How to get your policy to cover you — special circumstances and all

“I’m at a loss,” Bill Dunn wrote to me recently. “I’m looking for advice on how to appeal a decision against my travel insurance claim.”

The problem: Dunn had bought travel insurance for a recent trip to see his nephew get married. Six weeks before his departure, he lost his job.

“Being unemployed, I can no longer afford to make the wedding, so I canceled my flight and asked for a refund,” he adds. He filed a claim with his travel insurance company, but was denied.

The reason? He hadn’t been employed long enough. He’d been on the job 15 months, but 6 of them were through an employment agency. His insurance required 12 months of full-time employment.

Gotcha!

Cases like this come through here every day. In our five-part buyer’s guide on insurance, we’ve taken a closer look at the most common special circumstances, how insurance handles them, what insurance covers, and what happens when circumstances change on your trip. Today, in the final installment of this series, we look at how to handle a claim.

Dunn’s case is still in progress, and I’m optimistic. Yet even if he didn’t contact our advocacy team for assistance, he could have reached out to his travel insurance company — I list the names, numbers and email addresses on my consumer advocacy site — and filed a formal appeal. The employment clause really seems like hair-splitting, and his insurance company should have been able to cover him. (If you’re still out there, Bill, please let me know — I’d love to help.)

All of which brings us to the matter of appeals, a part of the insurance mystery that insurance companies understandably are reluctant to talk about. Why? Because if they told us exactly how they decided their appeals then we’d win every one.

Appeals are normally reviewed by a group of adjusters at a senior level. Their goal is to make sure nothing was overlooked by the first adjuster. This process can take as long as the initial claim, so give your company at least a month for a decision.

The adjusters have a surprising amount of flexibility. For example, I’ve seen cases like Dunn’s overturned on appeal, which is to say the insurance company honored the claim. And think about it: Technically, he was on the job more than a year.

The employment agency loophole really seems like an excuse to deny the claim, and honoring Dunn’s claim may not meet the requirements of his insurance down to the letter, but they more than meet the spirit. A senior claims adjuster probably would see that.

And what if the answer is “no”? Well, you only have one shot at an appeal, normally. After that, you have to ask a higher authority for help. (I offer a full examination of the appeals process in my frequently asked questions about travel insurance.)

Call your agent.
You can send a brief, polite email to your insurance agent or travel agent — whichever is appropriate — notifying them regarding your rejection. Agents often can and do act as intermediaries when something goes wrong with a policy. Remember, they took a commission on your policy, and they have to be licensed to sell the policy, so they have some skin in the game.

Contact the authorities.
Contact your state insurance commissioner. Your insurance commissioner may be able to help if your claim was rejected without cause. To find your insurance commissioner, visit the National Association of Insurance Commissioners site. Some travelers have reported that their claims were honored simply by copying their state insurance commissioner on their appeal.

Contact your Better Business Bureau.
You’ll want to copy your agent and insurance company. The BBB is known to investigate claims of this nature, but it has little sway over the final outcome of your appeal.

If none of these steps work, you can take the agent or your insurance company to small claims court. You don’t need an attorney to go to small claims court, but there’s a limit on the claim amount. Typically, this is your last resort. If your agent or insurance company prevails in small claims court, you are usually out of options.

When it comes to travel, everyone’s circumstance are special. In a perfect world, you’ll never have to file a claim, not to mention an appeal. But if you do, it’s useful to know what is — and isn’t — typically covered.

A close look at your policy might pleasantly surprise you at how much you’re covered. And if the surprise isn’t positive — well, you know where to find me.

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Elliott Advocacy is underwritten by Cavalry Travel Insurance

Cavalry takes the worry of out travel by providing 24/7 access to medical and security professionals combined with the best medical evacuation and security extraction services. Cavalry gets you home safely when you need it most. Learn more at Cavalrytravelinsurance.com.

Elliott Advocacy is underwritten by Seven Corners

Seven Corners has helped customers all over the world with travel difficulties, big and small. As one of the few remaining privately owned travel insurance companies, Seven Corners provides insurance plans and 24/7 travel assistance services to more than a million people each year. Because we’re privately held, we can focus on the customer without the constraints that larger companies have. Visit Seven Corners to learn more.

