Allianz customer service, or lack thereof

[Greyhound3]

I'm curious if anyone else has experienced problems with Allianz, formerly Access America.

 

Quick summary - we were scheduled to depart on a cruise in mid-August. Around the beginning of July, my wife became ill, but we still believed we'd be able to make the trip. In early August, however, she had a relapse, and her physician stated that the cruise was not an option. We cancelled inside the two week window, therefore it was a loss of 100% of the cruise fare.

 

I submitted a claim to Allianz via fax, but heard nothing. When I called to check on the claim status, I was told they had never received my initial claim. I have a fax receipt that says otherwise. I resubmitted the claim and Allianz eventually paid us about 50% of the cruise fare, claiming that had we cancelled in July we would have gotten more back from the cruise line. However, in July we (and her doctor) still felt that she's be able to cruise, so why cancel? Apparently, one needs to be psychic.

 

I appealed the decision, and this is where I am running into roadblocks. Allianz wanted more documentation, which my agent sent. Allianz claims they never got it. (Anyone see a pattern here?) So now, they want the agent to resend the info, which they will then "evaluate". This will take 7 to 10 business days, according to Allianz.

 

I feel as if this company is doing all in its power to put off payment of our claim. They have not contacted me at any time during the entire process - all contacts have been initiated by me. When I do contact them, they assure me that "all is being done to expedite the process". Somehow, I'm not buying that.

 

Anyone have any suggestions on where to proceed next? I'm thinking the State Insurance Commission and the BBB.

 

Thanks,

Grey

[6rugrats]

Difficult to comment, as I have no idea what type of policy/coverage you had or when you purchased your policy (was it before your wife was ill), and you don't discuss if this illness was due to a pre-existing condition.

 

I have cancelled a couple of vacations, due to illness/injury and have always received 100% of my insured costs back, as long as I cancelled before departure.

 

Usually, we purchase through Travelguard or Travelsafe, and if the person "causing" the cancellation was able to travel on the date of the insurance policy purchase, it isn't a problem.

 

It is possible that Allianz did not receive your initial fax, though you have a receipt showing it was sent. Suggest you (not your agent, because sad to say, you have no way to know what they actually did) resend all documentation by certified mail, return receipt requested. That way, you will have a receipt that it was received. Add a letter stating you need a response within ten business days, or you will be contacting your state's Department of Insurance. I don't feel it's unreasonable to wait another seven to ten days.

 

IMO, the BBB is worthless. All they do is send a letter to the company, which the company may or may not respond to. Don't waste your time unless you just want to hit them with an unresolved complaint. That would be the last thing I'd do anyway.

[klfrodo]

Calling and asking the advice of your State Insurance Commision would not be a bad idea.

 

Also keeps notes of dates and times and the name of all people you speak with on all sides of this issue.

[Greyhound3]

Thanks for the responses. I've replied in bold below.

 

Difficult to comment, as I have no idea what type of policy/coverage you had or when you purchased your policy (was it before your wife was ill), and you don't discuss if this illness was due to a pre-existing condition.

 

The policy was purchased the day after we booked the trip to ensure that pre-existing conditions were covered. My wife has asthma and this was a respiratory ailment, so had we not purchased the policy within the 15 day window after booking, they could have denied the entire claim. However, according to the policy we should have been able to receive 100% reimbursement.

 

I have cancelled a couple of vacations, due to illness/injury and have always received 100% of my insured costs back, as long as I cancelled before departure.

 

We cancelled 12 days prior to departure.

 

Usually, we purchase through Travelguard or Travelsafe, and if the person "causing" the cancellation was able to travel on the date of the insurance policy purchase, it isn't a problem.

 

It is possible that Allianz did not receive your initial fax, though you have a receipt showing it was sent. Suggest you (not your agent, because sad to say, you have no way to know what they actually did) resend all documentation by certified mail, return receipt requested. That way, you will have a receipt that it was received. Add a letter stating you need a response within ten business days, or you will be contacting your state's Department of Insurance. I don't feel it's unreasonable to wait another seven to ten days.

 

Nice idea. The agent will be resending the info tomorrow, and she is also sending me a copy via snail mail. Once I get the copy, I'll also send it with a cover letter similar to what you suggest.

 

IMO, the BBB is worthless. All they do is send a letter to the company, which the company may or may not respond to. Don't waste your time unless you just want to hit them with an unresolved complaint. That would be the last thing I'd do anyway.

