Cancelled cruise - insurance refuses to pay

[jay44]

Remember this post?

 

http://boards.cruisecritic.com/showthread.php?t=667817

 

Today I received a letter from my insurance company saying that they will not settle our claim whatsoever. Apparently because we knew dad was ill when we booked our insurance we have no grounds for claiming.

 

The fact that my sister and I waited for dad's medical clearance from Princess, British Airways, and his doctors before we took out our insurance has no bearing on the matter.

 

He was fit to travel. He was not expected to drop dead 3 days before he flew to fly to Miami!

 

I tell you what, we are going to fight this all the way.

 

The name of the insurance company is Insure and Go. Avoid them like the plague!

 

Oh, and just to add insult to inury. My mum has just received full settlement of her claim against dad's insurance, and he had a £1,500 excess if there was claim. His insurance company obviously have a soul and refunded my mother all the money. Every single penny.

 

*fumes*

[Colo Cruiser]

Sorry to hear of this, keep fighting. :)

[Spikesgirl]

As a former insurance employee - I would start pushing back - direct your next letter to the head of the claims or quality control unit. Things have changed some since I left the field, but your claim should be honored. In any event, a cancellation like this should be covered.

 

I will also tell you that the declination was probably automatic -absolutely keep fighting...and maybe drop a letter to your local paper's travel editor. More folks on your side, the better.

 

Good luck and my condolences to you and your family,

 

Charlie

[rjg41]

While not a lawyer, I am a travel agent and the key question is, did your insurance have a pre-existing condition clause? If the answer is yes and you did not purchase it so that that clause was waived, then you are unlikely to collect.

 

Most policies have such a clause and usually the only way to have it waived is to purchase it at time of cruise deposit. Note not all companies offer a waiver even if purchased at deposit.

 

If you booked through a travel agent and the agent did not explain this to you, you may have an issue with the travel agent. I cover it with all my clients.

 

Secondly, while it does not appear to be your case, people should be aware that getting a pre-existing clause waiver does not typically cover situations where someone is terminally ill even if the diagnosis is a life expediency of many years. At this time only one company that I know of has a policy that will cover terminal illness situations.

[yarlenna]

While not a lawyer, I am a travel agent and the key question is, did your insurance have a pre-existing condition clause? If the answer is yes and you did not purchase it so that that clause was waived, then you are unlikely to collect.

 

Most policies have such a clause and usually the only way to have it waived is to purchase it at time of cruise deposit. Note not all companies offer a waiver even if purchased at deposit.

 

If you booked through a travel agent and the agent did not explain this to you, you may have an issue with the travel agent. I cover it with all my clients.

 

Secondly, while it does not appear to be your case, people should be aware that getting a pre-existing clause waiver does not typically cover situations where someone is terminally ill even if the diagnosis is a life expediency of many years. At this time only one company that I know of has a policy that will cover terminal illness situations.

 

Please tell us which one!

[bubbadog]

dont waste any time doing it yourself, just get a lawyer;)

[cruze610]

Remember this post?

 

http://boards.cruisecritic.com/showthread.php?t=667817

 

Today I received a letter from my insurance company saying that they will not settle our claim whatsoever. Apparently because we knew dad was ill when we booked our insurance we have no grounds for claiming.

 

The fact that my sister and I waited for dad's medical clearance from Princess, British Airways, and his doctors before we took out our insurance has no bearing on the matter.

 

He was fit to travel. He was not expected to drop dead 3 days before he flew to fly to Miami!

 

I tell you what, we are going to fight this all the way.

 

The name of the insurance company is Insure and Go. Avoid them like the plague!

 

Oh, and just to add insult to inury. My mum has just received full settlement of her claim against dad's insurance, and he had a £1,500 excess if there was claim. His insurance company obviously have a soul and refunded my mother all the money. Every single penny.

 

*fumes*

 

Generally, it has been my experience that insurance companies will deny all claims. DENY, DENY, DENY!!! they seem to do that in the hopes that people will accept it and move on. Unfortunately, some people do just that. So the odds are probably on the side of the insurance companies. but if you persist, and fight them on it, I bet they would probably give in. tell them that you will call the Better Business Bureau and or Consumer Affairs Dept.

My wifes uncle who was scheduled to go with us on our cruise on 1/13/08 He was healthy when we booked in August. On December 4th, he got seriously ill very suddenly. Long story short, he passed away on December 14th. This time there was no travel insurance involved Princess allowed us to change the name on the booking since I was the one that made the booking, I was able to do this without any trouble at all. They even waived the fee for the name change. If he had gotten travel insurance, Im sure it would have been a fight with the insurance co. to get reimbursed.

[Toto2Kansas]

I wish you so much luck with this one.

 

Insurance policys have so much fine print you need an attorney just to read it and figure out what it means before you even purchase it with cases like this.