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Elliott Advocacy is underwritten by Travelex Insurance Services

Travelex Insurance Services is a leading travel insurance provider in the United States with over 55 years combined industry expertise of helping people dream, explore and travel with confidence. We offer comprehensive travel insurance plans with optional upgrades allowing travelers to customize the plans to fit their needs. Compare plans, get a quote and buy online at Travelexinsurance.com.

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AirHelp is the world’s leading flight delays compensation company, helping passengers apply for compensation following a delayed or canceled flight or when boarding has been denied. It is AirHelp’s mission to fight for passenger rights by holding airlines accountable for flights disruptions that are out of passengers’ control. AirHelp has already helped 5 million people, taking the stress out of applying for compensation and making it as hassle-free as possible for travelers around the world.

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The Allianz Travel Insurance company has built its reputation on partnering with agents all around the world to provide comprehensive travel insurance for their clients. Contact Allianz Travel Insurance for a comprehensive list of coverage.

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Chubb is the world’s largest publicly traded property and casualty insurance company, and recognized as the premier provider of insurance for successful individuals and families in the U.S. and selected international markets, offering coverage for high-value automobile, homeowners, recreational marine/aviation, valuables and umbrella liability coverage. As an underwriting company, Chubb assesses, assumes and manages risk with insight and discipline, and combines the precision of craftsmanship with decades of experience to conceive, craft and deliver the best insurance coverage and services to individuals, families and business of all size.

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An independent provider of low cost CDW/LDW insurance for use with rental cars. Up to $100,000 cover with no deductible. Policies available on a per day, per trip or per year basis. Also works with overseas rentals. Try  Insuremyrentalcar.comnow.

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The nation’s fifth-largest cable operator, serving the smaller cities and towns in the Midwest and Southern regions of the United States. We are a high-performance broadband, entertainment, and communications company that brings the power of modern technology and quality customer experience to life inside the connected home by combining ultra-fast gigabit speeds with personalized local and over-the-top entertainment choices that fit your lifestyle. Details at  Mediacomcable.com.

Elliott Advocacy is underwritten by Arch RoamRight

Arch RoamRight is one of the fastest growing, most-highly rated travel insurance companies in the United States. Travel advisors love working with us, and travelers feel protected with our trip cancellation and travel medical insurance coverage. We also make it easy to file a claim online with our fast, paperless claims website. Learn more about RoamRight travel insurance.

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The leading global network for luxury and experiential travel. This invitation-only organization comprises over 1,000 travel agency locations with 17,500 advisors in over 45 countries, and holds preferred relationships with 1,700 of the world’s finest travel companies. Virtuoso advisors collaborate with their clients to create personalized itineraries featuring exclusive perks, while also providing advice, access, advocacy, and accountability. For more information, visit  Virtuoso.com.

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As a company that is constantly striving to simplify travel insurance, VisitorsCoverage, is on a mission to help travelers make the better decisions about purchasing travel insurance, quickly. VisitorsCoverage has helped millions of travelers globally to buy the suitable travel insurance and explore the world with confidence. Get insurance for your next trip at  VisitorsCoverage. Lowest Price Guaranteed.

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Medjet is the premier global air-medical transport, travel security and crisis response membership program for travelers. With a MedjetAssist membership, if you become hospitalized more than 150 miles from home, we will get you from that unfamiliar hospital all the way home to the hospital you trust. All you ever pay is your membership fee. MedjetHorizon members add 24/7 personal security and crisis response benefits. Elliott.org readers enjoy discounted rates. Travel safer with  MedjetAssist.

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Squaremouth helps travelers easily and instantly compare travel insurance policies from all major providers. Only companies that meet the strict requirements of Squaremouth’s Zero Complaint Guarantee are available on the website. Compare policies on  Squaremouth.com to save over 70 percent on your next purchase.

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If you’ve been mistreated by the airlines, Travelers United is your voice in Washington. Join the #1 travel advocacy organization working with Congress to improve and protect travelers. Plus, get $400 of annual benefits you can use for travel for only $29/year. Add your voice to ours. Make travel better.  Join today.

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