Troubles on Norwegian Sun

[kylenyc]

Just read Travelguard's policy. The general exclusions state (paraphrase here)--> the plan does not cover any loss caused by or resulting from: use of drugs, narcotics or alcohol.

 

Now, I know you dive into the world of insurance semantics here, but it does not say you cannot drink. But you cannot have a claim as a result of drinking. A fine line, I know.

A fine line i'm willing to bet the insurance company will cross in their own favor.

 

I see no fine line in MedJetAssist's clause ... which doesn't coverage incidents "as a result of the use or abuse of alcohol or drugs (illicit or prescription)" my emphasis on "USE OR abuse". So, what if you're injured after having that one drink?... You're not covered whether or not another party is at fault? What if it wasn't alcohol in combination with heat stroke but a something else like slip-and-fall on a wet deck, ice/snow, etc? Scary.

[Seanote]

A fine line i'm willing to bet the insurance company will cross in their own favor.

 

I see no fine line in MedJetAssist's clause ... which doesn't coverage incidents "as a result of the use or abuse of alcohol or drugs (illicit or prescription)" my emphasis on "USE OR abuse". So, what if you're injured after having that one drinkl... You're not covered whether another party is at fault? What if it wasn't alcohol in combination with heat stroke but a slip-and-fall on a wet deck? Scary.

 

I guess it depends on how much time, money and will you have to argue with the insurance company. In my little bit of understanding, drinking would have to be the proximate cause or contributing factor to your injury. If you broke your ankle because you tripped in a pot hole, there would have to be some proof that alcohol was not only consumed, but a contributing factor. How would the insurance company prove this?

 

Unless you admitted to it like the OP did.

[tempura]

Unless you admitted to it like the OP did.

 

Right. I think OP tried so hard to shift the blame to someone else that they ended up shooting themselves in the foot.

[kylenyc]

Seanote, wow it gets even more complicated, Travelguard's "description of coverage" differs from state to state. In NY, there is no mention of alcohol. In CT, it mentions "intoxication". And then actually policy (which you only get after paying for it) may contain further "reductions, limitations, exclusions, and termination provisions."

 

Found another travel insurance that has reasonable exclusion with regard to alcohol (AMEX) so they do exist... it reads "Consumption of alcohol at or in excess of the legal blood alcohol level in the state or locality in which the Accident occurred;".

[jdvmd]

Welcome to Cruise Critic, OP. Luckily, you have recuperated now. Did anyone force you to drink? No, but you did. NCL is not at fault.

[billie5]

I wonder how many people go on a cruise and don't have a drink. Under the conditions of the policy it seems as if they would never pay for an accident.

Again, I think you are missing the point. The policy only excludes coverage when alcohol contributes to the accident. I certainly drink on cruises, but not just before an excursion -- in particular, not in the morning or early afternoon. I would guess most cruisers do likewise. In these cases, alcohol would have nothing to do with a subsequent accidents on excursions, and the insurance coverage would be intact.

 

A 160 lb person having 1 drink is unlikely to experience a blood alcohol level higher than 0.02%, and that only for a brief period. That level of impairment for most adults is, IMO, unlikely to prevail in court as contributory to a typical accident (assuming you are not a fighter jet pilot :) ).

[Sara_smile]

I feel for the OP. But it seems alcohol was only a factor with the incident. It seems many here want to think it was the only factor. The heat and sun also played a role. Not sure it is fair to say, to the OP....you had a drink so suffer the fate. The alcohol did not make the OP injure himself or miss the ship or something. But it played a role in dehydration with the heat.

 

The insurance company denied the claim but it was nice of NCL to offer future discounts or OBC.

[NLH Arizona]

I feel for the OP. But it seems alcohol was only a factor with the incident. It seems many here want to think it was the only factor. The heat and sun also played a role. Not sure it is fair to say, to the OP....you had a drink so suffer the fate. The alcohol did not make the OP injure himself or miss the ship or something. But it played a role in dehydration with the heat.

