Why doesn’t travel insurance cover dad’s illness?

When Jessica Kamzik’s father was diagnosed with stomach cancer last summer, there was no question about what she had to do. Dad’s prognosis was “grave” — the doctors said he probably wouldn’t make it to the holidays — and, “as any loving daughter would do, I immediately cancelled our vacation to stay closer to him,” she says.

Good thing she had travel insurance through Access America, she thought. At least she wouldn’t have to worry about losing the cost of her trip.

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But she thought wrong.

Kamzik make a claim on her policy, confident that it would help her recover the $1,400 she’d spent on her vacation. After all, her travel insurance covered the “illness of a family member” and specifically one that “is considered life threatening or requiring hospitalization” — which is what her father’s illness was.

But Access America didn’t see it that way.

She explains,

They refused to pay based on what they say is a “pre-existing” condition. They made this claim based on a doctor’s note that was first sent in, which stated that my father had symptoms two months prior to when he was diagnosed.

Their insurance policy says that if the client had symptoms 120 days prior to when the policy was bought (July 19th 2011), the refund was void.

Now, I understood this, so asked for verification from his doctor. His doctor sent in all the notes, explicitly stating that my father was very healthy prior to his cancer, and that any symptoms he had were not necessarily related to cancer.

Yet, the travel insurance company still refuses to refund our money.

As I reviewed her case and examined the fine print in her contract, I thought Access America was taking a very narrow view of what constituted a “pre-existing” condition. Had her father been diagnosed with cancer, or had his doctor’s suspected he had cancer and were in the process of testing him for it when she bought the policy, then they’d have a valid reason for denying her claim.

But stomach pain? I get that whenever I eat grandma’s spaghetti (but it’s a good kind of pain). Is my travel insurance going to deny a claim because I had a little heartburn? I thought this was worth bringing to Access America’s attention. Maybe one of its adjusters had failed to see the big picture.

Access America reviewed its decision. Here’s what it had to say:

We are very sorry that Ms. Kamzik’s father is ill and we wish him and his family the best. We had our claims department investigate the status of Ms. Kamzik’s claim.

The travel insurance policy that Ms. Kamzik purchased excludes claims for existing medical conditions. Existing medical conditions are defined as any illness occurring to a family member during the 120 days prior to and including the effective date of the purchased insurance for which: a) medical diagnosis or treatment by a Physician has been sought or advised or for which symptoms exist, which would cause a prudent person to seek diagnosis, care or treatment.

A review of Ms. Kamzik’s father’s physician’s notes from July 28 indicate that he had constant stomach pain for the past one and a half months. As these symptoms of illness occurred within 120 days of Ms. Kamzik’s purchase of her travel insurance policy, any subsequent claim based on a stomach illness or condition would be excluded from coverage.

I’m very sorry that we could not cover Ms. Kamzik in this situation, but we do wish her the best in her future travels.

That’s really too bad. I asked Kamzik for her reaction.

That’s disappointing. I will continue to fight this, however, because I believe that Access America will do everything they can to scam buyers out of their money.

They already gave me this answer (multiple times), so I went back to each of my father’s doctors and had them confirm that my father’s symptoms were not related to his current condition (a terminal illness). Even with both doctors backing me up, Access America refuses to do the right thing.

I’m moving Kamzik’s case into my “dismissed” file, but I’m not happy, either. Too many travelers are getting snagged by what seems to be a strict interpretation of the pre-existing conditions clause. It’s definitely something to be aware of the next time you buy travel insurance.

(Photo: Free and happy/Flickr)

128 thoughts on “Why doesn’t travel insurance cover dad’s illness?

    1. http://www.accessamerica.com/aa/aboutus.aspx

      Access America is the travel insurance brand of Mondial Assistance. Mondial Assistance is a global provider of travel insurance and assistance with offices in 28 countries and is owned by Allianz, the world’s largest insurance company (Fortune). Almost 10,000 people are employed by Mondial Assistance globally, over 800 of which are in our Richmond, Virginia office.


      1. If Access America is located in Virgina, then file a complaint with the Virginia Attorney General’s office. I live in VA and the OAG here is very consumer friendly and take consumer complaints seriously. Just provide them with all the doctors notes and the insurance policy info. They are very good at responding to consumer complaints quickly. When I had an issue with Verizon, I sent in all the info and Verizon was calling me 2 days later bending over backwards to fix the situation. Does not hurt to try the OAG, their website is:

        1. Unfortunately, her doctor’s first note stated he already had suffered from stomach pain for a month and a half, and was then diagnosed with stomach cancer.  To then turn around and say the stomach pains had nothing to do with the cancer would not be very truthful, and does lay the groundwork for a pre-existing condition.  That’s why we sell insurance with a waiver for pre-existing conditions.  I have asthma, and if my medication even changes 120 days prior, all bets are off.  Insurance is stringent, and why they follow up with doctors (who is the one who sent in the original notes to them).  I am sorry to hear about cases like this, but she may not have had the right policy, or waited too long to take it out, in which case all pre-existing conditions will apply.

