Insurance Nightmare - Travel Insured (be careful and help appreciated)

[cusematt4]

Hi All,

 

We are beyond frustrated - beware of a disgusting, unreliable travel insurance company Travel Insured International, Inc.

We were recommended this travel insurance company by Cruises-N-More

My family of 4 was denied boarding from a cruise in December due to one person testing positive for covid pier side (all negative within 48 hours to having traveled). We've always taken out travel insurance and have relied on this company despite never having to file a claim. Since we traveled together from NY, the entire traveling party of 4 (all part of the same policy) was denied boarding and forced to stay in Florida.

Travel Insured ensured us that all hotel expenses, including two rooms (one for the family member who had to quarantine and isolate and another for the other 3 family members) would be fully covered for the interrupted trip, in addition to meals for the 3 family members denied boarding + food for the covid + family member in his hotel room until all could get back home to NY. The 3 negative family members were unable to get a flight back to NY based on it being the holiday season, so we all stayed in Florida for 5 nights.  Their own representative said that all meals/lodging would be covered for all 4 denied family members with only the covid positive family member needing to quarantine.  Expenses for all denied boarding and having their trip interrupted would be covered, including the separate hotel rooms until all could safely get back to NY.

Travel Insured has been impossible to get in contact with for the past 5 months. We sent them every detailed receipt for the two hotel rooms, denied boarding letter, transportation and meals. They asked for additional documentation regarding flights and cruise cost, and we promptly provided that to them. Calls to the company have taken over 5 hours for someone to answer.

We just got a full denial letter from the company stating that based on receipts, it looks like quarantine guidelines were not abided by, so the entire claim was therefore denied. The covid positive family member did not leave his room for the entire 5 days, in accordance with CDC guidelines. The other family members were not required to quarantine and were covid negative but were denied by the cruise line and had their trip interrupted (trip interruption part of the policy) since we had traveled together.

I cannot fathom how this company is denying this claim when we did everything needed from receipts to separate rooms to the negative family members bringing food back to the positive family member and leaving it outside of his hotel room door. We incurred thousands of dollars for unexpected food and lodging costs, spoke to Travel Insured and followed all instructions to ensure coverage and relied on this company for covering and protecting us. To be sent a denial letter when we fully abided by their guidelines and all CDC requirements is beyond frustrating, upsetting and unfathomable.

If anyone has any experience with this, I'd appreciate any insight for how to appeal or resolve. If anyone has any contacts at Travel Insured International, Inc. please let me know.

In the meantime, please be careful and DO NOT USE THIS COMPANY if you want reliable coverage when traveling.

[cusematt4]

CDC guidelines at the time were that anyone exposed to covid but vaccinated did NOT have to isolate or quarantine. So the 3 family members who were denied boarding and had their trip interrupted followed CDC guidelines and worse masks but did not isolate at a hotel while stranded until they could get back to NY. The covid + family member isolated per CDC guidelines at the hotel in a separate room that Travel Insured assured would be covered.

[Babr]

It would help everyone to know why the claim was denied so that we can avoid the same outcome.

 

I am caught by the statement that quarantine rules were not followed. Did they give any explanation or justification for how they were violated?
 

You have given the details as you understand them, but some key element is missing. Otherwise the claim would not have been denied. Look again at the Trip Delay provision for covered reasons and expenses. That is the part that covers hotel and meals. The Trip Interruption provision usually covers the  unused prepaid nonrefundable expenses and return transportation.

I’m guessing if you were not required to quarantine and had no restrictions, you did not meet the terms of the policy.

 

 

 

[klfrodo]

If all else fails, you can always appeal to your State Insurance Commissioner. They would carry a lot of weight in this matter. Or, in this instance Home | Department of Financial Services (ny.gov)

[GeezerCouple]

2 hours ago, cusematt4 said:

Hi All,

 

We are beyond frustrated - beware of a disgusting, unreliable travel insurance company Travel Insured International, Inc.

