Claim denied on a terrorism technicality

By | October 24th, 2009

delhiQuestion: My travel insurance claim has been denied, and so have my appeals. I hope you can help us.

My husband and I were scheduled to visit India last Thanksgiving, the day after the horrific terrorist event began. British and Americans were being singled out and murdered, hotels were being burned, and threats were made of hijacking and attacks on airports and train stations in the country.

We were terrified of the unfolding events, and canceled our travel plans. We had purchased a travel insurance policy through Access America. One of the named perils is a terrorist event.

Access America has denied our claim because we were scheduled to travel to New Delhi, and the hotel that was under siege was in Mumbai. I believe that the definition of destination — according to their policy and the online dictionary — includes the entire country. Plus, as part of the terrorist activity, impending threats were made to airports, train stations and other places throughout India.

We’ve lost about $7,300. Is there anything you can do? — Diane Gandara, Napa, Calif.

Answer: I agree with your definition of a destination. Access America should have refunded the money you spent on your vacation.

Why didn’t it? I asked the company, and a representative told me that in order to make a successful claim, the terrorist event would have to occur in the city you were traveling to. Since you were on your way to Delhi, not Mumbai, the claims examiner was technically correct to deny your request.

That clause should have been clearly spelled out in your contract. If you didn’t read it before you bought your policy, you should have reviewed it before making your claim. That way, you could have saved yourself months of pointless back-and-forth between you and the insurance company.

Related story:   Hello, where's my cello?

Of course, Access America could have been clearer with you. A quick look at your policy and its definition of “destination” would have shown any capable phone agent that your claim would have gone nowhere. Why didn’t someone tell you that your trip to Delhi wouldn’t be covered if you canceled?

I read contracts every day, but none are as confusing as the ones for travel insurance. Now that I think of it, I’m not entirely convinced that you would have been able to understand your contract, even if you’d studied it. Do you need a law degree to make sense of the paperwork? Maybe.

You were correct to appeal your case to Access America. More than 90 percent of insurance appeals are decided in a traveler’s favor. After that, you could have gone to arbitration, which means you allow a neutral, third party to decide your case. Or you could have taken Access America to court.

Copying the insurance commissioner in your state might also motivate your insurance company to see things your way.

As it turns out, none of that would be necessary. Access America recently switched to a new underwriter with a more inclusive definition of “destination.” It reviewed your claim again. “In this case,” said spokesman Mark Cipolletti, “the entire country of India should be considered the destination.”

Access America agreed to process your $7,300 claim.

(Photo: Panoramas/Flickr Creative Commons)

We want your feedback. Your opinion is important to us. Here's how you can share your thoughts:
  • Send us a letter to the editor. We'll publish your most thoughtful missives in our daily newsletter or in an upcoming post.
  • Leave a message on one of our social networks. We have an active Facebook page, a LinkedIn presence and a Twitter account. Every story on this site is posted on those channels. The conversation ranges from completely unmoderated (Twitter) to moderated (Facebook and LinkedIn).
  • Post a question to our help forums or ask our advocates for a hand through our assistance intake form. Please note that our help forum is not a place for debate. It's there primarily to assist readers with a consumer problem.
  • If you have a news tip or want to report an error or omission, you can email the site publisher directly. You may also contact the post's author directly. Contact information is in the author tagline.