 

The insurance company denied the claim but it was nice of NCL to offer future discounts or OBC.

I don't think that anyone has said that alcohol was the only factor. Most are saying that the insurance policy said that they would not pay for an accident if the policy holder drank alcohol and by their choice they did, thus negating the policy. But yes, the OP did take a drink and unfortunately had to suffer the fate.

 

Also, since none of us were there, we don't know all the story. Did the OP have too many drinks, was the ground uneven, was the ground wet, was the Op dehydrated, was it some other reason that made the OP fall, was there a pre-existing medical condition that caused the fall, etc. You know what they say, there are always three sides to every story.

[tempura]

I feel for the OP. But it seems alcohol was only a factor with the incident. It seems many here want to think it was the only factor. The heat and sun also played a role. Not sure it is fair to say, to the OP....you had a drink so suffer the fate. The alcohol did not make the OP injure himself or miss the ship or something. But it played a role in dehydration with the heat.

 

The insurance company denied the claim but it was nice of NCL to offer future discounts or OBC.

 

The OP is the one who mentioned the drinks - I think they wanted to press the fact that NCL provided the drinks/somehow forced people to drink past their limits - and in that effort to try to evade culpability, put the nail in their own coffin and caused the insurance company to deny the claim.

[weltek]

Our NCL insurance policy from a January cruise is below if anyone is interested. The alcohol clause ("intoxicants") is under the exclusions list on pg. 12.

Book_Safe_Travel_Protection_10122012.pdf

[lolane1]

I do not think it is that unreasonable that the average person does not read the policy. How many have really read the entire policy, and/or the entire cruise contract? (yea, some do, but not many).

 

To have a "drinking" clause in a policy pretty much makes it worthless for so many things. Even if this person tripped/fell with only one drink, they would not be covered. Stop blaming the poster!

 

What this comes down to is insurance is generally a fools bet. You are betting something will happen and it will be covered and you will get some money back from the insurance company.

 

The insurance company is betting nothing will happen, and if it does, they can avoid paying. Or at least pay a small amount.

 

NCL, as the cruise line really owes you nothing. The company that does the insurance is to blame here.

 

By the way, I wish the title of this had mentioned problems with INSURANCE. It is not about trouble son the STAR.

 

I have been on cruise critic long enough to hear the horror stories about insurance mostly from people who think they were covered for just about everything. Those are the ones that didn't read the policy.

 

I have also heard about claims that companies have paid immediately. Personally, I called my insurer from Alaska once (brought copy of the policy and phone # with me) and they sent a refund for earrings I purchased and lost on the ship lightning fast. So, personally, I buy travel insurance but I know exactly what I am covered for. So travel insurance is not worthless. It covers way more things than alcohol involved activities, like flights, missed conections, lost baggage etc, etc.

 

Policies are available online. Websites that sell insurance have links and live contact numbers for questions you might have concerning their products. And even after purchase, most policies have a certain number of days you can cancel without penalty. So when a company insures you, they send you the plan, you can read it then and cancel if you wish. I, for one, compare several policies before purchasing and read every line of each. OK so I am a rarity but you can't argue that it's not a good idea.

 

I seriously do not blame insurance companies for denying claims that are alcohol and drug related. Yes, I've seen a lot of very, very happy people swerving on and off the ships in ports. However, it is usually not the majority of people, except maybe those pirate ship excursions!!!! At some point, you have to own your behavior.

[rvsullivan]

There's some very pertinent information missing throughout this whole thing.

We've done this excursion a couple of time now and there are drinks available beginning about 10:30-11 am. They are also available to the several hundred other guests at this all inclusive that is available to NCL guest and the general public. We've found it possible to have two or maybe three drinks during the cooking portion spread out over a couple of hours. To have substantial amounts of alcohol, you would have to neglect the cooking portion, it is quite busy.