We were recommended this travel insurance company by Cruises-N-More

My family of 4 was denied boarding from a cruise in December due to one person testing positive for covid pier side (all negative within 48 hours to having traveled). We've always taken out travel insurance and have relied on this company despite never having to file a claim. Since we traveled together from NY, the entire traveling party of 4 (all part of the same policy) was denied boarding and forced to stay in Florida.

Travel Insured ensured us that all hotel expenses, including two rooms (one for the family member who had to quarantine and isolate and another for the other 3 family members) would be fully covered for the interrupted trip, in addition to meals for the 3 family members denied boarding + food for the covid + family member in his hotel room until all could get back home to NY. The 3 negative family members were unable to get a flight back to NY based on it being the holiday season, so we all stayed in Florida for 5 nights.  Their own representative said that all meals/lodging would be covered for all 4 denied family members with only the covid positive family member needing to quarantine.  Expenses for all denied boarding and having their trip interrupted would be covered, including the separate hotel rooms until all could safely get back to NY.

Travel Insured has been impossible to get in contact with for the past 5 months. We sent them every detailed receipt for the two hotel rooms, denied boarding letter, transportation and meals. They asked for additional documentation regarding flights and cruise cost, and we promptly provided that to them. Calls to the company have taken over 5 hours for someone to answer.

We just got a full denial letter from the company stating that based on receipts, it looks like quarantine guidelines were not abided by, so the entire claim was therefore denied. The covid positive family member did not leave his room for the entire 5 days, in accordance with CDC guidelines. The other family members were not required to quarantine and were covid negative but were denied by the cruise line and had their trip interrupted (trip interruption part of the policy) since we had traveled together.

I cannot fathom how this company is denying this claim when we did everything needed from receipts to separate rooms to the negative family members bringing food back to the positive family member and leaving it outside of his hotel room door. We incurred thousands of dollars for unexpected food and lodging costs, spoke to Travel Insured and followed all instructions to ensure coverage and relied on this company for covering and protecting us. To be sent a denial letter when we fully abided by their guidelines and all CDC requirements is beyond frustrating, upsetting and unfathomable.

If anyone has any experience with this, I'd appreciate any insight for how to appeal or resolve. If anyone has any contacts at Travel Insured International, Inc. please let me know.

In the meantime, please be careful and DO NOT USE THIS COMPANY if you want reliable coverage when traveling.

 

I obviously have no specific insight into your situation and your claim.

 

However, we have purchased travel insurance for many trips (both cruise and land trips) from www.TripInsuranceStore.com since 2013 after reading about them here.  All but one of the policies was from Travel Insured.  (All claims were with TI, and that's who we use now exclusively, at least thus far...)

 

We have had quite a few claims (very unfortunately!), including a few large claims, and ALL of them were paid without any difficulty.  One time, when it was a season with several hurricanes in the Caribbean, the claims people there (and probably everywhere) were no doubt totally swamped.  So we had a delay, even though our claim had nothing to do with weather.  We contacted Steve (owner of TIS), and he apparently got a message to TI, and in short order, our claim was approved, and we got a check.

 

Obviously we can't know what the terms of your policy state or what was actually said on those calls.  However, those calls were almost definitely recorded.  If you can't "get satisfaction" from TI, and you are sure that there isn't any obvious reason that it should have been denied, then... Insurance is a regulated industry, so contact your state's Insurance Commissioner's office for assistance.

 

Did TI tell you the *specific* reason(s) that each claim was denied, and can you share that with us so we can try to help more?  If they didn't give specific reasons, then you could sent them a certified, return-receipt letter stating that you would like that answered - or if you do know and disagree, then why you disagree.  And tell them that if your claim does not get paid and you don't get a full and satisfactory explanation, that you will file a complaint with the State agency.  (And then DO IT if you still think they are wrong.)

