Without a supporting doctor’s note, this trip insurance claim is DOA

Some of my fondest vacation memories are from trips to the Yucatán peninsula when my kids were younger: tubing an underground river; bumping down dirt roads exploring the jungle in an open-top Jeep; watching my daughters snorkel for the first time, surrounded by a rainbow-hued school of fish.

So I can well understand how deeply disappointing it must have been for the whole family when Apryle Jackson’s son took ill, just as they were boarding their connecting flight for Cancún en route to their vacation resort. They canceled the trip and returned home.

But it gets worse. Now Jackson is on the hook for the more than $4,000 she prepaid for their vacation, even though she bought trip insurance at the suggestion of her travel agent. But her case is a warning to others about the limits of travel insurance and the importance of understanding what is does and doesn’t cover.

The problem is, she didn’t buy it until the day before the trip. The insurance company, AIG, denied her claim, explaining that because the child was ill on the day the policy became effective, the illness was considered a pre-existing condition.

“The claims agent stated I should have purchased travel insurance days beforehand to be covered,” she wrote our advocates, “But there was no need to purchase because no one was sick or had any prior illnesses.”

But the insurance company isn’t going to take her word for it. Like many such policies, hers had a provision excluding coverage for any pre-existing condition occurring during a 60-day window prior to the start of coverage. The frequently asked questions section of the website for AIG Travel Guard spells out the company’s policy:

Pre-existing Medical Condition Exclusions would likely be applicable to a condition of a traveler, traveling companion or family member who was first diagnosed, had a change in diagnosis or required a change in medication during the 60, 90, or 180 day look back period (depending on plan purchased) immediately preceding and including the effective date of coverage.

The site also explains that some plans include a Pre-existing Medical Condition Exclusion Waiver when purchasing the plan within a specified time period immediately following initial trip payment. But that wasn’t the case for the plan Jackson purchased.

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And the medical documentation she provided did nothing to support her claim. The doctor’s statement specifically says “I did not advise client to cancel.” In the portion of the claim form that asks if the the patient was unable to travel he noted “unknown,” probably because he did not see the child until five days after the cancellation.

Fortunately, she’d flown Southwest Airlines for the first portion of her trip, and they got the family back home at no additional cost. But there’s nothing our advocates can do to help with the rest of this unfortunate missed vacation.

The takeaway here is that while travel insurance can be an important safeguard, especially when you’ve prepaid for an expensive vacation package, you need to clearly understand the provisions of your policy. And if something goes wrong, immediately begin gathering the documentation you’ll need for your claim.

Of course that’s easier said than done, especially when you’re a mom and your first concern is your sick child. Still, we have no choice but to file this under Case Dismissed.

Dale Irvin

Dale Irvin is a semi-retired writer and editor, now living in south Florida after three years roaming around North America in an RV. You can read about those adventures at fabulousfifthwheel.com.

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