law offices of merwyn j. miller
191 calle Magdalena, suite 270 • encinitas, San Diego County, ca  92024 • 760-436-8832

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Links to Prior Articles on this Subject
Travel Insurance Package
Three Main Claims
Medical Insurance
Trip Interruption Insurance
Emergency Evacuation Insurance

This is a continuing series of articles with a number of "parts."  See Table of Contents and search for "Don't Leave Home Without Them" and "Don't Leave Home Without It."

Introduction: Once again we continue our discussion about my wife’s and my five day adventure in an Argentine hospital due to a bout with pneumonia. My wife is fine now and doing well, thank you very much. (back to top)

Links to Prior Articles on this Subject: So far we have discussed travel insurance that should be purchased, medical insurance, costs, and coverage, smart phone and apps people should have with them if they are caught in a medical emergency in a foreign country, and money issues and solutions in such a situation. This month we are going to deal with trip insurance and obtaining reimbursement. (back to top)

Travel Insurance Package: If you purchased a travel insurance “package” you probably have trip cancellation/interruption coverage as well as emergency evacuation coverage. But keep in mind, insurance companies are not charitable institutions. They are not going to reimburse you just “because.” You need to (1) meet all of the terms of the coverage and (2) provide the company with all of the required documentation as well as a claim form. And you need to do this within the time limits provided. (back to top)

Three Main Claims: I had three claims: medical insurance, trip interruption insurance, and emergency evacuation insurance. Dealing with all three at the same time seemed overwhelming so I decided to break it down. I went with the medical insurance first for two reasons: first, it was the largest claim I had and, second, much of the claim for the other two coverages depended on how much the medical insurance reimbursed me. (No, you are generally not going to get double payment. In other words, in most cases, the emergency evacuation coverage is only going to pay for the amount of the ambulance bill that the medical insurance did not pay, i.e. the co-pay and deductible.) Once I had the medical insurance packet filed, I moved on to the trip interruption and then, after that, the emergency evacuation claims. (back to top)

Medical Insurance: The medical insurance took about 30 days to send me reimbursement checks and the explanation of benefits (EOBs). They paid what they were supposed to pay subject to the co-pays and deductibles. My only complaint was that they used a different currency conversion factor than I did which cost me about $200. Since I had the other two claims pending, the $200 was not large enough to argue about and I probably would have lost, anyway.

I did have one problem dealing with the company on the phone. Since it was my wife’s medical bills they initially refused to talk with me due to privacy concerns. Since it was me who had sent in the packet (over my signature), since I was the primary insured, and since it was me who was claiming reimbursement, I thought there position was absurd. Further, since I had submitted the claim (and they knew that) I obviously had all of the medical information that they did (in the hospital bills that I had submitted). And I wasn’t asking for medical information, just what currency conversion rate they used. The representative stood her ground and when I was just about to ask for a supervisor, I noticed that the claim form that both my wife and I had signed contained a consent for them to release the information. That was enough for the representative and things went smoothly from there. (back to top)

Trip Interruption Insurance: In our case, dealing with the trip interruption company (yes, there can be different companies that you must deal with for each coverage), was not particularly difficult. For the uninitiated, trip interruption coverage typically picks up the tab for the unused, prepaid portion of the trip. So if you made it through half of the cruise, they’ll reimburse for the unused half. Similarly, for the hotel that you prepaid but now cannot use and cannot cancel. They generally are not going to reimburse for your return flight (since you are using that portion of the flight), nor your extra or increased expenses. Trip cancellation covers much the same stuff but kicks in when you cancel the trip without ever starting it.

I notified the trip interruption company, they sent me a claim form, I completed it and sent it back with the supporting documentation that they requested. The documentation consisted of such things as the physician’s statement of the illness or accident (no, they generally are not going to cover trip interruption if you decide to terminate the trip due to a hangnail), proof of the cruise ship fare, the hotel prepayment, etc. I also included a cover letter attempting to tie everything together and give a better explanation of what occurred than I could do on the space allotted on their preprinted claim form.

I did receive a call from the claims adjustor indicating that she didn’t see anything in my packet for which the trip interruption covered. Apparently, the cover letter went into too much detail for her and included many items of documentation that confused her. For example, I included the entire 6 page hospital bill and I think that when she saw that, she stopped, believing that I was claiming for my medical bills that, obviously, were not a type of expense included in this coverage. One phone call and email got everything back on the right track. She did ask for some additional documentation on one point. Since I had kept all my bills, etc. that was no problem.

They sent me the reimbursement checks, although no EOB. I did email to inquire about one item for which they did not pay—the air change fee. I thought that should be covered since without changing the existing air reservation we would have lost the fare we paid and they would have been on the hook for even more. She pointed out that mine was not an air change fee but an increased fare since we flew home from a different city. She was right and that closed that claim. I figured I’d get that from the Emergency Evacuation Insurance. (back to top)

Emergency Evacuation Insurance: Next month we’ll deal with the Emergency Evacuation Insurance, the problems I had there, and what I had to do to get reimbursement. Suffice it to say that as easy as the above two claims were to deal with was as difficult as the Emergency Evacuation Insurance claim was. Further, we’ll deal with the “morals of the story.”

This is a continuing series of articles with a number of "parts."  See Table of Contents and search for "Don't Leave Home Without Them" and "Don't Leave Home Without It." (back to top)

May 30, 2016