The policy excludes losses due to pre-existing health conditions and we needed medical information The medical provider told us they would only release medical information pursuant to an authorization signed by the executor of the decedent’s estate Upon further discussion the provider has agreed to give us the medical records pursuant to the authorization signed by the decedent’s son and the death certificate We sent those documents to the provider on 1/29/and told the insured the status of their claim
Complaint: [redacted] I am rejecting this response because: The Plan/Policy # [redacted] , a plan covered by the TRAVEL INSURED INTERNATIONAL, FOR TRIP DATE OF 11/27/WITH INITIAL DEPOSIT DATED 04/16/2016, I have not received any payment of any sort for this claim In fact, Kathy the company's representative is aware of this fact that the payment was never issued and to this day rejected for no obvious reason Most likely, this company is confused with another claim or better yet, these are deceitful tactics they utilize to conveniently and in a self-serving fashion evade paying the claimI HAVE EMAIL COMMUNICATIONS WITH THIS COMPANY TO THE FACT THAT THIS CLAIM WAS NOT PAID.If they have issued a check, this check was never cashed by me If they issued a check this check MUST have a reference number to the policy number Please provide a copy of this check Sincerely, [redacted]
The insured called our call center on November 5, 2014, and applied for the policy She told our customer service representative (CSR) that she was concerned about her mother’s health Our CSR explained the pre-existing condition exclusion, namely, that the policy would not cover any condition for which medical care, treatment or advice was given within the day period immediately prior to the effective date of coverage (11/6/14) Our CSR also discussed the day free look The insured called our call center on November 15, 2014, and spoke to a different CSR and explained that her fiancé was ill and she needed to either request a premium refund or file a claim for trip cancellationThe CSR told her that a fiancé is covered 0ur claims department declined the claim explaining that a fiancé was not a covered family member The medical report from the fiancé attending physician showed there was medical treatment in October, and the claim was declined pursuant to the pre-existing condition exclusion Since the insured called us within the day free look period and expressed an interest in the premium refund if the claim was not payable, we will issue a credit to her credit card for a full refund of premium
Complaint: [redacted] I am rejecting this response because: The explanation was not provided until after the purchase I would like a full refund on the premium costs of $if not payable Sincerely, [redacted]
RevDex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution is satisfactory to me. Sincerely, [redacted] ***
The insured cancelled his trip due to illness and filed a claim for trip cancellation benefitsOn January 23rd, 2017, the insured called in with questions about the pricing of policiesOur Customer Care Representative (CSR) quoted prices for several policies and he (the Customer) said he was reviewing policies online and was interested in a policy for $ Our CSR advised that we have a Lite policy with a $trip cost for $The CSR explained the coverage and clearly told him his trip cost would not be covered under this policy and he agreed to purchase this policyThe Confirmation of Benefit and policy were emailed to the insured immediately upon purchaseThe Policy has a Fourteen Day Look that gave the insured a right to cancel the policy and request a premium refund if he was unsatisfied with the policy for any reasonThat right was not exercised within the required time frameThe Schedule of Benefits in the policy states the Maximum Limit for Trip Cancellation is the Trip Cost [redacted] (Not applicable when $Trip Cost displayed on Your Confirmation of Benefits) Since the Trip Cost displayed on the Confirmation of Benefits is $0, the Trip Cancellation benefit is not applicable and no benefit is payable
Re: [redacted] ID # [redacted] Plan # [redacted] Travel Insured International has agreed to refund the insurance premium in full ($150.00) Please allow 10-days for the check to arrive.Thank you
The Customer purchased a plan on 12-01-for a trip departing 01-30- and returning 02-03- The Customer called on 01-20-to initiate a claim under the plan The Customer was cancelling due to the recent CDC travel warning regarding the Zika Virus However, cancellation due to the travel alert is not a covered reason under the insured’s plan
Travel Insured International (TII), is the claims administrator for the travel plan that includes short-term travel insurance benefits underwritten by United States Fire Insurance Company, and we appreciate the opportunity to address the insureds concernsOur records indicate that the insured