The OP has never come back with any details. How much to drink, how injured, what time of day did it occur etc. Something about this whole thing is not right and waiting two years to post is a bit odd?

 

It's always sad when someone is injured. But accepting responsibility for ones own actions is key.

[Saving Up To Be Eccentric]

The OP is the one who mentioned the drinks - I think they wanted to press the fact that NCL provided the drinks/somehow forced people to drink past their limits - and in that effort to try to evade culpability, put the nail in their own coffin and caused the insurance company to deny the claim.

^ This.

Also, I remember college. Has anyone on these boards never seen someone under the influence do stupid feats of daring they'd never do sober? While I'm perfectly willing to believe the OP wasn't about to loose a fistfight with a tree, I also completely understand the insurance company's limitation. And I don't think the trip insurance is completely invalidated the moment you take your first tipple. Only if you are under the influence at the time of an incident that resulted in a claim. I could get my money back through trip cancellation if I got into an accident on the way to the airport, unless it was found that I was drunk-driving, in which case, I'd get nothing.

[punkincc]

There's some very pertinent information missing throughout this whole thing.

We've done this excursion a couple of time now and there are drinks available beginning about 10:30-11 am. They are also available to the several hundred other guests at this all inclusive that is available to NCL guest and the general public. We've found it possible to have two or maybe three drinks during the cooking portion spread out over a couple of hours. To have substantial amounts of alcohol, you would have to neglect the cooking portion, it is quite busy.

The OP has never come back with any details. How much to drink, how injured, what time of day did it occur etc. Something about this whole thing is not right and waiting two years to post is a bit odd?

 

It's always sad when someone is injured. But accepting responsibility for ones own actions is key.

 

I don't think the OP necessarily had what many would consider a "substantial" amount of alcohol. Even 2 or 3 drinks spread out over 2+ hours would be too much for many people, especially this who usually do not drinknat all. The OP stated, "I am not used to drinking and as a result when we left the air conditioned building and started walking around. The heat and alcohol hit me and I fell.". It is possible he had only 1 strong drink, which would have been "substantial" to him.

 

I had a somewhat similar situation once in Cabo, although with damage only to my pocketbook. After downing a fishbowl sized margarita, we walked out into the hot sun. Wowza!! We eventually ducked into a jewelry store to get a respite and in a weakened state, I purchased a piece of very expensive jewelry. This situation was unfortunately not covered by insurance either. My point is don't underestimate the effects of a hot climate combined with alcohol.

 

I don't find it odd the OP did not post here until now. Being paralyzed from the chest down, I am sure he had his hands full with rehab, dealing with insurance and other worries. I do wonder how his fall resulted in paralysis. It would take a very severe tumble to break a back.

[smeyer418]

I don't know whether NCL is right or the Poster is but there is an relatively easy way for you to find out.

Except for the return of monies paid for the cruise, NCL's and all cruise lines issued insurance is really under written by a real insurance company that by law has to be issued by an insurance company authorized to do business in the State that you live.

You have a fairly active insurance commissioner in GA

and you can file a complaint on line

 

http://www.oci.ga.gov/ConsumerService/complaintprocess.aspx

 

but the policy does have a relatively short and enforceable time for making a complaint so get cracking...

 

NCL does use an administrator to review these claims for the insurance company. They work on guidelines set by the insurance company(they are called third party administrators)

[billie5]

Most are saying that the insurance policy said that they would not pay for an accident if the policy holder drank alcohol ....

 

This is so untrue. Weltek has actually linked to the NCL policy. It says "loss CAUSED BY or INCURRED RESULTING FROM being under the influence of .. intoxicants." Nowhere does it imply just drinking alcohol means they will not pay. Whether modest drinking would cause a particular accident is a matter of fact which juries (or judges) decide in individual cases. But a litigant would probably have a huge burden arguing that one drink, for example, caused a certain accident.

