Trip interruption insurance can save the day in many cases, but if you’re purchasing through a third-party travel agent, it’s still up to you to read, understand and verify the fine print.
Nikki Erinakis reports on two situations involving vacations that were cut short due to medical emergencies, and the travel insurance battles that followed.
Susan D. from Mapleton, Illinois encountered a long and frustrating battle with her travel insurance provider.
She and her husband purchased a six-day vacation package to Cancun through Apple Vacations, and had their vacation insured through Trip Mate. Before they left, Sue’s mother was hospitalized. Once she appeared to be improving, and with the advice from their travel agent that the insurance would cover an early return if necessary, the couple went ahead with their vacation.
Unfortunately, two days into the trip, Sue received a phone call from her family back home. Her mother’s condition was not improving and that the doctors did not think she would survive.
Sue made several unsuccessful attempts to reach her agent at Apple Vacations, and finally contacted Trip Mate to book a flight home. The couple made it back from Cancun quickly, and her mother survived, but remained hospitalized for about another three weeks.
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However, when Sue decided to file her claim with Trip Mate insurance, providing documentation and doctor’s reports, her claim was denied.
According to Trip Mate document, they denied the claim on the basis that they did not feel that her mother’s condition worsened while on her trip: “While we understand that [she] wanted to be present when her mother was taken off the respirator, we can not consider a condition that requires hospitalization prior to your trip and improves while coverage is in effect to have commenced while coverage is in effect.”
It was one word against another at this point, and Sue spent nearly two years pursuing this case. “I feel so very lied to by all involved,” writes Sue. “I feel cheated by Trip-Mate, my travel agency and my travel agent.”
It was only after her mother passed away that she contacted Peter Greenberg Worldwide to help.
When we contacted Trip Mate, they had the claim reopened by their insurance underwriters, who had an independent medical consultant review the file.
Know before you go: Tip: Questions To Ask When Buying Travel Insurance
The insurance providers agreed that Sue was entitled to payment in full to cover her trip-interruption costs.
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Nancy R. from Kalamazoo, Michigan purchased Travel Guard insurance through CheapOair.com. Her son, who was remaining at home, had spina bifida and Nancy, frequent business traveler, often purchased trip-interruption insurance in case she had to return unexpectedly.
When they spoke with a representative from CheapOair.com, she was informed that this type of insurance would make sense if she needed to cut short her trip.
While away, her son suffered from grand mal seizures and she quickly returned home. However, when the family filed their claim with Travel Guard, they were surprised to learn that their claim was denied.
They denied the claim on the basis of a pre-existing medical condition, something that was not made clear to the family when they purchased the insurance. This detail was outlined in the fine print of the insurance company’s contract.
According to Travel Guard, the pre-existing medical condition exclusion states:
“The Insurer will not pay for any Loss or expense incurred as the result of an Injury, Sickness or other condition of an Insured, Traveling Companion, Business Partner or Family Member which, within the 180 day period immediately preceding and including the Insured’s coverage effective date: (a) first manifested itself, worsened or became acute or had symptoms which would have prompted a person to seek diagnosis, care or treatment; (b) for which care or treatment was given or recommended by a Physician; (c) required taking prescription drugs or medicines, unless the condition for which the drugs or medicines are taken remains controlled without any change in the required prescription drugs or medicines.”
Initially, according to her son’s physician, he had received treatment within the 180-day window preceding the effective coverage date.
This crucial piece of information ended up being highly costly to the family. When the family contacted, CheapOair, the agent admitted in a letter, “We have no authority to either make decisions for the insurance company or reverse any decisions made by them.”
However, when we contacted Travel Guard on the family’s behalf, they had an arbitrator review the claim file. The initial review which included obtaining medical records showed her son’s history of seizures. However, with additional information provided to review, it was determined her early return for her son’s medical condition was not actually directly tied to her son’s pre-existing medical condition; it was considered a “new physical manifestation” for which she is covered.
After this review, Travel Guard was able to extend benefits, and the family receive full coverage for its out-of-pocket costs for the early return.
Travelers purchase insurance policies expecting that their out-of-pocket expenses will be covered in case of emergency. However, getting that claim approved is not always easy.
Here are a few tips to keep in mind when purchasing your travel insurance policy:
- Although travel agents can be helpful mediators in purchasing travel insurance, don’t assume they have all the facts on hand. It’s up to you to speak with a representative at the travel insurance company and, if it makes sense, purchase the policy yourself.
- If there are potential scenarios you are concerned about, outline them to the agent to confirm whether your particular policy will cover it.
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- Find out whether there is the option for a pre-existing medical condition waiver in your policy. Generally, for these waivers to apply, you have to purchase the policy within a certain window of paying for the trip in full, often within 14 days.
- When it comes down to filing a claim, your travel agent’s words won’t have much impact. However, getting written confirmation of a policy’s conditions and exclusions directly from the insurance provider can make a difference. They have a responsibility to provide accurate information.
- Create a paper trail of your interactions between you and your insurance representative. An oral agreement may possibly be disputed, but written agreements are more binding.
- Ask your representative if they accept and read emails or facsimiles. If you are unsure of certain policy, or feel they are not explaining the coverage correctly, let them know through a medium that requires writing. Recount what was explained to you over the phone, and ask for verification.
- Keep in mind, when buying travel insurance, you are buying from a privately owned company that has a profit motive. It’s up to you to know and understand your rights so if you have to fight for your claim, you’re armed with as much information as possible.
By Nikki Erinakis for PeterGreenberg.com.
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