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Old February 11th, 2004, 01:20 PM
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Default Trip Insurance Fraud - How can they do this?

This is an update to my post of last month. Since I havenít made any progress toward resolving the issue, Iím still looking for help.

On November 1, 2003, eight days before my wife and I were to leave on a cruise, my mother became very ill with internal bleeding. She died four days later. After her funeral, I filed a trip cancellation clam with the travel insurance company with whom we were insured. My claim contained a statement from Momís physician which stated that the illness which killed Mom first occurred on November 1.

Within two weeks, I received a check from the company for one-half of the claimed amount. As justification, the company cited a phone call that I made to them about two weeks before the onset of Momís illness. They stated that, when I made this call, I was still in the 50% penalty phase of the contract, and I should have cancelled then, which would have resulted in the cruise company paying 50%, and the insurance company paying the rest. This was a total misstatement by them of what was discussed during this phone call, which I made to inquire about what I would have to do if Mom became ill during our cruise. Mom was, at that time, 87 years old, and living in an extended care facility, but she was in no danger of dying.

The company stated that, if I wanted my claim reviewed, I should return the check, and asked for a review. I could also ask for binding arbitration by the American Arbitration Association if Iíd return the check with an additional check for $100. I followed their instructions to return the check, and I asked them to provide me with a recording or transcript of the call. I also gave them contact information for Momís physician, the extended care facility where Mom resided, and a couple of other people who could attest to the truth of my claim. One week later, they returned the original check with a statement that they stand by their original decision. I checked, and they did not contact any of the references that I cited.

Since that time, Iíve asked them at least five more times to provide me, or other neutral parties, with a recording or transcript of the call that theyíve cited as justification for cutting my claim in half, and Iíve been met with total silence. Iíve contacted the states of Florida, where I live, and where I purchased the insurance through an online cruise agency, and Tennessee, where the travel insurance company is located. Both states have contacted the company, and their only response was to send the states copies of their original and review denial letters. Iíve contacted Chris Elliott, an ombudsman, and the ombudsman for Conde Nast Travel, to enlist their help. The state investigations are ongoing, and it appears that the company may have been operating as an unlicensed entity when selling insurance in Florida, but that probably wonít help me get my money back. By the same token, I doubt that the American Arbitration Association will be any more successful if the travel company refuses to back up their claim by providing a recording of my call to either me, or the states of Florida or Tennessee.

Any suggestions that you might have would be greatly appreciated. You can reply by a post, or by contacting me directly.
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