sarlin Posted August 27, 2023 #1 Share Posted August 27, 2023 Hello all, We booked a Transatlantic Cruise-Oct 20-Nov. 4. It is now apparent that we will be unable to go due to I now need knee replacement surgery. I feel confident that my Doc. can write a letter to NCL saying that I cannot go. We have the Standard insurance for NCL.Question is: what are our chances of getting our money back or at least a credit? My osteoarthritis has quickly progressed to the point where I will not be able to handle the airports involved or just getting around the ship. We have looked into renting a scooter for the cruise if need be but the surgery takes 5-6 mos of rehab afterwards. We have the Bogo air through NCL as well. Thoughts on our chances of getting credit or our money back? sarlin Link to comment Share on other sites More sharing options...
Markanddonna Posted August 27, 2023 #2 Share Posted August 27, 2023 If your insurance includes medical, your doctor's letter stating that you are not well enough to take the cruise should be enough. Does your policy cover preexisting conditions? That might be the sticky wicket since yours was. 1 Link to comment Share on other sites More sharing options...
roger001 Posted August 27, 2023 #3 Share Posted August 27, 2023 If you have travel insurance, then whatever it covers should be a refund from them. I'm not familiar with NCL standard insurance. However, NCL themselves will not refund anything regardless of a medical issue. Wish you well on the knee replacement. My wife had both done and each, after two months, was like she had never had it, like new again. 1 Link to comment Share on other sites More sharing options...
Babr Posted August 27, 2023 #4 Share Posted August 27, 2023 NCL insurance does not cover pre-existing conditions. If the claims administrator determines that your surgery was related to something for which you were already receiving treatment, your claim will be denied. You will still be eligible for the 75% cruise credit under terms of the standard policy’s Cancel for any Reason provision. 1 Link to comment Share on other sites More sharing options...
Homosassa Posted August 27, 2023 #5 Share Posted August 27, 2023 You need to check the definition of Pre-existing condition. On policies we have had in the past, if a pre-existing condition has been stable for the six months prior to booking and buying the insurance upon booking, then the coverage exemption wouldn't apply. Stable is defined as no change in treatment or diagnosis status. 1 Link to comment Share on other sites More sharing options...
bluesea777 Posted August 27, 2023 #6 Share Posted August 27, 2023 Do you have the surgery date? I think you need it for insurance - if it takes place before your cruise date. 1 Link to comment Share on other sites More sharing options...
Babr Posted August 27, 2023 #7 Share Posted August 27, 2023 25 minutes ago, Homosassa said: You need to check the definition of Pre-existing condition. On policies we have had in the past, if a pre-existing condition has been stable for the six months prior to booking and buying the insurance upon booking, then the coverage exemption wouldn't apply. Stable is defined as no change in treatment or diagnosis status. http://www.ncl.com/sites/default/files/BookSafe-Travel-Protection-Plan_112514.pdf The look-back period for NCL is sixty days. It sets aside conditions controlled solely by taking prescription medication and must have been stable with no change in meds for the sixty days prior to the effective date of the policy. (Page 7) I don’t know if the OP’s situation conforms to that definition, but it is what the insurance company uses to determine coverage. Link to comment Share on other sites More sharing options...
Rare BirdTravels Posted August 27, 2023 #8 Share Posted August 27, 2023 2 hours ago, sarlin said: We booked a Transatlantic Cruise-Oct 20-Nov. 4. It is now apparent that we will be unable to go due to I now need knee replacement surgery. I feel confident that my Doc. can write a letter to NCL saying that I cannot go. We have the Standard insurance for NCL. Question is: what are our chances of getting our money back or at least a credit? My osteoarthritis has quickly progressed to the point where I will not be able to handle the airports involved or just getting around the ship. We have looked into renting a scooter for the cruise if need be but the surgery takes 5-6 mos of rehab afterwards. We have the Bogo air through NCL as well. Thoughts on our chances of getting credit or our money back? Your doctor does not need to "write a letter". Your doctor needs to fill out the required forms certifying that you are restricted from travel. Note: Many doctor's are reluctant to make certifications when there is no medical reason you not traveling (just it would be difficult for the patient to get around) because it borders on insurance fraud. With a knee replacement, you will probably be up on your feet within days of the procedure as part of your rehabilitation. All that being said, if you cancel, you get your port taxes, fees, any gratuities (free at see and daily service charge), any purchased items (including shore excursions) back to the original form of payment. Only the cruise fare is at risk (and incidental non-refundable travel costs e.g., scooter rental). If you are in a standard room, you are at the 75% penalty. If you are in a suite you are in a 100% penalty. If the insurance company (Aon) accepts your claim, they will pay you for your lost cruise fare and incidentals. If the insurance company denies your claim (either because of insufficient documentation from the Doctor or if it was considered an existing condition), then you send your claim denial to NCL and they will give you a 75% future cruise credit under their cancel for any reason provisions. This is an NCL entitlement and has nothing to do with the insurance company. Note: Your situation happens multiple times a week (SallySue breaks her leg, BillyBob decides to have elective surgery and does not feel like cruising). And the insurance adjusters will have a prescribed way of evaluating your claim. I think you would have a good chance of getting a 100% insurance claim reimbursement. But, in all situations, it is incumbent on you to cancel and make requisite notifications. It is incumbent on you to collect the requisite documentation from the cruise line showing a financial loss. It is incumbent on you to get the requisite certifications from your doctor on the required forms. Aon Insurance: 1. Your Sickness, Accidental Injury or death, that results in medically imposed restrictions as certified by a Physician at the time of Loss preventing Your participation in the Trip. A Physician must advise to cancel the Trip on or before the Scheduled Departure Date. Pre-Existing Condition means an illness, disease, or other condition during the sixty (60) day period immediately prior to the Effective Date of Your Certificate/Policy for which You, Your Traveling Companion, or a Family Member booked to travel with You: 1) that would have caused an ordinarily prudent person to seek diagnosis, care or treatment; or 2) for which medical advice, care or treatment was recommended or received; or 3) an existing pregnancy. 2 1 Link to comment Share on other sites More sharing options...
