TravelGuard issue defining "forfeited" cost

[steviet525]

On a 6-night RC Western Carribean cruise with family. Purchased TravelGuard (TG) Gold insurance. On first day, my spouse breaks her foot by the pool. Ships doctor x-rays and confirms it's broken. Day 2 we're at sea. Next port is Grand Cayman on Day 3. Contact TG and start process of enacting the trip interruption portion of the policy. However, in order for them to book the flight home, they need a doctor to compete a "fit to fly" form. What do you know? The ship's doctor will not sign the form since she's "not an orthopedic specialist". (it has basic questions about care during the flight, but maybe she can't/won't for liability purposes). So, on Day 3 ship arranges for us to be taken to ER on Grand Cayman so we can have her seen by a Dr. and get the form signed. This takes the better part of the day, so there's no way we can fly home from Grand Cayman.

 

At this point, I call TG and ask to speak to claims to discuss what my options are. I specifically ask whether I'll be able to claim the trip interruption occurred on Day 1, and whether I'll be receive reimbursement for all 6 nights. Generally wife is OK - in pain and it's not fun being on crutches, so it's not like we HAVE to leave - part of me is thinking maybe we tough out the rest of the week. However, we're not really sure if surgery is needed, and would prefer to have our own doctor look (nothing against the medical system on Grand Cayman, but the ER physician looked like he just graduated from high school) I tell the TG claims rep the information about what would be reimbursed will be crucial to my decision-making process. The person in claims I'm speaking with affirms that, although not an official claim at this point, based on what she was told that I should be entitled to be reimbursed for the entire cruise since the injury happened on the first day. I'm relieved and thinking to myself how great travel insurance is! I take down her name, copious notes of the discussion, and confirm that their calls are being recorded should I need to refer in the future. We decide to leave the cruise on Day 4 from Jamaica. Trip interruption covers my wife's flight home, but I need to come out of pocket for me and 3 kids, and will need to file for reimbursement from TG. We get home and file my claims/paperwork. So far I'm thrilled with TG and telling everyone how great it is and lucky we were by having them.

 

Fast forward to 1 month after. I'm fairly rapidly reimbursed for the flight home - which is nice, but they have reimbursed me $0 for the unused flight home and the cruise. Takes about a month of back and forth - eventually I get them to pull the recording and now their going to reimburse me for the unused air and the UNUSED portion of the cruise, which they determined to be 3 nights, since we left from Jamaica.

 

I'm happy for the partial reimbursement (vs. the initial $0), but I'm frustrated by their lack of adherence to what was explained to me on the phone. Had I been informed differently, we might have made a different decision and not cancelled the last half of the trip.

 

I know they have the recording of this call. However, they will not share a copy of the recording or a transcript unless I have them subpoenaed.

 

Do I keep fighting for the other three nights? Has anyone ever had to deal with a similar situation? We would have left on the first day except we were essentially captive at sea. Couldn't leave on Day 3 because we needed to get the form completed to allow them to book the flight.

 

Frustrated!! Any ideas/thoughts/words of encouragement to see this through?

[cruiseco]

 

Do I keep fighting for the other three nights? Has anyone ever had to deal with a similar situation? We would have left on the first day except we were essentially captive at sea. Couldn't leave on Day 3 because we needed to get the form completed to allow them to book the flight.

 

Frustrated!! Any ideas/thoughts/words of encouragement to see this through?

 

I would say they probably made the right decision in only reimbursing for the 3 days you were not on the ship. Even though those first three days might have been unpleasant due to the broken foot you were on the ship. Trip interruption is a very specific thing and doesn't take into account when the injury/illness actually happened but at what point you departed from the scheduled trip.

 

You might want to send everything to your state's department of insurance for their review. If they agree with your side of things you'll get paid. If they don't at least you'll know TG made the correct decision. I believe in all states you can find something on the state dept of insurance web site to get the ball rolling and the process should be free (your tax money at work).

[SuzanneSLO]

I would say they probably made the right decision in only reimbursing for the 3 days you were not on the ship. Even though those first three days might have been unpleasant due to the broken foot you were on the ship. Trip interruption is a very specific thing and doesn't take into account when the injury/illness actually happened but at what point you departed from the scheduled trip.

 

You might want to send everything to your state's department of insurance for their review. If they agree with your side of things you'll get paid. If they don't at least you'll know TG made the correct decision. I believe in all states you can find something on the state dept of insurance web site to get the ball rolling and the process should be free (your tax money at work).

 

Its also possible the the OP's wife's trip was interrupted on Day 1 due to the injury, but the OP's trip was not interrupted until Day 3 (spent the day at the GC hospital) or Day 4 (left the ship).

 

To the OP: Hope she is feeling better. Best of luck -- Suzanne

[sirwired]

I think the complications stems from this: If the injury was really bad enough to immediately interrupt the trip (which would justify a claim back-dating to Day 1, even if you left later), why didn't you all go home from Grand Cayman? Even though you were too late to leave for home that day, you could have left first thing the next morning (thereby getting you home earlier than you would from Jamaica), and TG would have covered your hotel in GC and airfare home. From their perspective, they may be thinking that the injury must not have been a Day-1 trip-ending problem, or you would have ended it ASAP.

 

I've filed TG claims before, and the claim-takers are very careful about not "pre-approving" claims based on your oral description of your situation. (Did you mention you were going to re-board and leave the cruise later on your call?)

[steviet525]

Thanks for the responses and the kind words. She's doing just fine - cruise was 6 months ago so she's all healed up. no lasting damage :)

 

Sirwired- we didn't leave from Cayman because we were waiting until we arrived at port that morning for confirmation that the cruise was going to arrange trnasport to doctor. Kinda long story but we were initiallytold we were getting an appointment with a doctor, but turnsout we were just being taken to ER. That took almost the entire day. There wasn't enough time to pack up family (3kids) and get off the ship to make last flight out from Cayman, plus all flights connected someplace and didn't want to deal with the nightmare of a wife in a wheelchair and dragging 3 kids thru airport to make a connection and getting in well after midnight. Jamaica had multiple daily direct flights. Told this to TG on phone and they understood/agreed.

 

 

****UPDATE****

Spoke again with TG after my post. They insist that the claims agent didn't discuss with me that I would receive full reimbursement. However, they have finally agreed to pay in full based on the timeline I outlined.

 

Not sure exactly what convinced them - I suspect they know their agent wasn't exactly clear with me when I called. Nevertheless, I'm pleased with the outcome (let's hope the check actually makes it...)

 

Although the last few months of constant follow up wasn't fun. I would endorse TG and use them again. I would just echo what I have read here multiple times - know what you're getting yourself into, and document everything meticulously and you should be fine. Going the extra mile to help them do their jobs seems like the best strategy. Also, be persistent! Don't get discouraged!

 

Happy travels all!

[PennyAgain]

For all the reasons detailed above I also carry an annual policy from MedJet assist but (and it is a huge BUT) that policy requires the covered person be in a hospital and be flown to another hospital for the coverage to kick in.

 

Fine print reading can be a full time job.

 

Very glad your wife has recovered.

[RJake1]

My experience with TravelGuard is that they nickel-dime every expense. For example, we had to divert due to illness. I paid for a hotel using my frequent-stay points instead of cash. When I submitted the claim, TG denied saying they don't pay for "points" but would have reimbursed if I had paid cash or credit.

 

Now, I provided cost of points (you can buy them on hotel website) which was essentially equivalent to the cost of one night's stay, but TG still denied.

 

It wasn't worth fighting about so I let it go. That's just one example.

 

Just seems to me that TG applies a much heavier hand than other companies I've experienced.