 

OK, I'll put that on hold for the moment.

 

 

 

Calling and asking the advice of your State Insurance Commision would not be a bad idea.

 

That's on my "to-do" list for tomorrow.

 

Also keeps notes of dates and times and the name of all people you speak with on all sides of this issue.

 

I've been doing that during the entire process. :)

 

I also find it VERY interesting that Allianz refuses to allow me to speak with the department that handles claims appeals. I have been told on multiple occasions that "that department does not accept phone calls". A strange way to run a business, IMO. A family member with 40 years experience in the insurance industry told me that it's likely Allianz is hoping I get frustrated and give up pursuing the claim. They obviously don't know me very well. :D

 

 

Grey

[sirwired]

You should have luck with the insurance commission. For legal purposes in most jurisdictions a fax transmittal memo is considered "proof of mailing". It's not sufficient for formal legal service (i.e. serving a lawsuit), but it IS sufficient to prove something was sent, and received.

 

The insurance commission should be able to help you remind Allianz of this fact.

[6rugrats]

I don't know why you are having so many problems, but I hope resending the documentation does the trick. Please come back and post the outcome. Good luck!

[cruiseco]

You should have luck with the insurance commission. For legal purposes in most jurisdictions a fax transmittal memo is considered "proof of mailing". It's not sufficient for formal legal service (i.e. serving a lawsuit), but it IS sufficient to prove something was sent, and received.

 

The insurance commission should be able to help you remind Allianz of this fact.

 

The "lost" faxes are definitely a nuisance but the only time-sensitive matters here are:

 

1) when did the doctor recommend against travel, and

2) when was the cruise line notified of the cancellation

3) what does the policy wording say about those two facts

 

Each of those will have some bearing on whether Allianz is on the hook for 100% of the lost cruise fare or only 50%. When they received the faxed and/or mailed claim information won't. If dealing with the department of insurance I wouldn't even bring it up as it's a customer service issue and not one that the folks at the department of insurance will care about or do anything about since the basis for the review is not that Allianz is somehow asserting that the claim amount is being reduced because the claim information was not received in a timely manner.

[Greyhound3]

The "lost" faxes are definitely a nuisance but the only time-sensitive matters here are:

 

1) when did the doctor recommend against travel, and

2) when was the cruise line notified of the cancellation

3) what does the policy wording say about those two facts

 

Each of those will have some bearing on whether Allianz is on the hook for 100% of the lost cruise fare or only 50%. When they received the faxed and/or mailed claim information won't. If dealing with the department of insurance I wouldn't even bring it up as it's a customer service issue and not one that the folks at the department of insurance will care about or do anything about since the basis for the review is not that Allianz is somehow asserting that the claim amount is being reduced because the claim information was not received in a timely manner.

 

1) The doctor made the determination on August 8th.

2) Cruise line was notified on August 9th.

3) Notification needs to be done within 72 hours.

 

Allianz is saying we should have cancelled back in July when she first became ill, and that's why they've only paid 50% so far.

 

My agent called me this morning and advised the information needed had been re-sent. I'm waiting for my copy to arrive so I can snail mail it to Allianz.

 

 

Grey

[cruiseco]

 

Allianz is saying we should have cancelled back in July when she first became ill, and that's why they've only paid 50% so far.

 

Grey

 

Unfortunately, their plan wording is written in such a way that you can never be sure you're doing the right thing:

 

"Specific requirement

The injury , illness or medical condition must be disabling enough to make a reasonable person delay, cancel or interrupt their trip .

 

A doctor must examine you or a traveling companion and advise you or a traveling companion to cancel or interrupt your trip before you cancel or interrupt it. If that isn't possible, a doctor must examine you within 72 hours of your cancellation or interruption."

 

So, if at the first doctor's visit the doctor DID NOT tell you to cancel and you had gone ahead and cancelled anyways your claim could be denied because "A doctor must examine you . . . and advise you . . . to cancel".

 

But if you wait to cancel until some point in time when the Doctor agrees with the decision to cancel the paid amount of the claim is now backdated to a time when the doctor did not recommend cancellation.

 

There is o way that this circular logic would stand up to review by your state's department of insurance -- or any reasonabe person. They can't say at one point that something is required and then later say it really wasn't.

 

Access America/Allianz is the one insurer I have no faith in. Never have.

