Travel Insured International, Inc.

According to the Trip Cancellation claim form submitted, the reason for cancellation was due to a nervous breakdownThe plan excludes losses due to mental or nervous conditions,
unless
hospitalized and since the Attending Physician’s Statement (APS) did not
show a diagnosis we requested the physician’s office notesWe were told that
there are no notes for the dates of treatment shown on the APS. The plan
requires treatment at the time of cancellation.
We will review this claim when we receive any additional medical
information that identifies the diagnosis and the dates of treatment

I was travelling for work reasons and my employer needed to cancel my flightI submitted a claim and TRAVEL INSURED INTERNATIONAL sent me a check in few daysAll the process took business days (From the day I claimed until I received the check on the mail)

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
class="MsoNormal">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

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

minor-bidi;">The policy excludes losses
due to pre-existing health conditions; however, that exclusion does not apply
if the loss is due to death ensuing from a pre-existing conditionOur claim
analyst overlooked this distinction and we apologize for any inconvenience we
may have caused
We will send a check for
$to the insured tomorrow

We have received the requested documentation and on October
23, 2015, we told Ms*** that we will pay her claim. A check for $will be
mailed to her
today
We sincerely apologize for any inconvenience this delay may
have caused

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

Complaint: ***You are correct, that is in the brochure and I had just failed to read that part Based on that I guess you can close the claim - BUT the claim is not resolved How did I know in June that I would change my mind in July? I paid for a trip that I did not take You were notified BEFORE the trip that I was not going so I still, and always will, feel I'm due my money back GOODBYE
Sincerely,
*** *** ***

*** *** 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

April 16,
"background: white; margin: 0in 0in 0pt; text-indent: 0in;">
Complaint ID # [redacted]
The customer submitted a claim
for
Trip Cancellation benefits under the
[redacted]Upon review of the information provided
we have determined the claim is not payable as there was no medical treatment
at the time of cancellation on 1/2/
Although sickness is a listed
covered reason, the policy requires treatment from a legally certified
physician at the time of cancellationThe customer cancelled the trip on
1/2/and the only dates of treatment we received near that date were 11/20/
and 12/4/
The analyst spoke to customer on
4/13/and discussed what is needed for further review of the claimCustomer advised
that she would obtain additional documentation from the treating physician
showing that treatment was ongoing and that it was medically necessary to
cancel the trip on 1/2/
Travel Insured
has not received the requested documentation

Complaint: [redacted]
I am rejecting this response because:  not all of the claims have been...

paid, I resent the info they overlooked & also some further claims.  When all is paid I will be satisfied.
Sincerely,
[redacted]

The Cancel for Any Reason benefit provides reimbursement
if the plan is purchased within 21 days of the deposit for...

the trip or full
trip payment.
The plan was purchased via the website [redacted]. 
The website states the Cancel for Any Reason coverage is
available if you purchase your plan within 21 days after making your initial
trip payment.  If you enter in a date of
deposit more than 21 days prior, the website states that the coverage is not
available.
The date of deposit on the application entered was 12/14/14.
Upon review of the claim, the actual deposit date was 11/17/14, disqualifying
the Cancel for Any Reason coverage.
The reason for cancellation is unfortunately not a
covered reason under the plan; therefore, no benefits are payable.

Re: [redacted]
ID #[redacted]
Plan #
[redacted]
Travel Insured International has agreed to refund the insurance premium in full ($150.00).  Please allow 10-12 days for the check to arrive.
Thank you.

Complaint:[redacted]
I am rejecting this response because:
As of January 1, 2014 health insurance companies are BARRED from declining people coverage due to a pre-existing condition. Why your organization, as a TRAVELERS insurance, feels it is within your right to continue this archaic practice is beyond me. And as I have said many times; My father in law WAS NOT AWARE he was ill until he DIED.  He received no treatment for his illness. He was admitted into the hospital and he DIED less than a week later.I did receive an update that they said they not have received the medical records and that our claim is being expedited, of which I am grateful. for. I am eager to see how this will be concluded. 
Sincerely,[redacted]

January 22,...

2016
Complaint ID [redacted]
The
customer submitted a claim for






Trip Interruption benefits under the








Worldwide Trip Protector Plan.
The
trip interruption benefit reimburses up to 150% of the total amount of coverage
purchased.
Per
the
confirmation of benefits the customer insured a trip cost of $2 and is
covered for a maximum trip cost of $250.  The plan was purchased by the customer
online through [redacted]. The confirmation of benefits was sent to the customer the
same day the plan was purchased. When asked, the customer
acknowledged receipt of this document showing the $2 trip cost insured.
Therefore,
based on this information the maximum amount payable for the additional
transportation expenses under Trip Interruption is $375. Unfortunately, the customer is
not
eligible for further reimbursement.

