Claim denied...what other avenues to I have?

[hallpau]

We were on the Holland America 2020 World cruise that was terminated half way through the cruise in Perth, Australia in March.  I filed our original claim early for all our losses but was able to negotiate refunds from most of our travel suppliers and reduced our claim considerably.  A group of us had booked an independent safari with a tour operator in Africa that we had to cancel since we didn't make it to Africa and we were within the 100% cancellation penalty with the tour operator (although they did go the "extra mile" and was able to refund about 25% of our money).  The other people in our group received payment from their travel insurance providers but our travel insurance provider denied our claim for the remaining 75% we had paid for our safari package.  I put numerous hours into uploading documentation, resubmitting a revised claim (per request from the claims analyst) and finally had to prepare an appeal letter.  But all of these was to no avail and my claim was denied except for a small amount the appeal manager approved under "itinerary change."  

I purchased this coverage in June 2018 for our 2020 World cruise and have read and reread the Plan Document and Confirmation of Benefits that was sent to me and I can't find anything that would justify them denying my claim.  Our travel agency that we bought our policy through has reached out to the sales rep and his reply was: they can’t pay due to boarder (their spelling but I think they mean border??) closures, it’s not in their filing" whatever that really means?

Do you have any recommendations as to what my next steps could be or do I need to take my loss and learn an expensive lesson?

[iamtrustworthy]

6 hours ago, hallpau said:

We were on the Holland America 2020 World cruise that was terminated half way through the cruise in Perth, Australia in March.  I filed our original claim early for all our losses but was able to negotiate refunds from most of our travel suppliers and reduced our claim considerably.  A group of us had booked an independent safari with a tour operator in Africa that we had to cancel since we didn't make it to Africa and we were within the 100% cancellation penalty with the tour operator (although they did go the "extra mile" and was able to refund about 25% of our money).  The other people in our group received payment from their travel insurance providers but our travel insurance provider denied our claim for the remaining 75% we had paid for our safari package.  I put numerous hours into uploading documentation, resubmitting a revised claim (per request from the claims analyst) and finally had to prepare an appeal letter.  But all of these was to no avail and my claim was denied except for a small amount the appeal manager approved under "itinerary change."  

I purchased this coverage in June 2018 for our 2020 World cruise and have read and reread the Plan Document and Confirmation of Benefits that was sent to me and I can't find anything that would justify them denying my claim.  Our travel agency that we bought our policy through has reached out to the sales rep and his reply was: they can’t pay due to boarder (their spelling but I think they mean border??) closures, it’s not in their filing" whatever that really means?

Do you have any recommendations as to what my next steps could be or do I need to take my loss and learn an expensive lesson?

Hi hallpau,

 

I'm sorry to hear about your trouble. Which exact policy did you have? And, where did you buy it from?

 

Steve Dasseos

[hallpau]

Hi Steve,

 

I purchased the insurance through my travel agency that I book my cruises with.  The insurance is with Travel Insured International and the plan is their Worldwide Trip Protector - FL.

 

Thank you for any advice you can give me.

[iamtrustworthy]

3 hours ago, hallpau said:

Hi Steve,

 

I purchased the insurance through my travel agency that I book my cruises with.  The insurance is with Travel Insured International and the plan is their Worldwide Trip Protector - FL.

 

Thank you for any advice you can give me.

Hi hallpau,

 

Have you already asked your travel agency to intervene on your behalf on your claim? If not, get them involved. I believe that if a seller earns a commission for selling a policy, they are ethically obligated to help you with your claim. In your case, the commission would've been relatively big, so that's another reason for them to "go to bat" for you.

 

I'll help anyone with a claim, but in your case, I prefer to wait until your travel agency has done all it can to get your claim paid.

 

Steve Dasseos

[hallpau]

My travel agency has already reached out to their sales rep but they got the same response Travel Insured gave me.  Travel Insured is not one of their preferred providers but I've insured with them for the last 5 years due to best rate and their affiliation with USAA.  In fact, I think I'm the only client that insures with Travel Insured through my travel agency.

The commission my travel agency received is nothing compared to the $26,406.28 in premiums I have paid to Travel Insured over the last 5 years.

I've exhausted all my avenues to get this claim approved (claim appeal, travel agency, USAA), I reaching out to you for direction to other avenues I may have.

 

Thank you

Edited December 17, 2020 by hallpau

[iamtrustworthy]

1 hour ago, hallpau said:

My travel agency has already reached out to their sales rep but they got the same response Travel Insured gave me.  Travel Insured is not one of their preferred providers but I've insured with them for the last 5 years due to best rate and their affiliation with USAA.  In fact, I think I'm the only client that insures with Travel Insured through my travel agency.

The commission my travel agency received is nothing compared to the $26,406.28 in premiums I have paid to Travel Insured over the last 5 years.

I've exhausted all my avenues to get this claim approved (claim appeal, travel agency, USAA), I reaching out to you for direction to other avenues I may have.

 

Thank you

Hi hallpau,

 

I'm surprised that neither your travel agent nor USAA were able to help you. I can look into it, but if you have a USAA Travel Insured policy, Travel Insured will tell me that I can't help you due to their contract with USAA.

 

You may email me at steve@tripinsurancestore.com . Send me a copy of your denial letter plus a copy of your policy. I'll let you know what I find out.

 

Steve

[klfrodo]

Just throwing this out there.

 

Every policy sold in the US MUST be approved by the State Insurance Commissioner in the state that you reside.

Therefore, one of your options is to reach out for help from your State Insurance Commission or whatever that official department in your state is.

[hallpau]

Thank you Steve...I just sent you an email with the documentation you asked for.

[hallpau]

6 hours ago, klfrodo said:

Just throwing this out there.

 

Every policy sold in the US MUST be approved by the State Insurance Commissioner in the state that you reside.

Therefore, one of your options is to reach out for help from your State Insurance Commission or whatever that official department in your state is.

Thank you klfrodo for the tip.

[iamtrustworthy]

Hi hallpau,

 

I sent you an email. Call me at 1-888-407-3854 or email me if you want to talk about this further.

 

Steve Dasseos