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 Regarding the [redacted] trip and the response from Seven Corners.? On the original claim form? [redacted] 's physician selected the option provided for other in regards to the condition of cystic acne.? We completely understood it not being an illness and that is the reason the option provided "other" was selected.? Also the Dramended the date she first saw [redacted] for the condition in a letterhead from her office which was faxed to Seven Corners.? My daughter was looking forward to attending this trip but just was physically unable to do so due to this debilitating condition which left her with huge lumps on her face.? I ask you to remember being among High School peers during such an extreme condition and being on such harsh medication which requires monitoring from said physician.? It has not been easy and having to have cancelled such a great opportunity with [redacted] was beyond troubling for [redacted] .? I have an original copy? from Dr [redacted] 's? letter head submitted to Seven corners (to amend the date on the claim form) Regards, [redacted]
February 23, 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 Complaint [redacted] which was filed by [redacted] on February 17, 2016.? ? ? ? We have reviewed the complaint and the claim file and have confirmed that the claim is not eligible for trip cancellation coverage benefits.? The reasoning for our decision is explained below In order to clarify the roles of the parties involved, Nationwide Mutual Insurance Company (“NMIC”) is the insuring company of the travel insurance policy purchased by Mr***.? Seven Corners is the third party administrator contracted by NMIC to provide customer service administration and claims adjudication services for individuals who purchase travel insurance products underwritten by NMIC.? OneTravel is the Travel Provider from whom Mr [redacted] purchased his flights On June 16, 2015, Mr [redacted] purchased airfare and travel insurance for travel dates August 5-7, 2015.? Our office received Mr***’s claim on September 10, 2015, wherein he presented a trip cancellation claim due to medical reasons.? Upon evaluation of the submitted claim, it was determined that a physician’s statement was not completed by Mr***’s attending physicianHowever, a doctor’s note was submitted stating that Mr [redacted] reported to the physician that he fell ill while on vacation and was not able to depart on his scheduled flight.? The travel insurance policy purchased by Mr [redacted] requires evidence of medical treatment and medically imposed restrictions by a physician preventing and/or advising against travel on or before the scheduled departure date.? In addition, the nature of the medical condition should be disclosed in order to determine if any policy exclusions would apply.? To date, no medical condition has been disclosed as mandated by the terms of the policy On September 24, 2015, a request for additional information was sent to Mr***Specifically, we asked for a fully completed physician’s statement, cancellation confirmation, and confirmation of the amount requested by Mr [redacted] for reimbursement.? A follletter was sent to Mr [redacted] again advising of this request, and the necessity to submit the pertinent information for further review and consideration of his claim On January 29, 2016, Mr [redacted] submitted duplicate copies of the initial claim submission documents; however, in addition, there was a note from Mr [redacted] advising that his medical condition has been present for years and that since he self-treated, there was no need to see a physician.? For this reason, his claim was subsequently denied because the documentation submitted by Mr [redacted] did not meet the policy’s definition of sickness.? Under the travel insurance policy purchased by Mr***, “sickness” is (1) an illness that requires a physical examination and medical treatment by a physician and (2) commences while the coverage is in effect.? Due to the failure of Mr [redacted] to present evidence to meet the definition of “sickness” under the travel insurance policy, a denial letter was mailed to Mr [redacted] on February 10, We appreciate the opportunity to address Mr***’s concerns.? Please contact this office should you have any further questions regarding this matter Sincerely, Seven Corners, Inc
Revdex.com: I have reviewed the? response made by the business in reference to complaint ID [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 ExpiryIs it still in force since the cancellation is rejected? [redacted] ***
September 18, [redacted] Revdex.comNDelaware Street #2020Indianapolis, IN 46204-RE: Complaint ID Number: [redacted] Certificate Number: [redacted] Dear Ms [redacted] : Seven Corners, Incis in receipt of Complaint ID: [redacted] and sent to the attention of Dennis W [redacted] on September 14, 2015regarding [redacted] * [redacted] We appreciate the opportunity to address herconcerns.Upon further review of the claim documents submitted on behalf of Ms [redacted] ,Seven Corners has determined the trip cancellation claim is eligiblefor payment and issued settlement in the amount of $ The settlement check was mailed to Ms [redacted] ’s addressof record: [redacted] R [redacted] *** Seven Corners apologizes for any miscommunication whichoccurred during the handling of her travel claimWe hope this answers [redacted] ’s concerns regarding herrecent travel claimShould you have any further questions involving this claimmatter, please contact me at the address listed below.Sincerely, Seven Corners, IncEnclosure
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 has been a while since we spoke (I was hoping Seven Corners had covered the bills), but we just received a new bill from the ambulance service.? We would like to reopen/reactivate our complaint against Seven Corners Insurance to have them cover the bills from our son's accident while he was on a service oriented retreat last March.? We certainly feel that the bills should be covered as Seven Corners was the accident insurance that was purchased by the church to cover the participants of the retreat.? [redacted] fell ft off of a ladder onto a concrete pad, broke vertebrae, his wrist, and his elbow.? It is clear that he needed ambulance servicesAttached are the two bills that have not been paidPlease let us know if you have any questions or need additional informationThank you, [redacted] and [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] Dear Sir or Madam, I checked my mailbox yesterday and havereceived the check from Seven Corners Ihope to deal with the check in the bank when I have time next week Thank you very much for the preciousassistance from the Best Business Bureau and Seven CornersOn September 28, I planned to sendyou the following email but then decided to wait for your further informationbecause the web system guide me to do soI attached my earlier message belowBest regards, [redacted] [redacted] email planned to send onSeptember 28, [redacted] Dear Sir or Madam, I hope you can help me communicatewith Seven Corners to just mail me acorrect check (amount: USD) via a correct address with the correctcountry’s name (“TAIWAN” only)My previous reply mentioned that Ireceived the first mail (country’sname was “TAIWAN” only) without a check from Seven Corners on September 21st This letter (dated September 4th) asked me togive Seven Corners my banking information for the wire transfer because it saidSeven Corners mailed me an incorrect check ($194.58) earlier(Actually, I didnot receive any check at the moment.) However, on September 25th,I received another mail from Seven CornersThis mail was a check (in the amount of USD) dated August 20th, This mail used “Taiwan, provinceof China” as the country’s nameI asked the employee in the postoffice (night service) why this situation happened (I did not pay attention tothe date, September 4th, on the first mail, before receiving thesecond mail from Seven Corners) We foundthat August 20th was quite a long time ago from September 25th After seeing the date and the address (withthe incorrect country’s name), the employee said that the second mail (receivedon September 25th) might have been sent to Mainland China and thensent back to Taiwan This was his onlypossible explanationI think the current best way is toask Seven Corners to mail me a check in the correct amount of USD I do not want the bank to take too much moneyfor the transitional fee, and prefer keeping/saving the money in USD but notchanging to the currency in TaiwanI write down my address again: [redacted] , [redacted] ***TAIWAN I really hope Seven Corners canaccept my request Thank you very muchfor your precious assistanceBest regards, [redacted] ***