Complaint: [redacted]
I am rejecting this response because:WHAT YOUR STATING THAT NCL DID WAS NEVER EXPLAINED TO ANYONE DURING THE PROCESS. IF THE $250.00 WAS A GOOD WILL CREDIT FOR [redacted], IT SHOULD BE REISSUSED  TO [redacted] IN GOODWILL IF I'M UNABLE TO TRAVEL BECAUSE OF ILLNESS. 
Sincerely,
[redacted]

December
29, 2014
 
Re: [redacted]
ID
#[redacted]
Plan
# [redacted]
 
 
Ms. [redacted] submitted a claim for
Trip Cancellation benefits under her [redacted] Deluxe Ticket Protector Plan. Upon review of the
information provided we have determined that her claim is not payable.
 
Ms. [redacted]’s claim was first created on
August 18, 2014 due to employer termination. Claim forms were then emailed the
same day as there is coverage if the insured is prevented from taking or
continuing the covered trip if the insured's or insured’s traveling companion
are laid off from employment.
 
On October 2, 2014, we received her
claim forms along with the supporting information. Under the brief explanation
for the circumstances of Ms. [redacted]’s claim, she indicated she canceled her
trip due to the illness of her teammate canine and removed from the world
championship team. She also indicated her canine is a registered emotional support
animal that without it she cannot fly.
 
This reason was not consistent with the one
provided when her claim was first initiated. Claims Analyst [redacted] contacted Ms. [redacted] on October 10, 2014 to discuss the reason for her claim.
She stated the event was canceled and she was taken off of the championship
team. Her dog was ill and so she canceled her trip. When the Analyst inquired
about the employment termination reason, Ms. [redacted] stated she chose to leave
her job due to unpleasant circumstances. Ms. [redacted] did not want to pursue her
claim under employer termination. Ms. [redacted] was then advised there were
covered reasons for cancellation under her policy and an illness of her canine
is not a covered traveling companion as defined in the policy. She responded
that she would be contacting her lawyer and will continue to pursue the appeal
until the claim is paid.
 
A copy of her policy along with her original
declination letter was emailed to her by the Analyst on December 18, 2014. The
Analyst pointed out that the policy’s document lists the covered reasons for
Trip Cancellation and the policy’s definition of a traveling companion means a
person.  She was advised her canine
traveling companion, even though it was an emotional support animal, is not a
covered reason. Unfortunately, the illness of an animal is not a covered reason
for cancellation and was advised that was the reason for her denial. She was
encouraged to submit additional information if she felt our information was
incorrect.

The
plan purchased provides benefits for trip cancellation and/or trip interruption
if a terrorist incident occurs in a city listed on the...

itinerary of the covered
trip and within 30 days prior to the scheduled departure date. The terrorist
incident must occur after the effective date of the trip cancellation coverage.
 
The
policy defines a terrorist incident as an incident deemed an act of terrorism
by the U.S. Government.
 
Although
[redacted] itself is named a terrorist group, the U.S. Government has not deemed any
of the events as terrorist incidents.
 
The
option cancel for any reason benefit was purchased, but interrupt for any
reason is not an option. In order to qualify for benefits under the cancel for
any reason, the insured must be prevented from departing for the covered trip
for all reasons up to 48 hours prior to departure. Since the insured already
departed on her trip, this benefit is not applicable.

Re:
[redacted]
ID #[redacted]
Plan #
[redacted]
The
insured purchased a plan via the internet on 2/23/15 for travel dates
3/1/15-38/15.
Immediately
following the purchase of the insurance plan, the Certificate of Insurance and Confirmation
of Benefits were emailed to the insured at [redacted].
The certificate of insurance states: “Trip Cancellation:
Coverage begins at 12:01 a.m. on the day after the date the appropriate premium
for this Policy for Your Trip is received by the Company or its authorized
representative prior to the scheduled departure time on the Scheduled Departure
Date of Your Trip. This is Your “Effective Date” and time for Trip
Cancellation.” 
The effective date
of the insureds plan is 2/24/15. According to the cruise line, the insured
cancelled her cruise on 2/23/15. Since the cancellation was prior to the
coverage being in effect, benefits are not payable.
We are not able to
locate any phone calls with the phone number provided. If the insured is able
to provide a date she contacted us and the phone number called from, we can
certainly look into her allegations further.

The
plan provides trip cancellation benefits for a sickness which necessitates medical treatment at the time of
cancellation and results in medically imposed restrictions, as...

certified by a
Legally Qualified Physician, which prevents the insureds participation in the
covered trip. There was no documentation from a legally qualified physician
certifying that a sickness resulted in medically imposed restrictions;
therefore, benefits are not payable.
 Under the Cancel For Any Reason benefit the insured must
be prevented from taking the covered trip for all reasons up to 48 hours prior
to departure.  Since the incident did not
occur 48 hours prior to departure, benefits are not payable.