacted] 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 sonThat should meet the insurance? requirement for partial hospitalizationI hope they accept it.? 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]
December 7, 2015Ms [redacted] Revdex.com Revdex.com of Central Indiana NDelaware StreetSuite # Indianapolis, IN? 46204-RE: Complaint Number:? ? [redacted] ? ? ? ? ? ? Complainant(s):? ? ? ? ? ? ? [redacted] and [redacted] ? ? ? ? ? ? Certificate Number:? ? [redacted] Dear Ms [redacted] :Seven Corners, Incis in receipt of Complaint ID Number [redacted] , forwarded to the attention of Dennis W***, Seven Corners, Incvia email on November 24, 2015.? The complainants, ? [redacted] and [redacted] , are requesting a refund of their airfare that was purchased on April 9, Upon further review of their file, we are unable to make a final determination on their claim as we still need medical information from Mr [redacted] ’s physicianIn 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 the [redacted] s.? 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 the [redacted] s purchased their flight and other vacation accommodations fromOur records show that on April 9, 2015, the complainants purchased airfare for a scheduled trip to Washington D.Cand days later on May 22, 2015, purchased their travel insurance policy? ? The travel insurance policy purchased by the [redacted] s contains a pre-existing clause which states that if travel insurance was not purchased within days of the initial travel deposit, any claims are subject to the following:GENERAL DEFINITIONSSickness:? means an illness or disease which is diagnosed or treated by a Physician after the Effective Date of Insurance and while You are covered under the Policy.Pre-Existing Condition means an illness, disease, or other condition during the sixty (60) day period immediately prior to the Effective Date for which You, a Traveling Companion, a Family Member booked to travel with You: 1) exhibited symptoms that would have caused one to seek care or treatment; or 2) received or received a recommendation for a test, examination, or medical treatment; or 3) took or received a prescription for drugs or medicineItem (3) of this definition does not apply to a condition that is treated or controlled solely through the taking of prescription drugs or medicine and remains treated or controlled without any adjustment or change in the required prescription throughout the sixty (60) day period before the Effective Date.The Pre-Existing Conditions exclusion is waived if You (a) enroll in this Certificate at the time You pay the deposit required for Your Trip (or within fourteen (14) days of the initial Trip deposit); (b) purchase this Certificate for the full cost of Your Trip; and (c) are medically able to travel on the Effective Date.? LIMITATIONS AND EXCLUSIONSThe following exclusions apply to Trip Cancellation.Loss caused by or resulting from:1.? Pre-Existing Conditions, as defined in the Definitions section.Per their submitted trip cancellation claim form, the [redacted] s requested reimbursement in the amount of $for prepaid airfare expenses and $for the cost of the insurance coverage premium.? We have reviewed the submitted documentation but since travel insurance was not purchased within days of the initial travel deposit, this claim must be investigated for a pre-existing medical conditionOn August 28, 2015, correspondence was sent to the [redacted] s requesting the names and addresses of the physicians who may have treated Mr [redacted] during the time period of March 23, to May 22, 2015.? In addition, Seven Corners requested a copy of the [redacted] ’s trip cancellation notice with the date of cancellation, amount of any fees incurred, and the amount of any refund / credit received from their travel provider.? We have received information regarding the [redacted] ’s trip cancellation notice but as of today’s date, we have not received the names and addresses of the doctors who have treated Mr [redacted] As soon as this information is received, we will be able to continue our review of the [redacted] ’s claim.Should you have any further questions involving this claim matter, please contact our companySincerely, Seven Corners
September 30, [redacted] Revdex.com N Delaware Street #Indianapolis IN 46204-RE: Complaint ID [redacted] Customer: [redacted] Certificate # [redacted] Policy Name: Inbound Choice Claim # [redacted] Dear Ms***: Seven Corners, Incis in receipt of Complaint ID Number [redacted] and sent to the attention of Sureleen S [redacted] on September 23, The complainant, [redacted] , has expressed concerns with the handling of a recent travel medical insurance claim under the certificate # referenced aboveThis office has reviewed the file and the claim in questionWe 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 $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 $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 officeSincerely, 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 treatmentWe were told by the employee that we purchased the insurance through that our trip was coveredCome to find out we have to pay an addition to cover the other half of our tripWhy would I want to cover 50% of my trip? [redacted]
Seven Corners, Incis in receipt of Complaint ID Number: [redacted] sent to the attention of Dennis [redacted] on February 16, The complainant, [redacted] , has expressed concerns with the handling of his Trip interruption/Trip Delay claim [redacted] purchased a short term travel insurance policy covering his trip dates 11/02/to 11/25/Mr [redacted] received notification from Philippine Airlines that his scheduled flight for 11/19/2015, had been changed to 11121/This change was the result of government authority runway closures, due to the arrival and departure of APEC leadersThe change in itinerary resulted in a Trip Delay loss for Mr [redacted] On 12109/2015, Seven Corners received a claim for the additional expenses incurred as a result of the original cancelled flightThe policy purchased provides benefits for Trip Cancellation, Trip Interruption, and Trip Delay for specific named unforeseen events listed in the policyUnfortunately, the reason the flight was cancelled/delayed was not a covered peril under this policyA denial letter was sent to Mr [redacted] on 1211612015, outlining the reason his loss was not covered under the policyThe denial letter quoted Trip Cancellation