Seven Corners, Incis in receipt of complaint ID [redacted] , which was sent to [redacted] on June 19, The complainant, [redacted] is requesting payment for a trip cancellation claim involving her relative, [redacted] Upon reevaluation of this claim, Seven Corners has reconsidered Mr [redacted] travel claim and payment of $ has been issued Attached is a copy of the Explanation of Benefits which affirms claim payment A prior payment had been issued to Mr [redacted] in the amount of $ We have also included an Explanation of Benefits affirming this claim amount Please contact our office if there are further questions regarding this matter
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] ***
December 3, [redacted] Revdex.com Revdex.com of Central Indiana NDelaware StreetSuite # Indianapolis, IN? 46204-2599RE: Complaint Number:? ? [redacted] ? ? ? ? ? ? Complainant(s):? ? ? ? ? ? ? [redacted] ? ? ? ? ? ? ? Insureds:? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? [redacted] and [redacted] ? ? ? ? ? ? ? Certificate Number:? ? [redacted] Dear Ms.? [redacted] :Seven Corners, Incis in receipt of complaint [redacted] , forwarded to the attention of Dennis W***, Seven Corners, Incvia email on November 30, 2015.? Upon additional information just received from One Travel, we are pleased to advise that payment in the amount of $ ($per person) has been issued.? The [redacted] also requested reimbursement for their rental car and the premium paid for their travel insurance policy.? There is no coverage under the travel policy for rental car expenses and in regards to the money paid for the travel insurance policy, all premiums are non-refundable after a ten (10) day free look period.? In order to clarify the roles of the parties involved, Nationwide Mutual Insurance Company (“NMIC”) is the insuring company of the travel insurance policy purchased by the [redacted] .? 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 issued by NMIC.? One Travel is the Travel Provider from whom the [redacted] purchased their flightsThe delay in the processing of this claim was the result of an incorrect booking number listed on the claim form filed by the insured.? The cancellation notice submitted by the insured, booking number [redacted] , was not insured under this travel insurance policy.? The correct booking notice was [redacted] .? We contacted One Travel and were able to obtain the correct booking number for the trip insured under the NMIC policy and upon such receipt of such information issued payment as described above.Should you have any further questions involving this claim matter, please let us knowSincerely, Seven Corners, Inc? Claims Administered on Behalf of Nationwide Mutual Insurance Company and affiliated companies
Seven Corners, Incis in receipt of Complaint ID Number: [redacted] and sent to the attention of Dennis [redacted] on September 16, The complaint was filed by [redacted] and we appreciate the opportunity to address Mr [redacted] concerns In order to clarify the role of the parties involved, Nationwide Mutual Insurance Company (“NMIC”) is the insuring company of the travel insurance policy you purchasedOne Travel is a travel provider of flight and other vacation accommodations, and Seven Corners is the third party administrator contracted by NMIC to provide customer service assistance and claim adjudication services for individuals who purchase the Nationwide Travel Insurance product On July 15, 2014, airfare was purchased for [redacted] and [redacted] August 13-20, trip to Tulsa, OklahomaPrior to the scheduled departure date, Mrs [redacted] sought medical care for an illness/sickness which led to the cancellation of their travel plansSeven Corners, Increceived a trip cancellation claim due to sickness/illness on behalf of [redacted] and [redacted] on August 21, After receipt of Mrand Mrs [redacted] claim documents by Seven Corners, there was a technical issue with processing the customer’s policy/claim information The matter was resolved on September 17, and we apologize for the delay that impeded the timely handling of Mrand Mrs [redacted] claim Seven Corners proceeded to evaluate the presented claim documentation, which included a completed physician’s statement from the client’s treating physician, Dr [redacted] , MDBased upon that review, we have determined that Mrand Mrs [redacted] trip cancellation loss is not eligible for benefits and the reasoning for our decision is explained below Per the completed physician’s statement and claim form, [redacted] onset of sickness began on August 3, Also on August 3, 2014, a Nationwide Travel Insurance plan was purchased by the [redacted] sPer the trip cancellation coverage benefit, trip cancellation coverage will take effect at 12:AM, on the day after the required premium is received by the Company; as a result, coverage became effective on August 4, Per the physician’s statement, Mrs [redacted] was treated for her illness by Dr [redacted] on August 4, Based upon the above information, the customer had no active policy at the time symptoms first manifested or were exhibited and therefore, the presented loss has no coverage Policy language which is pertinent to this matter: GENERAL PROVISIONS The following provisions apply to all coverages: WHEN YOUR COVERAGE BEGINS All coverage (except Trip Cancellation) will take effect at 12:A.Mlocal time, at Your location, on the Scheduled Departure Date provided: (a) coverage has been elected; and (b) the required premium has been paid Trip Cancellation coverage will take effect at 12:A.Mlocal time at Your location, on the day after the required premium for such coverage is received by the Company or its authorized representative BENEFITS TRIP CANCELLATION & TRIP INTERRUPTION The Company will pay a benefit, up to the maximum shown on the Confirmation of Coverage, if You are prevented from taking or unable to continue Your Trip due to: (a) Sickness, Accidental Injury or death of You, Traveling Companion, or Family Member; which results in medically imposed restrictions as certified by a Physician at the time of Loss preventing Your continued participation in the Covered TripA Physician must advise cancellation of the Covered Trip on or before the Scheduled Departure Date Pre-Existing Condition: means any injury, sickness or condition of You, or Your Traveling Companion for which within the sixty (60) day period prior to the Effective Date of Trip Cancellation coverage under the Policy (a) first manifested itself or exhibited symptoms which would have caused one to seek diagnosis, care or treatment; (b) required taking prescribed drugs or medicine, unless the condition for which the prescribed drug or medicine is taken remains controlled without any change in the required prescription; or (c) required medical treatment or treatment was recommended by a Physician The Pre-Existing Conditions exclusion is waived for You if You enroll in the Plan at the time You pay the deposit required for the Covered Trip (or within fourteen (14) days of the initial deposit) and You purchase the coverage under the Plan for the full cost of the Covered Trip LIMITATIONS AND EXCLUSIONS The following exclusions apply to Trip Cancellation & Trip Interruption, Trip Delay, Missed Connection, And Accidental Death & Dismemberment: Loss caused by or resulting from: Pre-Existing Conditions, as defined in the Definitions section unless the insurance is purchased within fourteen (14) days of the initial Covered Trip deposit; We apologize that we cannot respond more favorably at this timeThis office appreciates the opportunity to respond to [redacted] concerns and should you have any further questions or concerns, please do not hesitate in contacting this office