 

In OP's case, he seems to admit to excessive drinking and to the fact that the drinking contributed to the accident. Thus, it can not be a surprise that the insurance company refused to pay.

[cmdchiefthom]

It seems to me that the OP started his comments with "Troubles on Norwegian Sun", and having my next cruise booked on the Sun, it is why I first read this thread. Actually it seems his troubles were off the Sun, not actually on the ship. It would also seem that once his avenues of compensation for his injury, and the cruise days he missed because of his alcohol induced behavior were denied by the insurance company, it now becomes the ship's fault. He has two previous posts on Cruise Critic, yet has five NCL cruises without a comment. Suddenly 21 months after the incident he makes this post. It appears to me that denied compensation for his own misconduct, he pleads his case here.:rolleyes:

[shelly11]

I'll ignore this thread due to the fact it is regarding something so old! Why even complain now? And if you were so drunk that you fell and hurt yourself it is your problem. Anyone can offer you drinks but it's your choice to get so drunk and hurt yourself.

[NLH Arizona]

This is so untrue. Weltek has actually linked to the NCL policy. It says "loss CAUSED BY or INCURRED RESULTING FROM being under the influence of .. intoxicants." Nowhere does it imply just drinking alcohol means they will not pay. Whether modest drinking would cause a particular accident is a matter of fact which juries (or judges) decide in individual cases. But a litigant would probably have a huge burden arguing that one drink, for example, caused a certain accident.

 

In OP's case, he seems to admit to excessive drinking and to the fact that the drinking contributed to the accident. Thus, it can not be a surprise that the insurance company refused to pay.

I believe the OP said they would not pay because of his/her use of alcohol and I quote what he said: The travel insurance being sold by the insurance company used by Norwegian states that if ANY alchol is involved, the policy does not cover the accident. And many of us were just agreeing with what the OP said. If you disagree with the comments, then you need to take it up with the OP, since he/she was the one denied payment of their claim.

[ronandannette]

It seems to me that the OP started his comments with "Troubles on Norwegian Sun", and having my next cruise booked on the Sun, it is why I first read this thread. Actually it seems his troubles were off the Sun, not actually on the ship. It would also seem that once his avenues of compensation for his injury, and the cruise days he missed because of his alcohol induced behavior were denied by the insurance company, it now becomes the ship's fault. He has two previous posts on Cruise Critic, yet has five NCL cruises without a comment. Suddenly 21 months after the incident he makes this post. It appears to me that denied compensation for his own misconduct, he pleads his case here.:rolleyes:

 

Not sure he's "pleading" anything on a forum that obviously can't be of any help, and I actually think he's done some of us a service. Who else (besides me) didn't know or fully understand the consequences of such clauses? Granted I've never purchased NCL insurance but I have bought it from other cruise lines and independent sources. I also believe I have "read" the contents yet I too would have been very unplesantly surprised to have been denied coverage in the OP's case.

 

One thing I wish he would come back and clarify though is the issue of the medical coverage (as opposed to the trip-interruption). I imagine the acute care for a spinal-cord injury, possible medical evacuation and year and a half of rehab must have been astronomically expensive. Was that coverage denied too and if so, who would care about a thousand or two lost on the cost of the cruise?

[punkincc]

I'll ignore this thread due to the fact it is regarding something so old! Why even complain now? And if you were so drunk that you fell and hurt yourself it is your problem. Anyone can offer you drinks but it's your choice to get so drunk and hurt yourself.

 

We have no evidence that the OP was what most of us would consider drunk. Nowhere has he stated how many drinks he had. He only stated that "he is not used to drinking", and that "after leaving the air-conditioned building" "the heat and alcohol hit me and I fell".

 

Another poster here who has done the excursion stated that it is possible to have 2-3 drinks over an approx 2 hour cooking class. Many of us would not be drunk afterward. We don't know that he had 2 drinks or merely 1.