or Trip Interruption Unforeseen Events On 01/11/2016, Seven Corners received an Appeal on this claimMr [redacted] requested benefits apply under the Trip Delay benefits of the policyThis policy has the same named perils for Trip Cancellation, Trip Interruption, and Trip DelayNo benefits apply for the loss due to the runway or airport being closed by government authorityA denial of appeal letter was sent to Mr[redacted] on 02/02/The appeal analyst returned a call to Mr [redacted] on 02/16/tofurther explain the policy benefitsFollowing that conversation, Mr [redacted] was not pleased but understood that the policy did not provide benefits for his loss The policy language which is pertinent to this matter includes the following: "TRIP INTERRUPTIONWe 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 TRIP DELAYWe Will pay You for additional expenses on a one-time basis, up to the maximum shown in the Schedule of Benefits, if You are delayed en route to or from the CoverFor Trip Cancellation or Trip Interruption, Unforeseen Events Include:Accidental Injury, Sickness or death of You, Your Traveling Companion, Your Family Member, or Your Business Partner; which results in medically imposed restrictions as certified by a Physician at the time of loss preventing Your participation or continued participation in the Covered TripA Physician must advise cancellation of the Covered Trip on or before the Scheduled Departure Date.The death or hospitalization of Your Host at Destination.Inclement weather, Natural Disasters, Terrorist Attacks, or mechanical breakdown of the common carrier which results in the complete cessation of travel services at the point of departure or destination for at least consecutive hours.Adverse weather or Natural Disasters resulting in the complete cessation of travel services.Natural Disaster or documented man-made disaster at the point of departure or Your destination which renders Your primary residence or the accommodations at Your destination uninhabitable.(t) Strike that causes complete cessation of services of Your Common Carrier for at least consecutive hours.Your transfer by the employer with whom You are employed on the Effective Date of insurance which requires Your principal residence to be relocated.You or Your Traveling Companion are terminated, or laid off from employment, from aplace of employment for which You have been employed for the past consecutive years(1) Your business operations are interrupted by fire, flood, burglary, vandalism, product recall, Bankruptcy, Natural Disaster, or financial Default.If within days of Your departure, a politically motivated Terrorist Attack occurs within a mile radius of the territorial City limits of the City to be visited as shown in Youritinerary and the United States government issues a travel advisory indicating that Americans should not travel to a City named on the itinerary.Bankruptcy and/or Default of Your Travel Supplier which occurs more than days following Your Effective DateYour Scheduled Departure Date must be no more than months beyond Your Effective DateBenefits will be paid due to Bankruptcy or Default of an airline only if no alternate Transportation is availableIf alternate Transportation is available, benefits will be limited to the change fee charged to allow You to transfer to another airline in order to get to Your intended destinationThis coverage only applies if the Policy was purchased within calendar days of the initial Trip payment.(I) A documented theft of passports or visasDocumented means that You have reported the theft to the local authorities.(m) You and/or Your Traveling Companion are hijacked, quarantined, required to serve on a jury, subpoenaed, required to appear as a witness in a legal action, provided You are or Your Traveling Companion are not a party to the legal action or appearing as a law enforcement officer.SEVEN CORNERSYou and/or Your Traveling Companion are the victim of felonious assault; have Your principal place of residence made uninhabitable by fire, flood or other Natural Disaster, or burglary of Your principal place of residence within days of departure.You or Your Traveling Companion being directly involved in or delayed due to a traffic Accident substantiated by a police report, while en route to departure.You or Your Traveling Companion who are military personnel, are called to emergency duty for a disaster other than war or are called to active military duty, have their leave revoked or are reassigned for reasons other than War.A cancellation of Your Covered Trip if Your arrival on the Covered Trip is delayed and causes You to lose 51% or more of the scheduled Covered Trip duration due to the reasons covered under the Trip Delay benefit." We are sorry we cannot respond more favorably at this timeWe hope this answers your concerns regarding this matterShould you have any further concerns, please contact this office Sincerely, Seven Corners, Inc
March 20, [redacted] Revdex.com N Delaware Street #Indianapolis IN 46204-RE: Complaint ID [redacted] Customer: [redacted] Certificate [redacted] Insured: [redacted] Policy Name: [redacted] Dear Ms***: Seven Corners, Incis in receipt of the rebuttal to Complaint ID Number [redacted] and sent to the attention of Chelsi T [redacted] on March 17, The complainant, [redacted] ***, has expressed additional concerns with the handling of his wife’s travel medical insurance claims under the certificate # referenced aboveAs advised in our response of February 14, 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, and also mailed to him via U.SMail This detailed response does address the questions that Mr [redacted] has expressed in his rebuttal A copy of this response is attachedThank 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 17, [redacted] Revdex.com N Delaware Street #Indianapolis IN 46204-RE: Complaint ID [redacted] Customer: [redacted] Certificate # [redacted] Policy Name: Inbound Choice Claim # [redacted] Dear Ms***: Seven Corners, Incis in receipt of the rebuttal by [redacted] for Complaint ID Number [redacted] and sent to the attention of Sureleen S [redacted] on October 12, The complainant, [redacted] , has further disagreed with our responses to this complaintWe have reviewed our records and find that only invoices were filed for physical therapy services, one for July 5, and one for July 15, 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 officeSincerely, Seven Corners, Inc