May 26, [redacted] Revdex.com N Delaware Street #Indianapolis IN 46204-RE: Complaint ID [redacted] Customer: Russell SRambert Certificate #9LCL15-Dear Ms***: Seven Corners, Incis in receipt of the rebuttal regarding Complaint ID Number [redacted] , sent to the attention of Dennis W [redacted] on May 23, The complainant, [redacted] , has expressed disagreement with the handling of recent travel medical insurance claims for insured [redacted] under the certificate # referenced aboveThe original decision was made on the file based on a medical review of the records received and the definition in the policy Due the continued dissatisfaction of the complainant with the decision, we did submit the file for an additional Independent Medical Review This review has been returned with the determination that the insured’s illness was NOT the result of a pre-existing conditionTherefore, based on this new review, we are pleased to advise that we have overturned our denial of these claims and they will be processed according to the benefits allowed under the policy Thank you for your time and attention to this matter and should you have questions involving this claim matter, please contact this 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 I am an arthritis patientSo, when I booked my tickets with OneTravel.com, they lead me to Seven Corner Insurance company, which offered full refund of our tickets in case of sickness and of course some other reasons I didn't pay attention toRealizing that sometimes my condition gets worse, I thought it will be a good idea to buy the insurance so that if we are unable to travel due to my health problem, we get full refund of our tickets amountIsn't that why we buy the insurance? It so happened that Ramadhan came before our traveling date and due to fasting and night prayers my arthritis pains shot up such that I could not sit for 10+ hours in the economy class with cramped seatsAs a result, we had to cancel our flightI called the Insurance company well in time and told them that we cancelled our flights due to my health condition and want the refund as they had promisedThe lady sent me the Insurance form and asked me if I could provide a doctor's note to support my claim of sicknessI am an arthritis patient for the last over years, so I don't need to go to a doctor to know if I am able to travel or not because a long time patient often knows his/her sickness/condition better than a doctorBut realizing the fact that this is their policy and they have a right to confirm the authenticity of our claim, I went to a hospital and did all the tests that will prove the severity of my health condition, asked the doctor to fill up the required note from the insurance company (spent considerable time and amount to satisfy the insurance company) and sent it to themAnd, they say that you didn't go to the doctor before! If they were honest, they would not be looking for lame excuses to reject our claimNobody buys the tickets to cancel and claim the same amount they have paid from their pocketThe only reason one buys insurance is to protect the amount that they have paid from their pocket in case of any mis-hapSo, what is the reason for rejecting a claim that is genuine?! We had lodged our complaint with Revdex.com in September but instead of getting a refund, we received a letter from Revdex.com telling us that our case is closed since it is settled! We would like to know how did they reach this conclusion?We want our insured amount of the tickets $2300+ cancellation fee $150= $ASAP Regards, [redacted] & [redacted]
December 9, [redacted] Revdex.com of Central Indiana NDelaware StreetSuite # 2020Indianapolis, IN? 46204-2599RE:? Complaint Number:? [redacted] Complainant: [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 above referenced complaint.? The complaint was received by Seven Corners on December 9, 2015.? 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, 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 treatment received by [redacted] ***, The findings of the review revealed Ms [redacted] suffered 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 conditionBelow is the Policy language that is pertinent to this matter.DEFINITIONS“Acute Onset of a Pre-existing Condition(s)” shall mean a sudden and unexpected outbreak or recurrence of a Pre-existing Condition(s) which occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms and is of short duration, is rapidly progressive, and requires urgent careThe Acute Onset of a Pre-existing Condition(s) must occur after the effective date of the policyTreatment must be obtained within hours of the sudden and unexpected outbreak or recurrenceA Pre-existing Condition that is a chronic or congenital condition or that gradually becomes worse over time will not be considered Acute OnsetThis benefit does not include coverage for known, scheduled, required, or expected medical care, drugs or Treatments existent or necessary prior to the Effective Date of coverage."Pre-Existing Condition" 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 within the one hundred and eighty (180) days (three hundred and sixty five (365) days for Insured Persons and older) immediately prior to the Insured Person’s Effective Date under the policy, whether or not previously manifested, symptomatic, known, diagnosed, treated or disclosedThis 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 one hundred and eighty (180) days (three hundred and sixty five (365) days for Insured Persons and older) immediately preceding the effective date of coverage under this policy.GENERAL EXCLUSIONS AND LIMITATIONSNo benefits will be paid for loss or expense caused by, contributed to, or resulting from: Pre-existing Conditions, as defined hereinIf you are a non-U.Scitizen under age 70, this exclusion is waived for eligible medical expenses for an Acute Onset of a Pre-existing Condition(s) (as defined herein) as shown in the Schedule of Benefits for your chosen plan (Plan A, B, C, or D)Benefits will be administered as stated in section G, Acute Onset of a Pre-Existing Condition(s), for eligible medical expenses incurred in the United States, minus your Deductible and subject to the scheduled limits for benefits as stated in the Schedule of BenefitsFor persons age and over, there is no benefitThis benefit 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 programAny exclusion specifically listed in General Exclusions and Limitations, numbers through 35, as well as the section entitled Additional Limitations and Exclusions for Elective Surgery and Elective Treatment, will not receive benefits from this waiverBased upon the Policy’s Coverage Provisions and 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 claimIf you should have any further questions or need further clarification of the above, please do not hesitate to contact us.Sincerely,Claims Department Seven Corners, Inc
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, 2016.? ? ? ? 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, 2016.? This payment was made as we were able to confirm that the medical condition that resulted in the cancelled trip is not pre-existing We appreciate the opportunity to address Mr [redacted] ’s concernsPlease feel free to contact our office should you have any further questions regarding this matter Sincerely, Seven Corners, Inc
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [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] , ***- [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 conditionI 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 claimI will not be happy before this is settled correctly and ethicallyI will take further steps if necessaryI also find poor that no person responsible would sign the claim and assessment mentioned on behalf of Seven CornersLooking forward to some prompt and solid resolution Regards, [redacted]