purchased their travel arrangements and obtained their travel protection plan, the *** *** *** directly from a *** travel agency/tour operator, *** *** In their complaint, the insured is requesting reimbursement for the trip purchased because it was cancelled due to the fact that *** *** has apparently ceased all of its operations and they have submitted a claim under the *** *** *** plan for reimbursement. As we will explain in more detail below, a trip cancellation that was caused due to *** *** ceasing its operations is not an eligible covered reason under the plan issued to the insured. The *** *** *** plan provides Trip Cancellation benefits when the trip is cancelled due to a covered reason as defined in the plan. The *** *** *** plan reads, in its applicable part that: COVERAGE ATRIP CANCELLATION “Benefits will be paid, up to the Maximum Benefit Amount shown in the Confirmation of Benefits, to reimburse You for the amount of the Published Penalties and unused non-refundable Prepaid Payments You paid for the Travel Arrangements when You are prevented from taking Your Trip due to … “Bankruptcy or Default of an airline, cruise line, tour operator or other travel provider (other than the Travel Supplier, tour operator, travel agency, organization or firm from whom You purchased Your Travel Arrangements) causing a complete cessation of travel services more than days following Your Effective DateBenefits will be paid due to Bankruptcy or Default of an airline only if no alternate transportation is available.” As noted above, the insured purchased coverage from *** ***. Per the plan language quoted above, a trip cancellation caused by the Bankruptcy or Default of the travel agency or tour operator from whom coverage was purchased is not covered under the plan. Please note that the plan purchased does provide coverage for the reissue fee charged by the airlines as defined in the Trip Cancellation provision which states: “If Your Travel Supplier cancels Your Trip, a benefit will be paid for the reissue fee charged by the airline for the tickets”. However, since the airline tickets were not issued they are unable to be changed and therefore benefits are not payable Based on the foregoing, no benefits for this Trip Cancellation are payable under the plan issued to the insuredWe are sorry for the disappointing situation that has occurred as a result of the actions of *** *** and that the claimant was not satisfied with the outcome of the claim. However, we, as claims administrator, are required to adjudicate all claims in accordance with the terms and conditions of the applicable plan As an accommodation, we are willing to provide the insured with a refund for the travel protection plan purchased in connection with their trip in the amount of $268, which represents the plan cost paidThe refund will be mailed to the insured
We appreciate the opportunity to review the file again
Under the circumstances, although some of the expenses the insured is claiming
are not covered, we are willing to reimburse them
We apologize for the
miscommunication, the Change Fee benefit is not applicable for this claim Under the Itinerary Change benefit, the insured's policy states: In the event the travel supplier makes a change in an insured's trip itinerary after their scheduled departure date, which prevents the insured from participating in an event/activity prepaid prior to departure and scheduled on the insured's trip itinerary, non-refundable prepaid event/activity expenses will be payable up to the maximum benefit amount shown in the Confirmation of Benefits. The insured's cruise itinerary was changed but it did not prevent him from participating in any prepaid event/activity The difference in cruise fare for his original cruise and the cruise that he actually took is not refundable under the plan
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me
Sincerely,
*** ***
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID *** and find that this resolution is satisfactory to me
Sincerely,
*** ***
The
insured’s policy provides Trip Cancellation/ Trip Interruption benefits for a terrorist
incident that occurs in a city listed on the itinerary within days prior to
the scheduled departure date
The policy
defines a terrorist incident as an incident deemed an act of terrorism by
the
U.SGovernment
The event
that caused the insured’s interruption of his trip was not deemed an act of
terrorism by the U.SGovernment; therefore, benefits are not payable