sarlin Posted August 27, 2023 Author #9 Share Posted August 27, 2023 Thanks all. From my understanding After Knee replacement surgery it will take weeks-months of rehab for me to travel. My Doc told me a week ago that it will take 6 weeks to get on the surgery sch. Thanks you all for your helpful advice. We will call NCL tomorrow and see. My husband has said we will deal with it either way.75% credit sounds good to me at this point. Link to comment Share on other sites More sharing options...
mapleleaves Posted August 27, 2023 #10 Share Posted August 27, 2023 (edited) dup Edited August 27, 2023 by mapleleaves Link to comment Share on other sites More sharing options...
mapleleaves Posted August 27, 2023 #11 Share Posted August 27, 2023 Just now, mapleleaves said: this doesn't answer your question, but as a consolation, knee replacement surgery shouldn't require 5-6 months of rehab. I had surgery on July 1 and was gleefully wandering around Rome on Sept 14 with no problems at all. The hospital had me walking the afternoon of surgery! Rehab is really rough, but fight thru the pain and you'll achieve great results ! It's life changing. Good luck ! 2 Link to comment Share on other sites More sharing options...
bluesea777 Posted August 27, 2023 #12 Share Posted August 27, 2023 @sarlin perhaps you might want to wait until you receive the surgery date before proceeding to cancel cruise, etc. Link to comment Share on other sites More sharing options...
phoenix1181 Posted August 27, 2023 #13 Share Posted August 27, 2023 1 hour ago, BirdTravels said: If the insurance company denies your claim (either because of insufficient documentation from the Doctor or if it was considered an existing condition), then you send your claim denial to NCL and they will give you a 75% future cruise credit under their cancel for any reason provisions. This is an NCL entitlement and has nothing to do with the insurance company. A friend's granddaughter cancelled @ 50% due to pregnancy. Would she be able to receive a FFC? Where can I lovate this information? Who is it sent to? Link to comment Share on other sites More sharing options...
Rare Turtles06 Posted August 27, 2023 #14 Share Posted August 27, 2023 2 hours ago, BirdTravels said: With a knee replacement, you will probably be up on your feet within days of the procedure as part of your rehabilitation. I’ve had both knees replaced, and what you wrote here is too simplistic a view of the post-surgical schedule. Yes, they will get the person up on their feet very quickly, for some very limited walking. But months of physical therapy will be required for the person to regain the full use of their knee. In order to get that necessary PT, the person can’t be off traveling or on a cruise ship. It’s not a question of the person not being able to “get around” easily, it’s that there is an entire post-surgical rehab schedule that must be followed. 4 Link to comment Share on other sites More sharing options...
SoloAlaska Posted August 28, 2023 #15 Share Posted August 28, 2023 10 hours ago, Turtles06 said: I’ve had both knees replaced, and what you wrote here is too simplistic a view of the post-surgical schedule. Yes, they will get the person up on their feet very quickly, for some very limited walking. But months of physical therapy will be required for the person to regain the full use of their knee. In order to get that necessary PT, the person can’t be off traveling or on a cruise ship. It’s not a question of the person not being able to “get around” easily, it’s that there is an entire post-surgical rehab schedule that must be followed. It also depends on what type of physio you are doing. My physio therapist doesn’t see anyone more than once a week so with the way she works it makes travel much easier. As a patient of hers she expects you to put in the work which you can do from anywhere really. Also depends what type of knee replacement your having done along with a bunch of other considerations. Some people just bounce back faster than others. 1 Link to comment Share on other sites More sharing options...
sarlin Posted August 29, 2023 Author #16 Share Posted August 29, 2023 OK i did get some answers today from NCL and American Express. I feel much better now. What ever NCL does not cover our AmEx will as we have trip insurance through them too. One thing I left out of my post is that I am in pain from my knee so without the surgery the trip would have been difficult as well. In other words, I need to have the surgery ASAP so I can get back to traveling 🙂 Thanks you all for your responses. 1 Link to comment Share on other sites More sharing options...
Diver2014 Posted August 29, 2023 #17 Share Posted August 29, 2023 I had my knee replaced in April 2022. I'm now in my third session of physical therapy, 16 months later and I can barely walk a half block. Sure, lots of people just get up and go but then there are us who just don't recover like we're 'supposed' to. Give yourself a break and cruise some other time. 1 Link to comment Share on other sites More sharing options...
Babr Posted August 29, 2023 #18 Share Posted August 29, 2023 1 hour ago, sarlin said: OK i did get some answers today from NCL and American Express. I feel much better now. What ever NCL does not cover our AmEx will as we have trip insurance through them too. One thing I left out of my post is that I am in pain from my knee so without the surgery the trip would have been difficult as well. In other words, I need to have the surgery ASAP so I can get back to traveling 🙂 Thanks you all for your responses. Generally speaking, that is true; however, you won’t know for sure until you file the claim. Only the insurance company can see the associated medical records and documentation. After examining that, they will determine whether it is a pre-existing condition or whether it is fully covered under the terms of the policy. No insurance company will tell you over the phone that a claim will be paid without ever having seen it. If it is determined to be pre-existing, neither NCL nor American Express will pay. In any case, you still qualify for the FCC under the NCL policy. Best wishes for recovery and health. Link to comment Share on other sites More sharing options...
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