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and am submitting my response to them as follows:We didn’t see the insurance offer on our screen earlier, as soon as we saw it, realizing the health condition of [redacted] , we opted for it If it were late, as it is claimed, the payment should not have been accepted, instead the company should have informed us about the lapse of time! The company accepted the payment hoping that we will travel and they will get to eat up our $without having to ever take any responsibility towards the insured amount; a bogus offer which should be considered a spam!Nobody buys airfare to waste or claim back the amount s/he paid from his/her pocket! Is insurance company paying from their pocket more than we have already paid? So, this doubt that it might be claim and a doctor has to confirm the sickness, or the treatment for the sickness does not even make sense Millions of people buy insurance claims and the company digests them all without even a burp but when there is a claim of reimbursement due to the genuine condition, the insurance company starts coming up with unreasonable demands of proof of truthfulness of the claim!In any case, doctor’s name and phone noand the report was provided to seven corners on their demand, which they rejected on the pretext that it was not within the time-frame they require! Another bluff! The very fact that [redacted] is a patient of osteoarthritis, high blood pressure, Lyme disease and diabetes, which is proven by all the tests that were done on the request of seven corners and the report was provided, is not enough to prove that she was not in the condition of traveling due to the flare up of her condition!It is a very clear case of seven corners cutting of corners whenever people have claimed the insurance they bought from them You could check in reviews given about them; most of them are unpaid or paid way below the insured amount if paid at all! Regards, [redacted] & [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 as soon I receive the payment.? I had been told by the company on several occasions about them sending me letters by mail, but actually never got oneI hope it will be different this time Regards, [redacted]
January 28, Revdex.com of Central Indiana NDelaware Street #Indianapolis, IN 46204-RE: Complaint ID – [redacted] Complainant: [redacted] To whom it may concern: Seven Corners, Inc(“Seven Corners”) is in receipt of complaint [redacted] which was filed by [redacted] on January 21, Upon further review of Ms [redacted] ’s claim file, we have determined that the amount of $is payable based on the coverage purchased by Ms [redacted] pursuant to Certificate Number This payment represents the maximum amount payable under the trip cancellation coverage provided by this certificate and payment in this amount was issued to Ms [redacted] on January 28, In order to clarify the roles of the parties involved, Nationwide Mutual Insurance Company (“NMIC”) is the insuring company of the travel insurance policy purchased by [redacted] Seven Corners is the third party administrator contracted by NMIC to provide customer service administration and claims adjudication services for individuals who purchase travel insurance products issued by NMIC One Travel is the Travel Provider from whom Ms [redacted] purchased her flightsMs [redacted] ’s claim involves two separate travel insurance policies as she purchased two separate insurance policies for her trip: Certificate Number was purchased on December 15, and Certificate Number was purchased on December 18, The chart below provides the details surrounding each travel insurance policyDate airfare tickets purchased via One Travel website Nationwide Travel Protection certificate number Nationwide Travel Protection certificate purchase date Policy Effective Date Travel Date December 10, December 15, December 16, December 29, December 10, December 18, December 19, December 24, Ms [redacted] cancelled her family’s trip due to the illness of her daughter, [redacted] Medical documentation submitted reflects that Ms [redacted] ’s daughter became ill on December 15, and received medical treatment on December 17, Per the Nationwide Travel Protection insurance policy, when a trip is cancelled due to illness, the illness must be first diagnosed or treated by a physician after the effective date of insurance coverage and while coverage under the policy is still in[SO1] effect Under Certificate 31919753, [redacted] was treated after the effective date of coverage, resulting in payment of $However, [redacted] was treated prior to the effective date of coverage under Certificate 31940395, and as a result, the claim is not eligible for payment under this policy Policy language which is pertinent to this matter includes the following; Trip Cancellation The Company will reimburse You, up to the Maximum Benefit shown on the Confirmation of Coverage, if You are prevented from taking Your Trip for any of the following reasons that are Unforeseen and takes place after the Effective Date: Sickness, Accidental Injury or death of a Family Member or Traveling Companion, booked to travel with You, that results in medically imposed restrictions as certified by a Physician preventing that person’s participation in the Trip; Sickness means an illness or disease of the body that: 1) requires a physical examination and medical treatment by a Physician and 2) commences while Your coverage is in effect An illness or disease of the body that begins prior to the Effective Date of coverage is not a Sickness as defined herein and is not covered by this Certificate unless is suddenly worsens or becomes acute after the Effective DateEffective Date means 12:A.Mlocal time, at Your location, on the day after the required premium for such coverage is received by the Company or its authorized representativePlease understand that our action at this time should not be construed as a waiver of any and all rights and defenses which NMIC may have under the policy in question, and any applicable statutory or common law, all of where are hereby expressly reservedWe appreciate the opportunity to address Ms [redacted] ’s concerns Please contact this office should you have any further questions regarding this matterSincerely, Seven Corners, Inc [SO1] and while coverage under the policy is still in effect
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that the response would not resolve my complaint For your reference, details of the offer I reviewed appear belowI do not think Seven Corners considered that I was covered from August to December 31, (Certificate ID: [redacted] ) at the time the symptom happened and it was physically impossible for me to immediately go to a nearest provider as I was travelling at that timeThe August to December 31, coverage is the same group coverage I had from January to February 28, (Certificate ID: [redacted] )Both of these coverages are attached.If my claims are still denied after consideration of my coverage from August to December 2016, I will have to file a complaint against Seven Corners in the Indiana Department of Insurance and the Hawaii Department of Commerce Regards, [redacted] ***
