After a Trip Mate claim denial, is she out of luck?

After this Trip Mate claim denial, is she out of luck?

When Smitha Gopal received a Trip Mate claim denial after her family’s vacation, she was confident they’d gotten it wrong. Her trip from the Faroe Islands, just off the coast of Iceland, back to Baltimore, had been interrupted by a flight delay — a covered event under her travel insurance policy.

Not so fast.

True, the first leg of their flight from Vagar Airport to Reykjavik International Airport on Atlantic Airways didn’t take off on time. But you have to pay close attention to the definition of “flight delay” — otherwise you might think you’re covered, as she did.

Her Trip Mate claim denial case is a cautionary tale for anyone planning a getaway and who has taken out insurance and maybe is feeling overconfident about their coverage. Read the fine print — or you could end up with a big bill for air transportation.

Talk is cheap — even when it’s from your travel insurance company

Gopal bought a Trip Mate policy when she booked her Faroe Islands vacation last year for herself, her infant son, and husband. The outbound trip was uneventful. But then …

“We were supposed to fly Atlantic Airways from the Faroe Islands to Iceland, and then fly United from Iceland to the US,” she says. “The Atlantic flight did not take off. Initially, they listed it as a 12-hour flight delay.”

Yikes, 12 hours? That sure sounds like something travel insurance would cover. So Gopal contacted Trip Mate.

“I called the Trip Mate hotline and explained the situation,” she says. “The agent told me to rebook my trip as cheaply as possible, and my policy would cover my claim.”

Gopal didn’t read her travel insurance policy. Why would she? After all, someone from Trip Mate had assured her verbally that the company would cover her expenses, which came to $1,705.

Case closed, right?

What’s going on with this Trip Mate claim denial?

After Gopal reached out to our helpline, our advocate Mark Bergman took a hard look at her policy, which was underwritten by World Nomads. Let’s check the denial letter from Trip Mate (You can find Trip Mate company contacts on our site):

Thank you for contacting us.

We can certainly understand your disappointment that the outcome of your claim is not more favorable; however, as a claims administrator, we must review all claims according to the plan provisions and the documentation submitted.

According to the plan purchased, The Company will reimburse You, up to the Maximum Benefit shown on the Confirmation of Coverage, if You join Your Trip after departure or are unable to continue on the covered Trip due to any of the following reasons that are Unforeseen:

Strike that causes complete cessation of services for at least twenty-four (24) consecutive hours;

Weather that causes complete cessation of services for at least twenty-four (24) consecutive hours and prevents You from reaching Your destination. This benefit will not apply if the potential natural disaster has been forecasted or a storm has been named prior to purchase of this coverage.

Mechanical issues is not a listed covered reason for Trip Interruption.

If you have additional information which you think will have a bearing on your claim, please forward that information to our office, attention Appeals Unit, and we will be happy to review our decision.

Taking a closer look at this trip insurance policy

Mark took a closer look at her policy. Sure enough, coverage kicks in for the following named perils:

A strike that causes complete cessation of services for at least twenty-four
(24) consecutive hours
.

Weather that causes complete cessation of services for at least twenty-four (24) consecutive hours and prevents You from reaching your destination. This benefit will not apply if the potential natural disaster has been forecasted or a storm has been named prior to purchase of this coverage.

The operative word here is 24 hours. Not 12 hours, 24 hours. And even if you could get past that hurdle, it appears that a mechanical flight delay grounded Gopal and her family. That’s not covered, either.

It all adds up to a no-win case, even for my amazing advocacy team.

Next time, get everything in writing

I feel terrible about Gopal’s Trip Mate claim denial. After all, someone from the insurance company had given her bad advice, according to her. Shouldn’t that count for something? I think so, but reading the policy, it became clear to my advocacy team that this was an insurmountable hurdle. Trip Mate and World Nomads wouldn’t have covered this under her policy — ever.

My advice for Gopal and others like her who are considering travel insurance? Read the policy, dry and boring as it may be, from start to finish before you buy it. Remember the travel insurance company’s “free look” period that allows you to get a refund within a week or so, and ask for a refund if you have buyer’s remorse.

Had Gopal asked the phone representative for a written assurance that Trip Mate would cover her expenses, she’d have a check for $1,705. And we’d have another one in the “win” column. Alas, not this time.

Should Trip Mate have honored Smitha Gopal's claim?

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