 

If your dad had the illness when booking the insurance, there is definitely going to be a problem if that illness contributed to his passing. (my sympathy added in here).

 

I too would get an attorney to look over your policy and read all the fine print, just to make sure you have a leg to stand on with this.

 

Again, best of luck, I hope it all works out for you.

[San Diego Ellie]

My understanding has been that if you purchase the insurance within a certain number of days within the deposit date (it may be ten, but no more than that for sure) preexisting conditions are covered. If you purchase it later than that, they are not.

 

Could someone more expert than me affirm or correct that?

[Coral]

My understanding has been that if you purchase the insurance within a certain number of days within the deposit date (it may be ten, but no more than that for sure) preexisting conditions are covered. If you purchase it later than that, they are not.

 

Could someone more expert than me affirm or correct that?

 

With some insurances, this is true. Though there is often a condition that "one must be medically able to travel at the time insurance is purchased".

 

This happened to me once - I purchased a cruise on the Golden Princess for Thanksgiving. The next day, my mom was hospitalized for possible stroke. I had planned on buying insurance within the next few days. Well - there was no way that I could get insurance to cover my mom if I had purchased it that week.

 

So, we waited until she got better and booked a different ship for that same time period and then bought insurance right away. Due to how this insurance policy was written (Access America), I couldn't book the same ship again for that date and still be covered fully.

 

I am not sure who determines "if the person is medically able to travel at time of purchase" but this may be one of the issues with the denial of a claim.

 

On another situation, my mom needed bypass surgery for a different Thanksgiving cruise. We cancelled about a week before. Access America paid out within 10 days of receiving my claim. No hassles. I often think that paying out $3000 for this claim is probably small (and easier for insurance companies to do) compared to paying out $50,000 plus for someone getting sick while on vacation.

 

When we cancelled that cruise - we had to provide medical reports of my mom's visits to her doctor's before we knew of her condition. I assume that was to prove that she was medically able to travel at the time we booked and purchased insurance.

 

Good luck and let us know how the outcome comes out.

[paul929207]

My understanding has been that if you purchase the insurance within a certain number of days within the deposit date (it may be ten, but no more than that for sure) preexisting conditions are covered. If you purchase it later than that, they are not.

 

Could someone more expert than me affirm or correct that?

 

That is my understanding. My wife has a "pre-existing condition" that might someday force us to cancel a cruise. We always get the insurance when we book.

[cusyl]

Remember this post?

 

http://boards.cruisecritic.com/showthread.php?t=667817

 

The fact that my sister and I waited for dad's medical clearance from Princess, British Airways, and his doctors before we took out our insurance has no bearing on the matter.

 

*fumes*

If you have that in writing you should be able to collect.

Sorry for your loss.

[dforeigner]

As others have asked, the you have the pre-existing insurance clause.

 

On a more serious note, please accept my condolences for you lose.

[newmexicoNita]

I am sure I speak for all of us, our prayers are with your family.

 

As for the insurance issue, there is no way any of us, without seeing your policy can make a judgement. Regardless of what your father's doctor said or what kind of releases you got it has to do with that one little clause: pre-existing and depending on the complany you may or may not be able to collect. good luck

 

Nita

[FredS]

It would be interesting to hear from those in the UK as to their experience as that is where the OP is from. USA laws probably have some differences from the UK laws.

[Coral]

It would be interesting to hear from those in the UK as to their experience as that is where the OP is from. USA laws probably have some differences from the UK laws.

 

Good point - I hadn't realized/noticed that.

[cherylandtk]

SO sorry to hear of your troubles--keep in mind that much of the advice you will be given in this thread comes from US based readers and that it may not be applicable to UK rules, regulations, practices and laws.

 

I hope you are able to prevail upon your insurer to pay your claim upon appeal. Here in the US, death of a travelling member (even due to a pre-existing health condition) is a covered claim in nearly all travel insurance policies. I hope that is also the standard in the UK as Insure and Go is apparently one of the major travel insurance providers in the UK.

[MercedMike]

To the OP, my deepest sympathies for you loss. I know it is very difficult for you.

 

The lesson to be learned from this thread by all cruisers, regardless of the outcome of this particular case, is that anyone booking cruise insurance must read the policy thoroughly and ask questions about its provisions.

 

This whole issue of "pre-existing" conditions is a very difficult one and it seems that most insurance policies have widely varying terms. In some cases, pre-existing conditions are waived if purchased within a certain time of making the booking. In other cases, an "upgrade" covering pre-existing conditions can be purchased. It is very confusing and hard to understand, but anyone with any sort of medical condition MUST be sure they know what coverage they have.