February 26, [redacted] Revdex.com N Delaware Street #Indianapolis, IN 46204-RE: Complaint ID – [redacted] Complainant: [redacted] Dear Ms***: Seven Corners, Incis in receipt of Complaint ID Number [redacted] and sent to the attention of Dennis W [redacted] on February 22, The complainant, [redacted] , has expressed concerns with the handling of her recent claimsThis office has reviewed the file and the claims in question The member submitted invoices and receipts that were not legible Our Assistance Department promptly responded to Ms [redacted] , advising her of suchWe have been in direct contact with Ms [redacted] who has resubmitted her claims for reviewWe have advised her of what information is needed to continue our review 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 Regarding the [redacted] trip and the response from Seven Corners.? On the original claim form? [redacted] 's physician selected the option provided for other in regards to the condition of cystic acne.? We completely understood it not being an illness and that is the reason the option provided "other" was selected.? Also the Dramended the date she first saw [redacted] for the condition in a letterhead from her office which was faxed to Seven Corners.? My daughter was looking forward to attending this trip but just was physically unable to do so due to this debilitating condition which left her with huge lumps on her face.? I ask you to remember being among High School peers during such an extreme condition and being on such harsh medication which requires monitoring from said physician.? It has not been easy and having to have cancelled such a great opportunity with [redacted] was beyond troubling for [redacted] .? I have an original copy? from Dr [redacted] 's? letter head submitted to Seven corners (to amend the date on the claim form) Regards, [redacted]
February 23, 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 Complaint [redacted] which was filed by [redacted] on February 17, 2016.? ? ? ? We have reviewed the complaint and the claim file and have confirmed that the claim is not eligible for trip cancellation coverage benefits.? The reasoning for our decision is explained below In order to clarify the roles of the parties involved, Nationwide Mutual Insurance Company (“NMIC”) is the insuring company of the travel insurance policy purchased by Mr***.? Seven Corners is the third party administrator contracted by NMIC to provide customer service administration and claims adjudication services for individuals who purchase travel insurance products underwritten by NMIC.? OneTravel is the Travel Provider from whom Mr [redacted] purchased his flights On June 16, 2015, Mr [redacted] purchased airfare and travel insurance for travel dates August 5-7, 2015.? Our office received Mr***’s claim on September 10, 2015, wherein he presented a trip cancellation claim due to medical reasons.? Upon evaluation of the submitted claim, it was determined that a physician’s statement was not completed by Mr***’s attending physicianHowever, a doctor’s note was submitted stating that Mr [redacted] reported to the physician that he fell ill while on vacation and was not able to depart on his scheduled flight.? The travel insurance policy purchased by Mr [redacted] requires evidence of medical treatment and medically imposed restrictions by a physician preventing and/or advising against travel on or before the scheduled departure date.? In addition, the nature of the medical condition should be disclosed in order to determine if any policy exclusions would apply.? To date, no medical condition has been disclosed as mandated by the terms of the policy On September 24, 2015, a request for additional information was sent to Mr***Specifically, we asked for a fully completed physician’s statement, cancellation confirmation, and confirmation of the amount requested by Mr [redacted] for reimbursement.? A follletter was sent to Mr [redacted] again advising of this request, and the necessity to submit the pertinent information for further review and consideration of his claim On January 29, 2016, Mr [redacted] submitted duplicate copies of the initial claim submission documents; however, in addition, there was a note from Mr [redacted] advising that his medical condition has been present for years and that since he self-treated, there was no need to see a physician.? For this reason, his claim was subsequently denied because the documentation submitted by Mr [redacted] did not meet the policy’s definition of sickness.? Under the travel insurance policy purchased by Mr***, “sickness” is (1) an illness that requires a physical examination and medical treatment by a physician and (2) commences while the coverage is in effect.? Due to the failure of Mr [redacted] to present evidence to meet the definition of “sickness” under the travel insurance policy, a denial letter was mailed to Mr [redacted] on February 10, We appreciate the opportunity to address Mr***’s concerns.? Please contact this office should you have any further questions regarding this matter Sincerely, Seven Corners, Inc
Revdex.com: I have reviewed the? response made by the business in reference to complaint ID [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 ExpiryIs it still in force since the cancellation is rejected? [redacted] ***
September 18, [redacted] Revdex.comNDelaware Street #2020Indianapolis, IN 46204-RE: Complaint ID Number: [redacted] Certificate Number: [redacted] Dear Ms [redacted] : Seven Corners, Incis in receipt of Complaint ID: [redacted] and sent to the attention of Dennis W [redacted] on September 14, 2015regarding [redacted] * [redacted] We appreciate the opportunity to address herconcerns.Upon further review of the claim documents submitted on behalf of Ms [redacted] ,Seven Corners has determined the trip cancellation claim is eligiblefor payment and issued settlement in the amount of $ The settlement check was mailed to Ms [redacted] ’s addressof record: [redacted] R [redacted] *** Seven Corners apologizes for any miscommunication whichoccurred during the handling of her travel claimWe hope this answers [redacted] ’s concerns regarding herrecent travel claimShould you have any further questions involving this claimmatter, please contact me at the address listed below.Sincerely, Seven Corners, IncEnclosure
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 has been a while since we spoke (I was hoping Seven Corners had covered the bills), but we just received a new bill from the ambulance service.? We would like to reopen/reactivate our complaint against Seven Corners Insurance to have them cover the bills from our son's accident while he was on a service oriented retreat last March.? We certainly feel that the bills should be covered as Seven Corners was the accident insurance that was purchased by the church to cover the participants of the retreat.? [redacted] fell ft off of a ladder onto a concrete pad, broke vertebrae, his wrist, and his elbow.? It is clear that he needed ambulance servicesAttached are the two bills that have not been paidPlease let us know if you have any questions or need additional informationThank you, [redacted] and [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] Dear Sir or Madam, I checked my mailbox yesterday and havereceived the check from Seven Corners Ihope to deal with the check in the bank when I have time next week Thank you very much for the preciousassistance from the Best Business Bureau and Seven CornersOn September 28, I planned to sendyou the following email but then decided to wait for your further informationbecause the web system guide me to do soI attached my earlier message belowBest regards, [redacted] [redacted] email planned to send onSeptember 28, [redacted] Dear Sir or Madam, I hope you can help me communicatewith Seven Corners to just mail me acorrect check (amount: USD) via a correct address with the correctcountry’s name (“TAIWAN” only)My previous reply mentioned that Ireceived the first mail (country’sname was “TAIWAN” only) without a check from Seven Corners on September 21st This letter (dated September 4th) asked me togive Seven Corners my banking information for the wire transfer because it saidSeven Corners mailed me an incorrect check ($194.58) earlier(Actually, I didnot receive any check at the moment.) However, on September 25th,I received another mail from Seven CornersThis mail was a check (in the amount of USD) dated August 20th, This mail used “Taiwan, provinceof China” as the country’s nameI asked the employee in the postoffice (night service) why this situation happened (I did not pay attention tothe date, September 4th, on the first mail, before receiving thesecond mail from Seven Corners) We foundthat August 20th was quite a long time ago from September 25th After seeing the date and the address (withthe incorrect country’s name), the employee said that the second mail (receivedon September 25th) might have been sent to Mainland China and thensent back to Taiwan This was his onlypossible explanationI think the current best way is toask Seven Corners to mail me a check in the correct amount of USD I do not want the bank to take too much moneyfor the transitional fee, and prefer keeping/saving the money in USD but notchanging to the currency in TaiwanI write down my address again: [redacted] , [redacted] ***TAIWAN I really hope Seven Corners canaccept my request Thank you very muchfor your precious assistanceBest regards, [redacted] ***