 

By the way, the plan wording above is from their most popular plan. The wording that applies to your situation might vary depending on plan or state of residence.

[sirwired]

The "lost" faxes are definitely a nuisance but the only time-sensitive matters here are:

 

1) when did the doctor recommend against travel, and

2) when was the cruise line notified of the cancellation

3) what does the policy wording say about those two facts

 

Each of those will have some bearing on whether Allianz is on the hook for 100% of the lost cruise fare or only 50%. When they received the faxed and/or mailed claim information won't. If dealing with the department of insurance I wouldn't even bring it up as it's a customer service issue and not one that the folks at the department of insurance will care about or do anything about since the basis for the review is not that Allianz is somehow asserting that the claim amount is being reduced because the claim information was not received in a timely manner.

 

I agree that the faxes won't change the end decision to cover or not cover; the policy wording and event timing determines that. But conveniently "losing" documentation from policyholders and using that lost documentation as a reason to unreasonably delay a claim decision (which delays payment if the claim is valid) IS the sort of thing that insurance commissions pay attention to; it's more than just a "customer service issue."

[dread_pirate]

The "lost" faxes are definitely a nuisance but the only time-sensitive matters here are:

 

1) when did the doctor recommend against travel, and

2) when was the cruise line notified of the cancellation

3) what does the policy wording say about those two facts

 

Each of those will have some bearing on whether Allianz is on the hook for 100% of the lost cruise fare or only 50%. When they received the faxed and/or mailed claim information won't. If dealing with the department of insurance I wouldn't even bring it up as it's a customer service issue and not one that the folks at the department of insurance will care about or do anything about since the basis for the review is not that Allianz is somehow asserting that the claim amount is being reduced because the claim information was not received in a timely manner.

Not usually true. Almost every insurance policy for any coverage requires that the insurer be notified in a timely manner. Delay in notification of a claim can be legitimate grounds for denying a claim because it can interfere with the insurer's investigation of a claim. (This is standard in the insurance most of us are familiar with - homeowners, auto, umbrella, liability).

 

I wouldn't be surprised if Allianz had a requirement that it be notified promptly.

[Greyhound3]

Not usually true. Almost every insurance policy for any coverage requires that the insurer be notified in a timely manner. Delay in notification of a claim can be legitimate grounds for denying a claim because it can interfere with the insurer's investigation of a claim. (This is standard in the insurance most of us are familiar with - homeowners, auto, umbrella, liability).

 

I wouldn't be surprised if Allianz had a requirement that it be notified promptly.

 

Allianz was notified the day after we cancelled with our agent. They do have a 72 hour notification requirement.

 

On a positive note, I was able to verify that our agent's fax was received and there should be a resolution within the next week.

 

 

Grey

[Greyhound3]

According to their claims website, Allianz has issued checks for the remaining balance of our cruise fare. :)

 

While I'm appreciative that our claim is being paid, I'm not pleased with the fact that we were never contacted by Allianz at any time during this process, even though I received a postcard stating they would be in touch. One phone call could have gone a long way toward alleviating our concerns.

 

I'm watching my mailbox like a hawk.

 

 

Grey

[Hopes4]

According to their claims website, Allianz has issued checks for the remaining balance of our cruise fare. :)

 

While I'm appreciative that our claim is being paid, I'm not pleased with the fact that we were never contacted by Allianz at any time during this process, even though I received a postcard stating they would be in touch. One phone call could have gone a long way toward alleviating our concerns.

 

I'm watching my mailbox like a hawk.

 

 

Grey

 

I'm glad they came to their senses! I hope the check arrives ASAP.

[Greyhound3]

The checks have been deposited into our account. :)

 

 

Grey

[6rugrats]

Another case closed with a happy ending!

[mcmarya]

I actually had a pretty positive experience with Allianz. I had a problem with a tooth during the night before our cruise departure--coverage began the day before since we arrived at the departure city a day early. I was able to call my dentist to have him call in a prescription for an antibiotic which fortunately got me through the cruise. It was only $35 so not a big deal, but I submitted a claim to the claims department e-mail address and had a check in less than a week.

[sail7seas]

Happy you had your claim paid and very appreciative you shared the resolution of the matter with us. So many times people come to these forums, present their situation but never let us know the final result. Thank you for sharing with us.

[landj999]

They take your money, but are so slow to pay. Make you jump thru hoops

Won't use them ever again