 

If the travel agent sold you that policy, they got a commission, and they should help you with the claim.  Next time, regardless of what insurer you use, I'd strongly suggest that you use a travel insurance broker like TripInsuranceStore to purchase the policy (there is no extra cost to use an insurance broker).  They work with vetted insurers and sell policies they recommend.  AND they will help their clients if there are any diffficulties with claims.

 

There may have been some condition that you did not meet, or there was something about your claim submission that didn't clearly (enough) explain what you did/didn't do, and perhaps why it matched what you were told as well as the terms of the written policy.  We can't tell from the information provided.  It's the written terms that would ordinarily 'rule'.  But if some of you stayed longer (the non-quarantined people) BECAUSE of what TI told you on the phone, that is *very* important to include.

Sometimes a claim is initially rejected (by any insurer of any type) because there is some misunderstanding about what happened/what was done.  In that case, clarifying it would help.  In that case, regarding the quarantine for example, tell THEM more clearly what was done and why it does comply with the terms.

And sometimes it's because something about the policy terms were not met.  Sometimes this is getting a PHYSICIAN's letter (for a medical-based claim) or perhaps medical records need to be sent.  That may or may not be an issue in your case.

 

ETA:  cusemat4 and Babr have good points, and that may be part of all of the problem.

However, in your case, WHAT, exactly did the TI rep tell you by phone?  That could be key.  If you misunderstood something, that might be a problem anyway.  But if they stated that they would cover you if you did what that rep told you to do, and then you did exactly that, then the insurance commissioner's office should be able to help.  Unfortunately, you don't have a recording, so it's going to be your memory plus any contemporaneous notes you took that would give a hint about just what has happened.

IF cusematt4's idea is correct, then TI should have covered at least the expenses of that person.  So if TI denied all of it, then that still doesn't provide an explanation.

 

And as Babr wrote, we really don't have enough information to be able to help you more specifically.  Or we don't, yet....

 

Good luck, and I hope you can get this sorted out.  I can only imagine how aggravating this must be, on top of having missed the cruise!

 

Keep us posted.  Others here may have other suggestions.

GC

[Babr]

Under Trip Interruption, the policy should pay for the cruise you missed (unused prepaid nonrefundable expense - unless you received compensation from the cruise line) and the return transportation.

 

The quarantine part under Trip Delay seems to be the source of the problem. Quarantine is a covered reason; however, if all of you were not required to quarantine according to CDC and did not isolate - voluntarily or otherwise - then what covered reason is the basis for the claim?

 

That seems to be the crux of the matter; however, I would think at least partial reimbursement is in order to cover quarantine for the person affected by the positive test and trip interruption for cruise and transportation affecting all.

 

Please let us know how this is resolved because many will no doubt find themselves in the same situation, and there are already many trying to get home from Europe but can’t because of a positive test prior to boarding a plane. I’m sure they’d like to know how insurance handles Trip Delay in either instance.

Edited May 17, 2022 by Babr

[cusematt4]

Really appreciate the followup Babr and you summarized it spot on.

 

These are the facts:

-NCL denied all 4 of us boarding since we were the same traveling party and the two rooms were connected to the same reservation

-3 covid negative family members had their trip interrupted and were stranded in Florida.  Due to it being the holiday season, they were not able to rebook or reschedule their flight from Florida back to NY

-3 covid negative family members were NOT required to quarantine as they were vaccinated.  Per CDC guidelines since February 2021, anyone vaccinated but exposed to covid without symptoms did NOT need to isolate or quarantine.  NCL was being extra precautions and denied all 4 of us.

-Per Travel Insured, we booked 2 rooms while stranded in Florida - one for the covid positive family member to isolate for 5 days and one for the 3 covid negative family members.

-The covid negative family members incurred meal/food expenses while stranded in Florida and when reasonably dining near the hotel, ordered food for the covid positive family member and left it outside his hotel room where he ate meals isolated alone inside.

 

Insurance is stating that since we violated CDC quarantine guidelines, our claim is void.  That's just utterly false.  We were stranded and booked two rooms.  All were denied boarding and the covid + family member didn't leave isolation.  He like the others had to eat while stranded in Florida but the covid negative family members left meals outside of his room from restaurants they grabbed food from.