Seven Corners, Incis in receipt of complaint ID [redacted] , which was sent to [redacted] on June 19, The complainant, [redacted] is requesting payment for a trip cancellation claim involving her relative, [redacted] Upon reevaluation of this claim, Seven Corners has reconsidered Mr [redacted] travel claim and payment of $ has been issued Attached is a copy of the Explanation of Benefits which affirms claim payment A prior payment had been issued to Mr [redacted] in the amount of $ We have also included an Explanation of Benefits affirming this claim amount Please contact our office if there are further questions regarding this matter
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] ***
December 3, [redacted] Revdex.com Revdex.com of Central Indiana NDelaware StreetSuite # Indianapolis, IN? 46204-2599RE: Complaint Number:? ? [redacted] ? ? ? ? ? ? Complainant(s):? ? ? ? ? ? ? [redacted] ? ? ? ? ? ? ? Insureds:? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? [redacted] and [redacted] ? ? ? ? ? ? ? Certificate Number:? ? [redacted] Dear Ms.? [redacted] :Seven Corners, Incis in receipt of complaint [redacted] , forwarded to the attention of Dennis W***, Seven Corners, Incvia email on November 30, 2015.? Upon additional information just received from One Travel, we are pleased to advise that payment in the amount of $ ($per person) has been issued.? The [redacted] also requested reimbursement for their rental car and the premium paid for their travel insurance policy.? There is no coverage under the travel policy for rental car expenses and in regards to the money paid for the travel insurance policy, all premiums are non-refundable after a ten (10) day free look period.? In order to clarify the roles of the parties involved, Nationwide Mutual Insurance Company (“NMIC”) is the insuring company of the travel insurance policy purchased by the [redacted] .? 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 issued by NMIC.? One Travel is the Travel Provider from whom the [redacted] purchased their flightsThe delay in the processing of this claim was the result of an incorrect booking number listed on the claim form filed by the insured.? The cancellation notice submitted by the insured, booking number [redacted] , was not insured under this travel insurance policy.? The correct booking notice was [redacted] .? We contacted One Travel and were able to obtain the correct booking number for the trip insured under the NMIC policy and upon such receipt of such information issued payment as described above.Should you have any further questions involving this claim matter, please let us knowSincerely, Seven Corners, Inc? Claims Administered on Behalf of Nationwide Mutual Insurance Company and affiliated companies
Seven Corners, Incis in receipt of Complaint ID Number: [redacted] and sent to the attention of Dennis [redacted] on September 16, The complaint was filed by [redacted] and we appreciate the opportunity to address Mr [redacted] concerns In order to clarify the role of the parties involved, Nationwide Mutual Insurance Company (“NMIC”) is the insuring company of the travel insurance policy you purchasedOne Travel is a travel provider of flight and other vacation accommodations, and Seven Corners is the third party administrator contracted by NMIC to provide customer service assistance and claim adjudication services for individuals who purchase the Nationwide Travel Insurance product On July 15, 2014, airfare was purchased for [redacted] and [redacted] August 13-20, trip to Tulsa, OklahomaPrior to the scheduled departure date, Mrs [redacted] sought medical care for an illness/sickness which led to the cancellation of their travel plansSeven Corners, Increceived a trip cancellation claim due to sickness/illness on behalf of [redacted] and [redacted] on August 21, After receipt of Mrand Mrs [redacted] claim documents by Seven Corners, there was a technical issue with processing the customer’s policy/claim information The matter was resolved on September 17, and we apologize for the delay that impeded the timely handling of Mrand Mrs [redacted] claim Seven Corners proceeded to evaluate the presented claim documentation, which included a completed physician’s statement from the client’s treating physician, Dr [redacted] , MDBased upon that review, we have determined that Mrand Mrs [redacted] trip cancellation loss is not eligible for benefits and the reasoning for our decision is explained below Per the completed physician’s statement and claim form, [redacted] onset of sickness began on August 3, Also on August 3, 2014, a Nationwide Travel Insurance plan was purchased by the [redacted] sPer the trip cancellation coverage benefit, trip cancellation coverage will take effect at 12:AM, on the day after the required premium is received by the Company; as a result, coverage became effective on August 4, Per the physician’s statement, Mrs [redacted] was treated for her illness by Dr [redacted] on August 4, Based upon the above information, the customer had no active policy at the time symptoms first manifested or were exhibited and therefore, the presented loss has no coverage Policy language which is pertinent to this matter: GENERAL PROVISIONS The following provisions apply to all coverages: WHEN YOUR COVERAGE BEGINS All coverage (except Trip Cancellation) will take effect at 12:A.Mlocal time, at Your location, on the Scheduled Departure Date provided: (a) coverage has been elected; and (b) the required premium has been paid Trip Cancellation coverage will take effect at 12:A.Mlocal time at Your location, on the day after the required premium for such coverage is received by the Company or its authorized representative BENEFITS TRIP CANCELLATION & TRIP INTERRUPTION The Company will pay a benefit, up to the maximum shown on the Confirmation of Coverage, if You are prevented from taking or unable to continue Your Trip due to: (a) Sickness, Accidental Injury or death of You, Traveling Companion, or Family Member; which results in medically imposed restrictions as certified by a Physician at the time of Loss preventing Your continued participation in the Covered TripA Physician must advise cancellation of the Covered Trip on or before the Scheduled Departure Date Pre-Existing Condition: means any injury, sickness or condition of You, or Your Traveling Companion for which within the sixty (60) day period prior to the Effective Date of Trip Cancellation coverage under the Policy (a) first manifested itself or exhibited symptoms which would have caused one to seek diagnosis, care or treatment; (b) required taking prescribed drugs or medicine, unless the condition for which the prescribed drug or medicine is taken remains controlled without any change in the required prescription; or (c) required medical treatment or treatment was recommended by a Physician The Pre-Existing Conditions exclusion is waived for You if You enroll in the Plan at the time You pay the deposit required for the Covered Trip (or within fourteen (14) days of the initial deposit) and You purchase the coverage under the Plan for the full cost of the Covered Trip LIMITATIONS AND EXCLUSIONS The following exclusions apply to Trip Cancellation & Trip Interruption, Trip Delay, Missed Connection, And Accidental Death & Dismemberment: Loss caused by or resulting from: Pre-Existing Conditions, as defined in the Definitions section unless the insurance is purchased within fourteen (14) days of the initial Covered Trip deposit; We apologize that we cannot respond more favorably at this timeThis office appreciates the opportunity to respond to [redacted] concerns and should you have any further questions or concerns, please do not hesitate in contacting this office