*** *** spoke to our customer care representative (CSR) on 4/10/16. He did not tell our CSR that his father was receiving medical treatment and our CSR did not tell him that if any party member couldn’t go for any reason, his ticket cost would be refunded. The Confirmation of
Benefits and Plan document were sent to *** *** via email on 4/10/16. The Plan Document tells the insured to read the document carefully and if not satisfied to request a premium refund within days. *** *** did not request a premium refund within that period The Plan excludes losses due to a pre-existing health conditionA pre-existing condition is defined as an illness, disease, or other condition during the day period immediately prior to the date Your coverage is effective for which You or Your Traveling Companion, Business Partner or a Family Member : 1)received or received a recommendation for a test, examination, or medical treatment for a condition which first manifested itself, worsened or became acute or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment; or 2) took or received a prescription for drugs or medicine According to the documentation submitted, there was treatment for the condition on 4/1/Since this is within the days prior to the 4/11/ effective date, the condition is pre-existing as defined in the planSince pre-existing conditions are excluded, benefits are not payable
Thank you for the opportunity to review the claim documentationUpon receipt of additional documentation, we have reimbursed the insureds claim for the penalty amount of $
Travel Insured International (TII), is the claims administrator for the travel plan that includes short-term travel insurance benefits underwritten by United States Fire Insurance Company, and we appreciate the opportunity to address the insureds concernsOur records indicate that the insured
purchased their travel arrangements and obtained their travel protection plan, the Worldwide Trip Protector directly from a Florida travel agency/tour operator, *** *** In their complaint, the insured is requesting reimbursement for the trip purchased because it was cancelled due to the fact that Legendary Tours has apparently ceased all of its operations and they have submitted a claim under the Worldwide Trip Protector plan for reimbursement. As we will explain in more detail below, a trip cancellation that was caused due to *** *** ceasing its operations is not an eligible covered reason under the plan issued to the insured. The Worldwide Trip Protector plan provides Trip Cancellation benefits when the trip is cancelled due to a covered reason as defined in the plan. The Worldwide Trip Protector plan reads, in its applicable part that: COVERAGE ATRIP CANCELLATION “Benefits will be paid, up to the Maximum Benefit Amount shown in the Confirmation of Benefits, to reimburse You for the amount of the Published Penalties and unused non-refundable Prepaid Payments You paid for the Travel Arrangements when You are prevented from taking Your Trip due to … “Bankruptcy or Default of an airline, cruise line, tour operator or other travel provider (other than the Travel Supplier, tour operator, travel agency, organization or firm from whom You purchased Your Travel Arrangements) causing a complete cessation of travel services more than days following Your Effective DateBenefits will be paid due to Bankruptcy or Default of an airline only if no alternate transportation is available.” As noted above, the insured purchased coverage from *** ***. Per the plan language quoted above, a trip cancellation caused by the Bankruptcy or Default of the travel agency or tour operator from whom coverage was purchased is not covered under the plan. Please note that the plan purchased does provide coverage for the reissue fee charged by the airlines as defined in the Trip Cancellation provision which states: “If Your Travel Supplier cancels Your Trip, a benefit will be paid for the reissue fee charged by the airline for the tickets”. However, since the airline tickets were not issued they are unable to be changed and therefore benefits are not payable Based on the foregoing, no benefits for this Trip Cancellation are payable under the plan issued to the insuredWe are sorry for the disappointing situation that has occurred as a result of the actions of *** *** and that the claimant was not satisfied with the outcome of the claim. However, we, as claims administrator, are required to adjudicate all claims in accordance with the terms and conditions of the applicable plan As an accommodation, we provided the insured with a refund for the travel protection plan purchased in connection with their trip in the amount of $on 1/23/18, which represents the plan cost paid
The initial claim notice did not give us
sufficient information and on 12/9/14, we sent an e-mail to the tour operator
requesting additional information. We sent a second e-mail on 12/23/14,
and on 1/14/15, we called the tour operator and then called the insured
and told him that the
claim for $was approved. The claim check was
mailed on 1/15/