 

The definition of "pre-existing" conditions is also variable and confusing. While almost all policies require that you be "fit to travel" at the time of buying the insurance, this does NOT necessarily mean there is no "pre-existing" condition. In some definitions, if you visit a doctor and have any change in your treatment, such as a new medication, during the six months prior to buying the insurance, the condition is "pre-existing."

 

A good lawyer can help you deal with an insurance company, but it is unlikely that the amount involved will cover his bill! A better answer is to let your Travel Agent fight for you. A good TA will be familiar with the policies of the insurance company and their requirements on a claim, and can frequently smooth the process for you.

 

Again, my sympathy to the OP and best wishes in your claim.

[vmom]

Remember this post?

 

http://boards.cruisecritic.com/showthread.php?t=667817

 

Today I received a letter from my insurance company saying that they will not settle our claim whatsoever. Apparently because we knew dad was ill when we booked our insurance we have no grounds for claiming.

 

The fact that my sister and I waited for dad's medical clearance from Princess, British Airways, and his doctors before we took out our insurance has no bearing on the matter.

 

He was fit to travel. He was not expected to drop dead 3 days before he flew to fly to Miami!

 

I tell you what, we are going to fight this all the way.

 

The name of the insurance company is Insure and Go. Avoid them like the plague!

 

Oh, and just to add insult to inury. My mum has just received full settlement of her claim against dad's insurance, and he had a £1,500 excess if there was claim. His insurance company obviously have a soul and refunded my mother all the money. Every single penny.

 

*fumes*

 

To clarify the information you gave us, When did you purchase the insurance? Was the insurance purchased when you made your deposit for the cruise? Or was it purchased later.

 

It may all come down to when you purchased the insurance. Most (but not all) insurance companies waive pre-existing conditions if you purchase the insurance within a certain time limit of the day you put down your deposit.

 

So, is this insurance company one of the few exceptions that does not waive pre-existing conditions or did you buy the insurance after the set limited time period?

[BJS]

Today I received a letter from my insurance company saying that they will not settle our claim whatsoever. Apparently because we knew dad was ill when we booked our insurance we have no grounds for claiming.

 

The fact that my sister and I waited for dad's medical clearance from Princess, British Airways, and his doctors before we took out our insurance has no bearing on the matter.

 

The name of the insurance company is Insure and Go. Avoid them like the plague!

 

First I want to say how sorry I am for your loss and now this denial.

 

You need to look at your policy terms very carefully as I'm sure you did when you purchased the insurance. There are many policies out there.

Since you mentioned the insurance company I looked at their web site for their single trip policy and found that it is very restrictive. I don't remember you saying what your father's medical condition was other than he was in failing health so will mention many things.

 

The following is just part of what I found:

Claims will not be covered if a terminal prognosis has been given.

They will not be covered for conditions that could reasonably be expected to give rise to a claim.

You need underwriters acceptance for these conditions: heart, blood, diabetic, breathing, cancer in the last 5 years, or if you have been seen by a hospital doctor, surgeon or were an inpatient in the last year.

 

It is very unfortunate that you did not go with Princess Travel Care because even if they denied your claim you could have used the "cancel for any reason" clause and received up to 90% of the non-refundable fare back in a credit for a future cruise. This won't help you now but it is something to consider in the future. Also their "pre-existing" condition is waived if there has been no change in the condition, diagnosis, or recommended treatment or medication change in the 60 days prior to purchasing the insurance (insurance can be purchased anytime from booking up to final payment date).

 

 

.

[Suzanne123]

The Pre-Existing Condition Lookback Period�

 

What is the Pre-Existing Condition Lookback Period?

The Lookback Period is a period of 60, 90 or 180 days prior to the travel insurance policy's effective date. If you are insuring a trip cost, your policy's effective date is 12:01 am of the day following your purchase date. However,(and this can be important to know) a few policies make the effective date to 12:01 am of your departure date with a $0 trip cost. Those companies are CSA, HTH and Travelex.

 

Why is the Effective Date Important?

The Effective Date is important because it helps determine when the Lookback Period starts. The Lookback Period is a period of 60, 90, 120 or 180 days prior to the travel insurance policy's effective date. In other words, you count backwards from the effective date to determine if a medical condition is a pre-existing medical condition.

 

Why does it matter if a medical condition is a pre-existing medical condition?

It matters because if it is and you don't waive the pre-existing medical condition exclusion, then you have no coverage for trip cancellation, interruption nor medical treatment for that medical condition.

 

This takes us back to the Lookback Period. The Lookback Period defines whether or not a pre-existing medical condition exists. The Lookback Period doesn't affect you when there aren't any pre-existing medical conditions. The Lookback Period is important if:�

 

* Today is past the first 14 or 21 days after the date you made your initial trip deposit and

* You, a family member or a traveling companion has a pre-existing medical condition and

* You're concerned the pre-existing medical condition may cancel / interrupt your trip or cause you to seek treatment while you're on your trip.

