Zika Coverage Without Cancel for Any Reason Insurance

[escapethecube]

Have you canceled a trip because of Zika and have been denied trip insurance coverage? I want to share my experience, maybe it will help others.

 

My brother and pregnant sister-in-law had to cancel a cruise on the advice of her doctor because several of their ports were on the CDC list for Zika. They had travel insurance with Nationwide's "Luxury Cruise" policy. They filed a claim and were initially denied. They asked me to help and I reviewed their policy.

 

About me: I work in the property casualty insurance industry, not at Nationwide, and I am not a lawyer. I know just enough to be dangerous.

 

My brother's policy offered Trip Cancellation coverage when: " the Center for Disease Control issues a travel warning that travel should be avoided..." You'd think this means it's covered, but Nationwide denied the claim because the CDC issued a Level 2 Travel Alert not a Level 3 Travel Warning.

 

Insurance policies are a funny thing called a "contract of adhesion." Meaning the insurance company wrote the policy and you can take it or leave it. When there is ambiguity in wording and it can be reasonably interpreted in favor of the customer, it is.

 

Every policy has a definitions section. Nationwide could have easily defined "travel warning" as a "Level 3 Travel Warning", but instead they left it for interpretation. Well, the CDC's special statement for pregnant women to postpone travel to affected areas sure seemed like a warning to us.

 

We appealed the denial stating that the term "travel warning" is vague and that we reasonably interpreted the CDC's statement as a warning. After a couple days we got the following back from Nationwide, "The CDC has not issued a travel warning but rather an Alert-Level 2, Practice Enhanced Precautions. Because our policy does not define "travel warning," we agree to provide trip cancellation benefits." Chalk one up for the little guy, they covered the claim! :D

 

So if your policy has similar language, you should consider appealing the claim examiner's decision. Don't just assume the first person you talk to is right, they may be misinformed or repeating what they've been told.

 

Remember, your mileage may vary! Good luck!

[fishywood]

Many cruise lines are allowing expectant parents to cancel without penalty, or at least rebook to an itinerary free of this issue. Did they not directly explore this possibility first before having to involve an insurance claim?

 

And I'm just wondering if the fine print in the insurance policy also includes a confidentiality agreement within the appeal process. I am surprised someone working in the industry has no issue naming a specific carrier and quoting verbatim from their communication to a client on a public forum. Hopefully there will be no blowback.

[sail7seas]

Just a suggestion you likely have thought of but many cruise lines are either refunding or giving future cruise credits for pregnant woman and their partner/travel companion if their cruise goes to ports where Zika virus has been identified.

 

A credit would be better than nothing.

 

I'm happy to read the insurer reconsidered and will cover the claim.

 

Edited February 26, 2016 by sail7seas

[Keith1010]

Thanks for sharing your experience.

 

Keith

[escapethecube]

You know with all the news it seemed the cruise lines and airlines were tripping over themselves to be accommodating. I thought it wasn't going to be an issue at all. Not so much.

 

Airlines may have been offering refunds but only for travel directly to Latin America and maybe the Caribbean. Since they were flying to a US port the airline was unwilling to even wave their cancellation fee and offer a credit. Although I will add they had a very sympathetic reservations rep who tried very hard to get a refund under the winter storm at the time, but no dice. The cruise line was the same. Didn't waver from their usual cancellation policy.

 

I shared this story and named the insurer because requiring a customer to fight for coverage is what gives the whole insurance industry a bad reputation. Hundreds of thousands of women and men in the industry work every day to offer great customer service and pay covered claims fairly.

[Clarea]

Thanks, appreciate the info.

[Karysa]

Reading up on the Zika outbreak in Brazil brought up information that the pesticide widely used in Rio and not the mosquito itself could very likely be the cause of the birth defects. Obviously more research is being done on that but Zika itself has been around since the middle of the last century and the pesticide used in Rio is banned in North America due to safety concerns so you can see how researchers and doctors are bringing this up. I also read where women in Brazil were told not to get pregnant for 2 years. The thought that pesticides may have contaminated the water and soil rather than the Zika virus itself may be the rationale for this as well. It all is certainly food for thought for travelers, and the travel industry to.

[CPT Trips]

You know with all the news it seemed the cruise lines and airlines were tripping over themselves to be accommodating. I thought it wasn't going to be an issue at all. Not so much.

 

SNIP.

 

They may be accommodating, but at least one cruise line would not commit as to what the would do IF the Zika virus were to turn up in a country where it has not yet hit. They also haven't been real helpful to family groups when only one cabin involves a pregnancy.

 

Reading up on the Zika outbreak in Brazil brought up information that the pesticide widely used in Rio and not the mosquito itself could very likely be the cause of the birth defects. Obviously more research is being done on that but Zika itself has been around since the middle of the last century and the pesticide used in Rio is banned in North America due to safety concerns so you can see how researchers and doctors are bringing this up. I also read where women in Brazil were told not to get pregnant for 2 years. The thought that pesticides may have contaminated the water and soil rather than the Zika virus itself may be the rationale for this as well. It all is certainly food for thought for travelers, and the travel industry to.

 

Absent more clarity, are you suggesting women take the risk?

[sail7seas]

You know with all the news it seemed the cruise lines and airlines were tripping over themselves to be accommodating. I thought it wasn't going to be an issue at all. Not so much.

 

Airlines may have been offering refunds but only for travel directly to Latin America and maybe the Caribbean. Since they were flying to a US port the airline was unwilling to even wave their cancellation fee and offer a credit. Although I will add they had a very sympathetic reservations rep who tried very hard to get a refund under the winter storm at the time, but no dice. The cruise line was the same. Didn't waver from their usual cancellation policy.

 

I shared this story and named the insurer because requiring a customer to fight for coverage is what gives the whole insurance industry a bad reputation. Hundreds of thousands of women and men in the industry work every day to offer great customer service and pay covered claims fairly.

 

 

OP, I appreciate your posts. If we don't hear of situations such as this, we go merrily on our way thinking some claims would 'obviously' be paid when clearly it is not quite so obvious to some insurers.

 

 

I wonder if same insurer refused to pay the claim of a pregnant woman, she should (heaven forbid) become infected on that trip with zika virus and her baby is born with that bad birth deformity?

 

Any lawyers wish to speculate if the insurance company would bear some responsibility. (Sure, they didn't make the pregnant woman travel but they certainly influenced her decision making.)

 

[Karysa]

 

Absent more clarity, are you suggesting women take the risk?

 

I wouldn't suggest what people do here but I saw several pregnant workers at our resort in DR so I hope for the sakes of those that live day to day with this issue that the truth is discovered and shared sooner rather than later.