The policy excludes losses due to pre-existing health conditions and we needed medical information The medical provider told us they would only release medical information pursuant to an authorization signed by the executor of the decedent’s estate Upon further discussion the provider has agreed to give us the medical records pursuant to the authorization signed by the decedent’s son and the death certificate We sent those documents to the provider on 1/29/and told the insured the status of their claim
Complaint: [redacted] I am rejecting this response because: Sincerely, [redacted]
Complaint: [redacted] I am rejecting this response because: The Plan/Policy # [redacted] , a plan covered by the TRAVEL INSURED INTERNATIONAL, FOR TRIP DATE OF 11/27/WITH INITIAL DEPOSIT DATED 04/16/2016, I have not received any payment of any sort for this claim In fact, Kathy the company's representative is aware of this fact that the payment was never issued and to this day rejected for no obvious reason Most likely, this company is confused with another claim or better yet, these are deceitful tactics they utilize to conveniently and in a self-serving fashion evade paying the claimI HAVE EMAIL COMMUNICATIONS WITH THIS COMPANY TO THE FACT THAT THIS CLAIM WAS NOT PAID.If they have issued a check, this check was never cashed by me If they issued a check this check MUST have a reference number to the policy number Please provide a copy of this check Sincerely, [redacted]
The insured called our call center on November 5, 2014, and applied for the policy She told our customer service representative (CSR) that she was concerned about her mother’s health Our CSR explained the pre-existing condition exclusion, namely, that the policy would not cover any condition for which medical care, treatment or advice was given within the day period immediately prior to the effective date of coverage (11/6/14) Our CSR also discussed the day free look The insured called our call center on November 15, 2014, and spoke to a different CSR and explained that her fiancé was ill and she needed to either request a premium refund or file a claim for trip cancellationThe CSR told her that a fiancé is covered 0ur claims department declined the claim explaining that a fiancé was not a covered family member The medical report from the fiancé attending physician showed there was medical treatment in October, and the claim was declined pursuant to the pre-existing condition exclusion Since the insured called us within the day free look period and expressed an interest in the premium refund if the claim was not payable, we will issue a credit to her credit card for a full refund of premium
Complaint: [redacted] I am rejecting this response because: The explanation was not provided until after the purchase I would like a full refund on the premium costs of $if not payable Sincerely, [redacted]
RevDex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution is satisfactory to me. Sincerely, [redacted] ***
The insured cancelled his trip due to illness and filed a claim for trip cancellation benefitsOn January 23rd, 2017, the insured called in with questions about the pricing of policiesOur Customer Care Representative (CSR) quoted prices for several policies and he (the Customer) said he was reviewing policies online and was interested in a policy for $ Our CSR advised that we have a Lite policy with a $trip cost for $The CSR explained the coverage and clearly told him his trip cost would not be covered under this policy and he agreed to purchase this policyThe Confirmation of Benefit and policy were emailed to the insured immediately upon purchaseThe Policy has a Fourteen Day Look that gave the insured a right to cancel the policy and request a premium refund if he was unsatisfied with the policy for any reasonThat right was not exercised within the required time frameThe Schedule of Benefits in the policy states the Maximum Limit for Trip Cancellation is the Trip Cost [redacted] (Not applicable when $Trip Cost displayed on Your Confirmation of Benefits) Since the Trip Cost displayed on the Confirmation of Benefits is $0, the Trip Cancellation benefit is not applicable and no benefit is payable
Re: [redacted] ID # [redacted] Plan # [redacted] Travel Insured International has agreed to refund the insurance premium in full ($150.00) Please allow 10-days for the check to arrive.Thank you
The Customer purchased a plan on 12-01-for a trip departing 01-30- and returning 02-03- The Customer called on 01-20-to initiate a claim under the plan The Customer was cancelling due to the recent CDC travel warning regarding the Zika Virus However, cancellation due to the travel alert is not a covered reason under the insured’s plan
Travel Insured International (TII), is the claims administrator for the travel plan that includes short-term travel insurance benefits underwritten by United States Fire Insurance Company, and we appreciate the opportunity to address the insureds concernsOur records indicate that the insured
