Travel insurance policy claim denied for vaccine cancellation

Richard Effress though he had a perfectly legitimate reason for canceling part of his trip to Africa with his mother: a new requirement that travelers entering South Africa needed a yellow fever vaccine. He was certain his travel insurance policy would cover the change.

Maybe he shouldn’t have been so certain.

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Today’s “case dismissed” file is a sad lesson in making assumptions about a travel insurance policy that you shouldn’t. It is also a reminder to compare travel insurance. The fine print in your contract, it turns out, can cost you lots of money.

Let me hand the mike over to Effress to tell his travel insurance tale.

This past summer, my family went to Africa for a safari to celebrate my mother’s 70th birthday. The trip was quite expensive for the six of us and we purchased a comprehensive travel insurance policy called the Worldwide Trip Protector Plan from Travel Insured International.

The policy totaled $6,142 for all of us, and included pre-existing medical conditions as well as trip cancellation, delay and interruption.

On June 16, 2011, five days prior to our June 22 departure, we received notice from our travel agent that the yellow fever vaccine was now required of passengers entering South Africa who previously visited Zambia. As our trip included a stop in Livingstone, Zambia (near Victoria Falls), our travel agent advised us we needed the vaccine and related immunization certificate or risked not being allowed entry into South Africa.

We initially flew from the U.S. to South Africa, but then planned to travel on to Zambia and Botswana before re-entering the country for our final stop in Cape Town.

Due to my mother’s prior experience with shingles, her primary care physician, specialist and her travel doctor all informed her that she could not have certain immunizations prior to the trip, including live viruses such as yellow fever, due to the risks that with her weakened immune system she could actually catch the disease.

As such, we re-routed the trip for two of the six people in our party (my mother Jane Effress as well as her companion Harvey) to Zimbabwe for the two days we would otherwise be in Zambia. This allowed them to see Victoria Falls, albeit not with the rest of our group.

That made perfect sense. You don’t want Mom to succumb to yellow fever, a painful viral infection that could kill her.

Effress’ travel agent made the rebooking at a cost of $1,332, which included airfare, hotel and ground charges. Then Effress submitted a claim to Travel Insured International.

I would have imagined that such a necessary change would be covered under a gold-plated travel insurance policy that cost $6,142. Not so.

Effress reports,

Travel Insured denied the claim on the basis that Jane’s doctor “did not certify your illness at the point when you cancelled/interrupted your trip.

Proof of medical is required for cancellation at the point of interruption. A Physician did not advise cancellation nor certify the illness at the time of loss that prevented you from continuing your trip. Unfortunately, no benefits are payable.

Here’s the chapter and verse in her policy they invoked in a subsequent rejection letter. The World Wide Trip Protector Plan Description of Coverage under Part A says,

Trip Interruption: A) Sickness, Accidental Injury, or death of You, Your Traveling Companion, etc which results in medically imposed restrictions as certified by a Physician at the time of loss, preventing your continued participation in the Trip. A physician must advise cancellation/interruption of the trip.

Trip Insured notes,

It is my understanding that you had to re-route your trip due to not having the Yellow Fever vaccination prior to traveling. Based on the information in your file, your doctor indicates on the Attending Physician Statement form that he did not certify your illness at the point when you cancelled/interrupted your trip. Proof of medical is required for cancellations at the point of interruption. A Physician did not advise cancellation nor certify the illness at the time of loss that prevented you from continuing your trip.

Effress tried to get a doctor to help with the claim, but was turned down.

“I think the insurance company’s position is nonsense,” he says.

I’m inclined to agree, so I contacted Travel Insured on his behalf. This time I heard back from the company’s general counsel.

It is unfortunate that Ms. Effress and Mr. Lambert were precluded from visiting Zambia because she did not receive a yellow fever vaccination.

It is our understanding that all guests entering or transiting through Zambia were required to have a yellow fever vaccination prior to travel and Ms. Effress’s physician stated that the vaccination was not administered, as it was medically contraindicated for personal health reasons.

Their Worldwide Trip Protector plan provides coverage for trips that are cancelled or interrupted due to events specified in the plan. Non compliance with a vaccination requirement is not a covered event.

I understand Effress frustration with his travel insurance policy. The family paid more than six grand for insurance that didn’t cover then.

But the blame for this failure doesn’t just fall to Travel Insured for failing to see the big pictures. Always compare travel insurance offerings before you make a buying decision. Effress should have read his travel insurance policy carefully. And his travel agent should have given the policy a second read prior to making his claim.

I hate having the tell readers that they’re out of options, but I’ve taken this as far as I can. An appeal to a state insurance commissioner and a trip to small claims court would almost certainly not be worth Effress’ time. And besides, a contract is a contract.

It just doesn’t seem fair to him.

(Photo of Cape Town, South Africa by Gurney 5/Flickr)