 

If the OP did bring up the drinking issue himself, then he gave the insurance company an immediate out. Don't forget that if the insurance company does use the alcohol clause, it might be a subjective decision, rather than an objective one. In very few cases are they going to have your blood alcohol level. If you have a fall after dinner, and in the investigation it comes out that you had a glass of wine, you will have a very difficult time refuting this denial based on the alcohol clause unless you want to hire an attorney.

[kylenyc]

We have no evidence that the OP was what most of us would consider drunk. Nowhere has he stated how many drinks he had. He only stated that "he is not used to drinking", and that "after leaving the air-conditioned building" "the heat and alcohol hit me and I fell".<snip>

^Someone with reading comprehension.

[lww46]

First of all let me make it clear I am not posting just to place blame or find fault on anyone, but only to educate and inform through my own experience. As someone stated in a post it is now almost two years later and why bring it up now. I just want everyone who purchases travel insurance to make sure and read the policy before cruising.

I will try to answer some of the questions raised about my accident. It is true I did not request a copy of the insurance policy before the cruise. However when I booked this cruise I also purchased the travel insurance and the agent did not offer to provide a copy. This was my 5th cruise with NCL and I purchased travel insurance through them each time and never received a policy. I found out the hard way I should have asked for a copy.

While I was in the Mexican hospital, paralyzed in my arms and from the chest on down, there was contact with the NCL representative. This conversation about what had happened brought up in details if drinking had been involved. We told him we had a couple of drinks during the excursion. The next day we found out the travel insurance would not cover any of our expenses due to my drinking. However there was never a blood alcohol test done on me to determine if I was drunk. Which led me to assume any drinking would be cause for denying insurance coverage. The medical evacuation flight cost us more then $13,000 back to the USA. Upon returning home, my wife then requested a copy of the policy from NCL.

During the time at the Mexican hospital, several families were experiencing emergencies off different cruise lines. They, too, had to find a way to come up with funds in order to get their loved one’s back home. Some had really life threatening events, but unless they could come up with a way of paying, they were stuck.

Ironically, at the end of this cruise, NCL emailed the “end of cruise statement” we all get after each cruise, and there was a charge for using the mini bar the morning of my accident. However, upon arrival for our cruise, we had already told the steward to remove the mini bar set up as we wouldn’t use it, and especially feared if someone else had, we couldn’t prove it wasn’t us. They did remove the charge from the bill after my wife explained the removal of the mini bar the first day of the cruise.

My wife was in communication with NCL constantly after our return home. After several months we received a letter from NCL offering us a few hundred dollars credit on a cruise we would have to take within a year. It also stated we could not discuss my accident with anyone if we accepted the agreement. At that time I was still in a wheelchair and did not know if I would walk again let alone take a cruise. We went to an attorney to seek legal advice. We showed him the policy and all the correspondence we had with NCL, including the NCL offer. The lawyer stated the insurance policy would not cover me. He also said the insurance policy was typical for cruise lines to use. The lawyer advised us not to sign that agreement which we did not sign. He also suggested we write back to NCL telling them exactly what we wanted, which we did. All we wanted was to recover the already paid for gratuities and shore excursions we did not use that we booked, through NCL prior to departure. I thought that this would be a fair attempt to end on a positive note. Expectations fell short when NCL took many months to respond and then in a letter stating “time had run out for any further action”.

Again just to make clear my whole purpose in posting this is to warn all cruisers, if they purchase travel insurance, to make sure they read the policy before cruising.

[MsTabbyKats]

Did you have to pay the medical/hospital bills in Mexico "out of pocket".

 

Lesson learned....keep details to yourself.

[SciFiCruiser]

I'll ignore this thread due to the fact it is regarding something so old! Why even complain now? And if you were so drunk that you fell and hurt yourself it is your problem. Anyone can offer you drinks but it's your choice to get so drunk and hurt yourself.

 

How exactly is sharing your opinion "ignoring?"