May 26, [redacted] Revdex.com N Delaware Street #Indianapolis IN 46204-RE: Complaint ID [redacted] Customer: Russell SRambert Certificate #9LCL15-Dear Ms***: Seven Corners, Incis in receipt of the rebuttal regarding Complaint ID Number [redacted] , sent to the attention of Dennis W [redacted] on May 23, The complainant, [redacted] , has expressed disagreement with the handling of recent travel medical insurance claims for insured [redacted] under the certificate # referenced aboveThe original decision was made on the file based on a medical review of the records received and the definition in the policy Due the continued dissatisfaction of the complainant with the decision, we did submit the file for an additional Independent Medical Review This review has been returned with the determination that the insured’s illness was NOT the result of a pre-existing conditionTherefore, based on this new review, we are pleased to advise that we have overturned our denial of these claims and they will be processed according to the benefits allowed under the policy Thank you for your time and attention to this matter and should you have questions involving this claim matter, please contact this 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 I am an arthritis patientSo, when I booked my tickets with OneTravel.com, they lead me to Seven Corner Insurance company, which offered full refund of our tickets in case of sickness and of course some other reasons I didn't pay attention toRealizing that sometimes my condition gets worse, I thought it will be a good idea to buy the insurance so that if we are unable to travel due to my health problem, we get full refund of our tickets amountIsn't that why we buy the insurance? It so happened that Ramadhan came before our traveling date and due to fasting and night prayers my arthritis pains shot up such that I could not sit for 10+ hours in the economy class with cramped seatsAs a result, we had to cancel our flightI called the Insurance company well in time and told them that we cancelled our flights due to my health condition and want the refund as they had promisedThe lady sent me the Insurance form and asked me if I could provide a doctor's note to support my claim of sicknessI am an arthritis patient for the last over years, so I don't need to go to a doctor to know if I am able to travel or not because a long time patient often knows his/her sickness/condition better than a doctorBut realizing the fact that this is their policy and they have a right to confirm the authenticity of our claim, I went to a hospital and did all the tests that will prove the severity of my health condition, asked the doctor to fill up the required note from the insurance company (spent considerable time and amount to satisfy the insurance company) and sent it to themAnd, they say that you didn't go to the doctor before! If they were honest, they would not be looking for lame excuses to reject our claimNobody buys the tickets to cancel and claim the same amount they have paid from their pocketThe only reason one buys insurance is to protect the amount that they have paid from their pocket in case of any mis-hapSo, what is the reason for rejecting a claim that is genuine?! We had lodged our complaint with Revdex.com in September but instead of getting a refund, we received a letter from Revdex.com telling us that our case is closed since it is settled! We would like to know how did they reach this conclusion?We want our insured amount of the tickets $2300+ cancellation fee $150= $ASAP Regards, [redacted] & [redacted]
December 9, [redacted] Revdex.com of Central Indiana NDelaware StreetSuite # 2020Indianapolis, IN? 46204-2599RE:? Complaint Number:? [redacted] Complainant: [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 above referenced complaint.? The complaint was received by Seven Corners on December 9, 2015.? 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, 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 treatment received by [redacted] ***, The findings of the review revealed Ms [redacted] suffered 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 conditionBelow is the Policy language that is pertinent to this matter.DEFINITIONS“Acute Onset of a Pre-existing Condition(s)” shall mean a sudden and unexpected outbreak or recurrence of a Pre-existing Condition(s) which occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms and is of short duration, is rapidly progressive, and requires urgent careThe Acute Onset of a Pre-existing Condition(s) must occur after the effective date of the policyTreatment must be obtained within hours of the sudden and unexpected outbreak or recurrenceA Pre-existing Condition that is a chronic or congenital condition or that gradually becomes worse over time will not be considered Acute OnsetThis benefit does not include coverage for known, scheduled, required, or expected medical care, drugs or Treatments existent or necessary prior to the Effective Date of coverage."Pre-Existing Condition" 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 within the one hundred and eighty (180) days (three hundred and sixty five (365) days for Insured Persons and older) immediately prior to the Insured Person’s Effective Date under the policy, whether or not previously manifested, symptomatic, known, diagnosed, treated or disclosedThis 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 one hundred and eighty (180) days (three hundred and sixty five (365) days for Insured Persons and older) immediately preceding the effective date of coverage under this policy.GENERAL EXCLUSIONS AND LIMITATIONSNo benefits will be paid for loss or expense caused by, contributed to, or resulting from: Pre-existing Conditions, as defined hereinIf you are a non-U.Scitizen under age 70, this exclusion is waived for eligible medical expenses for an Acute Onset of a Pre-existing Condition(s) (as defined herein) as shown in the Schedule of Benefits for your chosen plan (Plan A, B, C, or D)Benefits will be administered as stated in section G, Acute Onset of a Pre-Existing Condition(s), for eligible medical expenses incurred in the United States, minus your Deductible and subject to the scheduled limits for benefits as stated in the Schedule of BenefitsFor persons age and over, there is no benefitThis benefit 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 programAny exclusion specifically listed in General Exclusions and Limitations, numbers through 35, as well as the section entitled Additional Limitations and Exclusions for Elective Surgery and Elective Treatment, will not receive benefits from this waiverBased upon the Policy’s Coverage Provisions and 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 claimIf you should have any further questions or need further clarification of the above, please do not hesitate to contact us.Sincerely,Claims Department Seven Corners, Inc
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, 2016.? ? ? ? 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, 2016.? This payment was made as we were able to confirm that the medical condition that resulted in the cancelled trip is not pre-existing We appreciate the opportunity to address Mr [redacted] ’s concernsPlease feel free to contact our office should you have any further questions regarding this matter Sincerely, Seven Corners, Inc
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [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] , ***- [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 conditionI 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 claimI will not be happy before this is settled correctly and ethicallyI will take further steps if necessaryI also find poor that no person responsible would sign the claim and assessment mentioned on behalf of Seven CornersLooking forward to some prompt and solid resolution Regards, [redacted]