purchased their travel arrangements and obtained their travel protection plan, the *** *** *** directly from a *** travel agency/tour operator, *** *** In their complaint, the insured is requesting reimbursement for the trip purchased because it was cancelled due to the fact that *** *** has apparently ceased all of its operations and they have submitted a claim under the *** *** *** plan for reimbursement. As we will explain in more detail below, a trip cancellation that was caused due to *** *** ceasing its operations is not an eligible covered reason under the plan issued to the insured. The *** *** *** plan provides Trip Cancellation benefits when the trip is cancelled due to a covered reason as defined in the plan. The *** *** *** plan reads, in its applicable part that: COVERAGE ATRIP CANCELLATION “Benefits will be paid, up to the Maximum Benefit Amount shown in the Confirmation of Benefits, to reimburse You for the amount of the Published Penalties and unused non-refundable Prepaid Payments You paid for the Travel Arrangements when You are prevented from taking Your Trip due to … “Bankruptcy or Default of an airline, cruise line, tour operator or other travel provider (other than the Travel Supplier, tour operator, travel agency, organization or firm from whom You purchased Your Travel Arrangements) causing a complete cessation of travel services more than days following Your Effective DateBenefits will be paid due to Bankruptcy or Default of an airline only if no alternate transportation is available.” As noted above, the insured purchased coverage from *** ***. Per the plan language quoted above, a trip cancellation caused by the Bankruptcy or Default of the travel agency or tour operator from whom coverage was purchased is not covered under the plan. Please note that the plan purchased does provide coverage for the reissue fee charged by the airlines as defined in the Trip Cancellation provision which states: “If Your Travel Supplier cancels Your Trip, a benefit will be paid for the reissue fee charged by the airline for the tickets”. However, since the airline tickets were not issued they are unable to be changed and therefore benefits are not payable Based on the foregoing, no benefits for this Trip Cancellation are payable under the plan issued to the insuredWe are sorry for the disappointing situation that has occurred as a result of the actions of *** *** and that the claimant was not satisfied with the outcome of the claim. However, we, as claims administrator, are required to adjudicate all claims in accordance with the terms and conditions of the applicable plan As an accommodation, we are willing to provide the insured with a refund for the travel protection plan purchased in connection with their trip in the amount of $268, which represents the plan cost paidThe refund will be mailed to the insured
We appreciate the opportunity to review the file again
Under the circumstances, although some of the expenses the insured is claiming
are not covered, we are willing to reimburse them
We apologize for the
miscommunication, the Change Fee benefit is not applicable for this claim Under the Itinerary Change benefit, the insured's policy states: In the event the travel supplier makes a change in an insured's trip itinerary after their scheduled departure date, which prevents the insured from participating in an event/activity prepaid prior to departure and scheduled on the insured's trip itinerary, non-refundable prepaid event/activity expenses will be payable up to the maximum benefit amount shown in the Confirmation of Benefits. The insured's cruise itinerary was changed but it did not prevent him from participating in any prepaid event/activity The difference in cruise fare for his original cruise and the cruise that he actually took is not refundable under the plan
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me
Sincerely,
*** ***
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID *** and find that this resolution is satisfactory to me
Sincerely,
*** ***
The
insured’s policy provides Trip Cancellation/ Trip Interruption benefits for a terrorist
incident that occurs in a city listed on the itinerary within days prior to
the scheduled departure date
The policy
defines a terrorist incident as an incident deemed an act of terrorism by
the
U.SGovernment
The event
that caused the insured’s interruption of his trip was not deemed an act of
terrorism by the U.SGovernment; therefore, benefits are not payable