 

Followed every CDC and insurance guideline, including all receipts, to the tee.  Therefore beyond frustrated.  This was the exact reason we took out extra insurance from a company we thought we could rely on.  And also called them and did exactly as told.

[Babr]

Well then, all you can do is file an appeal. There should be information about how to do that included with the denial letter you received. Cite the February CDC ruling and include a copy of it. They need to clarify how you violated it and/or the terms of the insurance policy. 
 

Perhaps when they re-evaluate it, they will pay the claim. If you are still not satisfied with the result, you can contact your state’s department of insurance.

[Babr]

https://www.cdc.gov/media/releases/2021/s1227-isolation-quarantine-guidance.html

 

I found this update for December, 2021. It says you do not have to isolate if you have been boosted or within 6 months of last vaccine. Did insurance company ask for your vaccine records?

 

I did not find the February, 2021 guideline you mentioned so I do not know how it is different.

Edited May 17, 2022 by Babr

[cusematt4]

Thank you.  They definitely did not ask for any vaccine records although we would gladly provide that.

 

The covid positive family member isolated and the others were not required to, a CDC update since February 2021.  While their website has been replaced with most recent data, they came out with the updated guidance on 2/10/2021 regarding no need to isolate if exposed and vaccinated.

 

https://www.nbcnews.com/health/health-news/cdc-fully-vaccinated-people-don-t-need-quarantine-if-exposed-n1257336

[Babr]

Funny. I got my first dose of vaccine on February 6, 2021. I did not remember that there were enough people vaccinated by then to relax quarantine measures. People were still lining up at mass vaccination sites in parking lots.

 

The December update I linked probably took effect after your cruise; nevertheless, the guidelines in place at the time of the incident will govern the outcome. It will be necessary to establish that if you are to be successful. There must be an official archive somewhere to locate that data. How else can they say you were in violation?

[cusematt4]

This should be easy then - CDC official policy as of 2/10 was no quarantine for those exposed if vaccinated.  I will absolutely be including this in my appeal.  I wonder if they deny most assuming that the majority will not take the time to appeal.  Based on Yelp and Google, this seems to be a trend based on Travel Insured's mostly 1 star reviews.

[Babr]

https://www.cfins.com/wp-content/uploads/2022/01/COVID19-FAQ-Consumers-0122.pdf

 

I found this that may be useful. See the answers pertaining to quarantine. Not sure where your claim went wrong. Let us know how this works out.

 

 

[Babr]

I think the key is that CDC guidelines do not factor into the decision. Neither the policy nor the FAQ’s refer to them.

 

You mentioned CDC guidelines as a justification for your actions, but it is Travel Insured’s policy and Travel Insured’s rules that determine if a claim is approved.

 

If their representative told you otherwise, you’ll have to go back to the recorded call. Seems his information is not in line with the adjuster that evaluated your claim.

 

 

 

 

Edited May 18, 2022 by Babr

[cusematt4]

Here is the latest - the restaurant receipts we provided covered meals for the 4 of us.  Insurance is ASSUMING that since a meal for the covid + family member was part of the same receipt as the other family members, that the covid family member therefore violated quarantine guidelines and dined out and left his hotel room for meals.  This is absolutely false.  He did not leave quarantine and remained in isolation per CDC guidelines.

 

When the 3 negative family members dined out and ate meals, they ordered food for the covid + family member and left it in front of his hotel room door where he was isolated.  I"m unsure how or why they would assume he left his hotel room, but they are assuming he joined and dined out and therefore claim is void.,

 

I am unsure how they can prove that he dined out vs us prove that the family members ordered for him and brought back in a to go box and left it outside his hotel room door - but that's literally the truth.  He had to eat, they were allowed to leave, and they brought him food back each meal.