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and am submitting my response to them as follows:We didn’t see the insurance offer on our screen earlier, as soon as we saw it, realizing the health condition of [redacted] , we opted for it If it were late, as it is claimed, the payment should not have been accepted, instead the company should have informed us about the lapse of time! The company accepted the payment hoping that we will travel and they will get to eat up our $without having to ever take any responsibility towards the insured amount; a bogus offer which should be considered a spam!Nobody buys airfare to waste or claim back the amount s/he paid from his/her pocket! Is insurance company paying from their pocket more than we have already paid? So, this doubt that it might be claim and a doctor has to confirm the sickness, or the treatment for the sickness does not even make sense Millions of people buy insurance claims and the company digests them all without even a burp but when there is a claim of reimbursement due to the genuine condition, the insurance company starts coming up with unreasonable demands of proof of truthfulness of the claim!In any case, doctor’s name and phone noand the report was provided to seven corners on their demand, which they rejected on the pretext that it was not within the time-frame they require! Another bluff! The very fact that [redacted] is a patient of osteoarthritis, high blood pressure, Lyme disease and diabetes, which is proven by all the tests that were done on the request of seven corners and the report was provided, is not enough to prove that she was not in the condition of traveling due to the flare up of her condition!It is a very clear case of seven corners cutting of corners whenever people have claimed the insurance they bought from them You could check in reviews given about them; most of them are unpaid or paid way below the insured amount if paid at all! Regards, [redacted] & [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 as soon I receive the payment.? I had been told by the company on several occasions about them sending me letters by mail, but actually never got oneI hope it will be different this time Regards, [redacted]
January 28, Revdex.com of Central Indiana NDelaware Street #Indianapolis, IN 46204-RE: Complaint ID – [redacted] Complainant: [redacted] To whom it may concern: Seven Corners, Inc(“Seven Corners”) is in receipt of complaint [redacted] which was filed by [redacted] on January 21, Upon further review of Ms [redacted] ’s claim file, we have determined that the amount of $is payable based on the coverage purchased by Ms [redacted] pursuant to Certificate Number This payment represents the maximum amount payable under the trip cancellation coverage provided by this certificate and payment in this amount was issued to Ms [redacted] on January 28, In order to clarify the roles of the parties involved, Nationwide Mutual Insurance Company (“NMIC”) is the insuring company of the travel insurance policy purchased by [redacted] Seven Corners is the third party administrator contracted by NMIC to provide customer service administration and claims adjudication services for individuals who purchase travel insurance products issued by NMIC One Travel is the Travel Provider from whom Ms [redacted] purchased her flightsMs [redacted] ’s claim involves two separate travel insurance policies as she purchased two separate insurance policies for her trip: Certificate Number was purchased on December 15, and Certificate Number was purchased on December 18, The chart below provides the details surrounding each travel insurance policyDate airfare tickets purchased via One Travel website Nationwide Travel Protection certificate number Nationwide Travel Protection certificate purchase date Policy Effective Date Travel Date December 10, December 15, December 16, December 29, December 10, December 18, December 19, December 24, Ms [redacted] cancelled her family’s trip due to the illness of her daughter, [redacted] Medical documentation submitted reflects that Ms [redacted] ’s daughter became ill on December 15, and received medical treatment on December 17, Per the Nationwide Travel Protection insurance policy, when a trip is cancelled due to illness, the illness must be first diagnosed or treated by a physician after the effective date of insurance coverage and while coverage under the policy is still in[SO1] effect Under Certificate 31919753, [redacted] was treated after the effective date of coverage, resulting in payment of $However, [redacted] was treated prior to the effective date of coverage under Certificate 31940395, and as a result, the claim is not eligible for payment under this policy Policy language which is pertinent to this matter includes the following; Trip Cancellation The Company will reimburse You, up to the Maximum Benefit shown on the Confirmation of Coverage, if You are prevented from taking Your Trip for any of the following reasons that are Unforeseen and takes place after the Effective Date: Sickness, Accidental Injury or death of a Family Member or Traveling Companion, booked to travel with You, that results in medically imposed restrictions as certified by a Physician preventing that person’s participation in the Trip; Sickness means an illness or disease of the body that: 1) requires a physical examination and medical treatment by a Physician and 2) commences while Your coverage is in effect An illness or disease of the body that begins prior to the Effective Date of coverage is not a Sickness as defined herein and is not covered by this Certificate unless is suddenly worsens or becomes acute after the Effective DateEffective Date means 12:A.Mlocal time, at Your location, on the day after the required premium for such coverage is received by the Company or its authorized representativePlease understand that our action at this time should not be construed as a waiver of any and all rights and defenses which NMIC may have under the policy in question, and any applicable statutory or common law, all of where are hereby expressly reservedWe appreciate the opportunity to address Ms [redacted] ’s concerns Please contact this office should you have any further questions regarding this matterSincerely, Seven Corners, Inc [SO1] and while coverage under the policy is still in effect
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that the response would not resolve my complaint For your reference, details of the offer I reviewed appear belowI do not think Seven Corners considered that I was covered from August to December 31, (Certificate ID: [redacted] ) at the time the symptom happened and it was physically impossible for me to immediately go to a nearest provider as I was travelling at that timeThe August to December 31, coverage is the same group coverage I had from January to February 28, (Certificate ID: [redacted] )Both of these coverages are attached.If my claims are still denied after consideration of my coverage from August to December 2016, I will have to file a complaint against Seven Corners in the Indiana Department of Insurance and the Hawaii Department of Commerce Regards, [redacted] ***
February 26, [redacted] Revdex.com N Delaware Street #Indianapolis, IN 46204-RE: Complaint ID – [redacted] Complainant: [redacted] Dear Ms***: Seven Corners, Incis in receipt of Complaint ID Number [redacted] and sent to the attention of Dennis W [redacted] on February 22, The complainant, [redacted] , has expressed concerns with the handling of her recent claimsThis office has reviewed the file and the claims in question The member submitted invoices and receipts that were not legible Our Assistance Department promptly responded to Ms [redacted] , advising her of suchWe have been in direct contact with Ms [redacted] who has resubmitted her claims for reviewWe have advised her of what information is needed to continue our review 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