*** *** spoke to our customer care representative (CSR) on 4/10/16. He did not tell our CSR that his father was receiving medical treatment and our CSR did not tell him that if any party member couldn’t go for any reason, his ticket cost would be refunded. The Confirmation of
Benefits and Plan document were sent to *** *** via email on 4/10/16. The Plan Document tells the insured to read the document carefully and if not satisfied to request a premium refund within days. *** *** did not request a premium refund within that period The Plan excludes losses due to a pre-existing health conditionA pre-existing condition is defined as an illness, disease, or other condition during the day period immediately prior to the date Your coverage is effective for which You or Your Traveling Companion, Business Partner or a Family Member : 1)received or received a recommendation for a test, examination, or medical treatment for a condition which first manifested itself, worsened or became acute or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment; or 2) took or received a prescription for drugs or medicine According to the documentation submitted, there was treatment for the condition on 4/1/Since this is within the days prior to the 4/11/ effective date, the condition is pre-existing as defined in the planSince pre-existing conditions are excluded, benefits are not payable
Thank you for the opportunity to review the claim documentationUpon receipt of additional documentation, we have reimbursed the insureds claim for the penalty amount of $
We apologize for the misunderstandingIf the insured will submit documentation confirming her allegations of being charged twice, we can review further
Travel Insured International (TII), is the claims administrator for the travel plan that includes short-term travel insurance benefits underwritten by United States Fire Insurance Company, and we appreciate the opportunity to address the insureds concernsOur records indicate that the insured
purchased their travel arrangements and obtained their travel protection plan, the Worldwide Trip Protector directly from a Florida travel agency/tour operator, *** *** In their complaint, the insured is requesting reimbursement for the trip purchased because it was cancelled due to the fact that Legendary Tours has apparently ceased all of its operations and they have submitted a claim under the Worldwide Trip Protector plan for reimbursement. As we will explain in more detail below, a trip cancellation that was caused due to *** *** ceasing its operations is not an eligible covered reason under the plan issued to the insured. The Worldwide Trip Protector plan provides Trip Cancellation benefits when the trip is cancelled due to a covered reason as defined in the plan. The Worldwide Trip Protector plan reads, in its applicable part that: COVERAGE ATRIP CANCELLATION “Benefits will be paid, up to the Maximum Benefit Amount shown in the Confirmation of Benefits, to reimburse You for the amount of the Published Penalties and unused non-refundable Prepaid Payments You paid for the Travel Arrangements when You are prevented from taking Your Trip due to … “Bankruptcy or Default of an airline, cruise line, tour operator or other travel provider (other than the Travel Supplier, tour operator, travel agency, organization or firm from whom You purchased Your Travel Arrangements) causing a complete cessation of travel services more than days following Your Effective DateBenefits will be paid due to Bankruptcy or Default of an airline only if no alternate transportation is available.” As noted above, the insured purchased coverage from *** ***. Per the plan language quoted above, a trip cancellation caused by the Bankruptcy or Default of the travel agency or tour operator from whom coverage was purchased is not covered under the plan. Please note that the plan purchased does provide coverage for the reissue fee charged by the airlines as defined in the Trip Cancellation provision which states: “If Your Travel Supplier cancels Your Trip, a benefit will be paid for the reissue fee charged by the airline for the tickets”. However, since the airline tickets were not issued they are unable to be changed and therefore benefits are not payable Based on the foregoing, no benefits for this Trip Cancellation are payable under the plan issued to the insuredWe are sorry for the disappointing situation that has occurred as a result of the actions of *** *** and that the claimant was not satisfied with the outcome of the claim. However, we, as claims administrator, are required to adjudicate all claims in accordance with the terms and conditions of the applicable plan As an accommodation, we provided the insured with a refund for the travel protection plan purchased in connection with their trip in the amount of $on 1/23/18, which represents the plan cost paid
The initial claim notice did not give us
sufficient information and on 12/9/14, we sent an e-mail to the tour operator
requesting additional information. We sent a second e-mail on 12/23/14,
and on 1/14/15, we called the tour operator and then called the insured
and told him that the
claim for $was approved. The claim check was
mailed on 1/15/