[canadianbear]

4 minutes ago, cusematt4 said:

Here is the latest - the restaurant receipts we provided covered meals for the 4 of us.  Insurance is ASSUMING that since a meal for the covid + family member was part of the same receipt as the other family members, that the covid family member therefore violated quarantine guidelines and dined out and left his hotel room for meals.  This is absolutely false.  He did not leave quarantine and remained in isolation per CDC guidelines.

 

When the 3 negative family members dined out and ate meals, they ordered food for the covid + family member and left it in front of his hotel room door where he was isolated.  I"m unsure how or why they would assume he left his hotel room, but they are assuming he joined and dined out and therefore claim is void.,

 

I am unsure how they can prove that he dined out vs us prove that the family members ordered for him and brought back in a to go box and left it outside his hotel room door - but that's literally the truth.  He had to eat, they were allowed to leave, and they brought him food back each meal.

I’ve been reading about your ordeal.  Would the restaurant have any video you could ask for to prove the covid + person was not there?  
 

It seems people buy insurance in good faith then when they need it they are denied.  It has us reconsidering a very long cruise that we have our final payment coming up soon.   The insurance policy is so long you almost have to be a lawyer to understand it all.  
 

I sure hope you can get this resolved in favour for you.  Insurance policies need to be more user friendly in what they cover or don’t. 

[Flipchild32]

23 minutes ago, cusematt4 said:

Here is the latest - the restaurant receipts we provided covered meals for the 4 of us.  Insurance is ASSUMING that since a meal for the covid + family member was part of the same receipt as the other family members, that the covid family member therefore violated quarantine guidelines and dined out and left his hotel room for meals.  This is absolutely false.  He did not leave quarantine and remained in isolation per CDC guidelines.

 

When the 3 negative family members dined out and ate meals, they ordered food for the covid + family member and left it in front of his hotel room door where he was isolated.  I"m unsure how or why they would assume he left his hotel room, but they are assuming he joined and dined out and therefore claim is void.,

 

I am unsure how they can prove that he dined out vs us prove that the family members ordered for him and brought back in a to go box and left it outside his hotel room door - but that's literally the truth.  He had to eat, they were allowed to leave, and they brought him food back each meal.

 

The best way to have avoided that would have been to have the three dine order their meals and paid. Then ordered the COVID+ person their meals separately with dineout/carryout on a separate bill.  To me this would be the first choice and most logical to me as it makes it easier for the food to be fresh and not cause confusion in the kitchen with having to wait for them if it was a sit down location. 

 

Sorry, but when I read the thread that was the first thought on how to do it and most logical. 

[Babr]

Double check your receipts to see if there is anything to distinguish dine-in from take-out. Sometimes there is a notation on the ticket or a separate service charge. Beyond that, I guess you are down to the security tapes, as canadianbear suggests. That is a bit extreme. 
 

I still feel there is some other detail contributing to the problem.

Edited May 18, 2022 by Babr

[mauimary]

In this case scenario would it have been better to have just used a copy of a visa statement which would have had all meals charged together.  They could have all been picked up or delivered.   

Would it have been better to not even claimed meals and just deal with them as your own expenses. 
 

We have this same policy and I was on hold yesterday for over 90 min prior to giving up as we too would like to know exactly how to handle this if we encounter the situation traveling out of the country and unable to fly home. 

[happy cruzer]

Matt,  I too am dealing with an insurance claim (for weather related trip delay) so I totally understand your frustration.

 

I think you are going to have to have to get the state insurance board involved.  But first get their denial with reason in writing.  Respond in writing.  Get it all in writing.  Then copy everything.  Write as short as possible cover letter and attache the mass of information to it.  Then mail a copy to every agency you can think of including the state board of insurance.  Just because they think they can require some document or action does not mean that a third party will agree.

 

I have felt that an appeal was going to be required on my claim from the beginning but you have to play their game to the end.

 

 

[ridge4]

@cusematt4, any updates on your claim?  We also have a Travel Insured policy and a travel delay claim due to quarantine in progress.  We are following your story with interest.