 

Let's say your Mother has heart problems... She's fine now. Her condition is completely controlled with no changes in medication, diagnosis, care or treatment in the past 60, 90, 120 or 180 days. Therefore if you get travel insurance, your Mother's condition won't be considered a pre-existing medical condition.

 

The Lookback Period is important in two situations:

 

1. You don't insure the full prepaid, non-refundable cost of your trip, or

2. Today is past the first 14 or 21 days following the date you made your initial trip deposit or any payment toward your trip. If today is before the end of the 14 or 21 days, the exclusion for pre-existing medical conditions can be waived.

 

Even if you're past the first 14 or 21 calendar days after making your initial trip deposit (depending on the provider), a medical condition may be a valid reason for trip cancellation or interruption. The person with the pre-existing medical condition has to be medically stable when you get your insurance. Medically Stable means that in the 60, 90 or 180 days (depending on the provider) prior to the day you buy travel insurance, there can't have been any medical condition which:

 

1. Manifested itself, became acute or exhibited symptoms which would have caused one to seek diagnosis, care or treatment;

2. Required the taking of prescribed drugs or medicine, unless the condition for which the prescribed drug or medicine is taken remains controlled without any change in the required prescription; or

3. Required medical treatment or treatment was recommended by a legally qualified physician.

 

If 1, 2 or 3 apply and you're past the first 14 or 21 days after you made your initial trip deposit you won't have coverage for claims from that pre-existing medical condition.

Here Are The Lookback Periods:

 

 

The Lookback Period (number of days)

 

CSA - both CSA Freestyle plans

180 calendar days

 

HTH - both Trip Protector plans

180 calendar days

 

Travelex

90 calendar days

 

Travel Guard Cruise, Tour & Travel

60 calendar days

 

Travel Guard Protect Assist

180 calendar days

 

Travel Insured

180 calendar days

 

Travel Safe - both Travel Safe plans

60 calendar days

[MercedMike]

First I want to say how sorry I am for your loss and now this denial.

 

You need to look at your policy terms very carefully as I'm sure you did when you purchased the insurance. There are many policies out there.

Since you mentioned the insurance company I looked at their web site for their single trip policy and found that it is very restrictive. The following is just part of what I found:

Claims will not be covered if a terminal prognosis has been given.

They will not be covered for conditions that could reasonably be expected to give rise to a claim.

You need underwriters acceptance for these conditions: heart, blood, diabetic, breathing, cancer in the last 5 years, or if you have been seen by a hospital doctor, surgeon or were an inpatient in the last year.

 

.

 

WOW -- those are indeed some of the most restrictive terms I have ever seen! What is this "reasonably expected" clause?? I have never seen anything like that. Sure to wind up in litigation, isn't it?

 

Bad news for the OP, I am afraid. I think I tend to go with her recommendation -- DON'T use this company!

[jay44]

Hello everyone, thank you all for your comments.

 

The particular wording in our contract which is preventing us receiving settlement to our claim is as mentioned above:

 

"We will not be liable for claims where at the time of taking out this insurance, you are aware of any medical condition or set of circumstances which could reasonable be expected to lead to a claim."

 

The is what actually happened:

 

Sister and I waited for dad to get all medical clearance for our trip, and this was done without hesitation by all parties concerned. His lung doctor, his own GP, British Airways, and in the end Princess who did not for one second expect dad to drop down dead of heart failure three days before his cruise. And I must make this clear... dad was suffering from a lung condition, his heart condition was deemed as stable, three weeks before the cruise, as it had been so for three years.

 

So once all these certificates had been authorised, sister and I took out our insurance. If dad had not been cleared, we would still have taken out insurance, and gone on the cruise without him.

 

How our insurance company can say that we may reasonably have been accepted to make a claim is beyond belief! Dad dropping dead, literally, was not something anyone expected, least of all his doctor who was completly shocked by the suddeness of it all. All this was put in a medical report to the a..hole insurers.

 

God, they have got my goat, I can tell you!

 

Wish I could really swear on here!

 

AARRghhhhhhhhhhhhhhh!

[jay44]

WOW -- those are indeed some of the most restrictive terms I have ever seen! What is this "reasonably expected" clause?? I have never seen anything like that. Sure to wind up in litigation, isn't it?

 

Yes, didn't you know we reasonably expected our dad to die.

 

Jeez...

 

:(

[vmom]

WOW! That does sound pretty restrictive since your dad did not have a heart issue, it was a lung condition, but died from a heart condition. As I see it, he did not have a pre-existing heart condition, but I guess all body systems interact with each other.

 

Based on what you said then, basically unless you take out insurance that waives all pre-existing conditions, then there are alot of loopholes that an insurance company can take. Lets face it, alot of us have older parents who have been on some kind of medication within the last 6 months.