Realistic time for processing claim?

I bought trip insurance through insuremytrip.com and 17 days before we were to leave I ended up having emergency surgery. Our 30+ day cruise and land package needed to be cancelled. I submitted all the necessary paperwork including their form signed by the neurosurgeon, confirmation of payment, hospital records, itinerary, etc. In all, I faxed 100+ pages. Even though I am not claiming any reimbursement for tours we had planned (all were refunded or payment was due at time of tour) the insurance company is contacting tour operators for data. I had submitted confirmation of all tours cancelled and refunds. Even though I submitted my entire hospital record and their necessary form from the doctor, they are contacting the hospital and the doctor.

They requested more information from me (even though I had already submitted it) so I faxed another 32 pages. I made up a spreadsheet with my original fax showing item by item what the cost was, what we paid, what we were refunded and amount being claimed to the insurance company. All credit card statements, emails, airline tickets, cruise documentation was sent to them.

Once when I called I was told my information was forwarded to the claims department (after 6 weeks) and if I wanted they could "expedite it" - which I then requested.

It has been over 8 weeks and so far all I have received from them is a postcard saying they are in receipt of the information. When I call, I get someone who reads me the latest entry on the computer - which I can also access from home.

I realized early on that this is an agency who does claims processing for more than one travel insurance company.

For those who have submitted a claim, is this normal? When I first called to make the claim, I was told 10-15 working days once all information is obtained. We have far exceeded that. I do not want to be unrealistic or unreasonable and I understand they need to do their due diligence to confirm my claims for reimbursement. Yet this seems to be moving quite slowly.

Comments? Thoughts?

Complex cases (high dollar amounts with multiple expense types) generally take 2-3 months from the time paperwork is submitted. Usually that means the bulk of the paperwork, not including small additional requests, but not something major (such as failing to submit primary medical EOB with a medical claim, for example).

That said, if it has been eight weeks since they said they could expedite your claim, I would be on the phone every couple of days looking for an update, or at least some proof of 'progress'. It almost sounds as if they might be confused by all the information....it should be as simple as confirming this was not an excluded PEC and paying the cancellation costs.

Is this a third party provider or one of the cruiseline policies? If they continue to stall (cannot give you an update), I would file a complaint with your state insurance board.

I suggest communicating by email if you can get a contact email address. I had to file a claim for my parents and all communication was done by email. Papers I had faxed were scanned and also attached to emails. It created a good trail.

fWIW, it took several months to get reimbursement. At least a portion of the delay was doctors' offices taking a long time to complete paperwork and return it.

Complex cases (high dollar amounts with multiple expense types) generally take 2-3 months from the time paperwork is submitted. Usually that means the bulk of the paperwork, not including small additional requests, but not something major (such as failing to submit primary medical EOB with a medical claim, for example).

 

That said, if it has been eight weeks since they said they could expedite your claim, I would be on the phone every couple of days looking for an update, or at least some proof of 'progress'. It almost sounds as if they might be confused by all the information....it should be as simple as confirming this was not an excluded PEC and paying the cancellation costs.

 

Is this a third party provider or one of the cruiseline policies? If they continue to stall (cannot give you an update), I would file a complaint with your state insurance board.

Thank you for your thoughts. It is not a cruise line insurance provider but a stand alone one purchased through insuremytrip.com but being handled by an intermediary. It may be that the volume of information I supplied by the many facets of the trip/cruise has been overwhelming for them to sort through. I had the benefit of organizing so being part of the planning whereas they are coming in at the end and trying to sort through it. I will continue to be patient but place the occasional call to make sure my file stays active. If it drags on much longer, I like your suggestion of contacting the state insurance board. It is not an option I thought of.

I suggest communicating by email if you can get a contact email address. I had to file a claim for my parents and all communication was done by email. Papers I had faxed were scanned and also attached to emails. It created a good trail.

 

fWIW, it took several months to get reimbursement. At least a portion of the delay was doctors' offices taking a long time to complete paperwork and return it.

Good suggestion, too. I do have an email address (no direct phone number) as I received a letter requesting the additional information. I may resort to that route just to have a more complete paper trail.

Thank you for sharing your experience. This, fortunately, is my first time through this process. I want to stay on top of it but not be unrealistic.

When we had to cancel our planned Baltic cruise last May just two days before we were supposed to fly to AMS and sail 5 days later because of my own medical emergency it took almost 8 weeks to get the claim settled in full. It only happened that quickly because I called the people who sold me the policy, I called the insurance company constantly after the first month and would not the standard "we are very busy" reply. We cancelled on May 27, filed all of the necessary paper work on June 10, the day after my first doctor follow up/the first chance I had to get paperwork signed and we did not receive anything for another 6 weeks and then we spend 4 more weeks chasing the refund for our pre-paid AMS hotel stay. In the end, we got about 90% of what we paid covered but it was a long long battle. I am glad I had insurance but our replacement trip is insured with a different company contracted through a different web site and it was insured quickly after booking because I now have a pre-exisiting condition to deal with. You really need to stay on top of these people, both the people who sold the policy and people who issued the policy.

It may have been a coincidence, but my reimbursement seemed to speed up once I called to pointedly inquire what the delay was. Like you, I had faxed all the required paperwork and was fairly detailed about what each piece of documentation was in my cover letter. I would say it was about 5-6 weeks for me from the time I filed to get the reimbursement check.

The first time I complained about how slow the process was I got a lot of double talk, the second time I complained, after they lost a lot of my paperwork and never told me it was lost and after I went public here they got things moving. I put my original claim docs in the mail 12 days after we had to cancel, the day after my first follow up with my cardiologist where he signed off on my medical stuff. "cardiac cath on Wednesday, no way you were getting on a plane and then a ship a day later...". It is typical of most things in life, when people want your money they are very very attentive,when they owe you money... um not so much.

Finally received payment from our trip insurance claim. It took over 14 weeks, hours on the phone, faxed over 120 pages some of which was sent multiple times. Only after I got a supervisor involved at the claims processing center AND a supervisor at insuremytrip.com did things move along. I did not realize that the trip insurance has a third party administrator and therein lies the problem. You can never speak to the person processing your claim which results in endless delays. Truly the process was horrible, stressful and exhausting. And the reason we cancelled was because of my emergency surgery. Recovering from the surgery was bad enough but dealing with the claims processing certainly did nothing to help me recover.

Then once we got the check the explanation of payment took me forever to figure out. It was not entirely accurate which required more duplicate paperwork. In all fairness, ours was not a simple claim as it involved air fare, land tours with a cruise in between totalling about 6 weeks.

The good news, I am feeling much better and we were reimbursed almost to the dollar of what we submitted. I thought I had been thorough in my research before purchasing the insurance...shows one never knows!