          1. The point is that at the time of buying the insurance the client did not know of a diagnosis of cancer. Only after the diagnosis can the doctor then say that the pain was probably due to cancer. Pain is not a diagnosis.

          2. But it does show the person was seeking treatment – and if that is the case within 120 days of the policy purchase, pre-existing conditions apply.  Pretty standard in all policies.

    2. They are.  That’s the next step she needs to pursue, but I’m not sure it’s going to work without more conclusive letters from the doctors.

  1. She needs to see a lawyer – there is a LARGE body of insurance law on what constitutes pre-ex – and the nature of the disease must be of such a nature that a normally attentive person would seek care and a reasonably competent physician would expect to locate the condition.  Otherwise, the way that Access America is interpreting its language discourages people from seeing the doctor.

    Moreover, KNOWLEDGE, ‘scienter,’ is an important element of pre-ex – did the OP KNOW that her father had ‘stomach pain’ and was going to see a doctor?  If the answer to that is no, the entire purpose of the pre-ex clause is to prevent adverse selection against the carrier – if a person has ZERO knowledge that a family member has gone to the doctor for stomach pain that ends up being stomach cancer diagnosed 2 months later – the purpose of the clause gets turned on its head.

    Access America needs a class action – they have a history here.  And it is not a pretty history. 

    1. As much as people deride lawyers, I agree.  Class actions, or the threat thereof, make people honor not only the letter of the law (or letter of their contracts) but the spirit of them also.  Get a lawyer, seek Class Action, and force them to do what’s right.

  2. Honestly – I see where they’re coming from.  I don’t particularly like insurance companies.  However, it certainly sounds to me as if the stomach pains were a symptom of the stomach cancer, and medical treatment was sought for those symptoms.  They’re absolutely correct that a symptom of the underlying condition manifested itself before she purchased the policy.

    Also – I’m pretty sure they’re not going to take the word of the insured that they had no knowledge that a family member sought treatment.  It would be too easy to lie about it.

      1. That’s NOT what the doctors said. What they said was that the symptoms “were not necessarily related to the cancer” (thereby not ruling out that they were). The daughter’s the one who says they were unrelated.

      2. And let’s be honest — a month and a half of constant pain, and you don’t think one thing applied to the other?  How do you think the doctors FOUND the stomach cancer – they went looking for it based on the symptoms.  This is an unfortunate case!

        1. Unless you are a doctor, you cannot state that stomach pains are related to stomach cancer.  Is that how doctors determine that someone has stomach cancer. I don’t know, and I’m sure you don’t either.

          The OP stated that , ” I went back to each of my father’s doctors and had them confirm that my
          father’s symptoms were not related to his current condition (a terminal

          IF that is true then we should abide by the doctor’s opinions, and not try to play physician.

          If I were the OP I would sue and attach the doctor’s note as evidence.

          1. But the doctors could NOT rule it out, and subsequently found the cancer.  If that had NOT thought it was a basis for their further tests, they would not have included it.

          2. Ok, here is a situation that worries me.  I go on a trip and have a heart attack and have to be evacuated. I have been in good healt up to this heart attack. The doctor says it is caused by atherosclerosis. The insurance company says that a pre-existing condition caused the heart attack.
            WOW- everyone has atherosclerosis to some degree. So no one can buy travel insurance to cover a heart attack on a trip.
            Pre-existing condition should be defined as a medical diagnosis prior to buying insurance not a condition.
            Now you have asthma and the insurance company knows this and you know it. That is a pre-existinig medical diagnosis. Buy insurance that covers it. You could have an allergic reaction on a ship manifested as asthma symptoms and require emergency treatment that pobably wouldn’t be covered though it is not related to your asthma, but presented as bronchospasm from the allergic reaction.

          3. But as long as you had not been treated for the artheriosclerosis within the prior 120 days, no basis for the pre-existing condition in this case – again, standard on the policies.  (I keep track as I KNOW I have a tricky case of asthma, and if I seek treatment, or my meds change 120 days prior, I am screwed without the pre-ex waiver – which is what SHE needed!)

          4. Some travel insurance policies waive the pre-existing condition clause if you purchase them within a certain number of days of making your first trip deposit (TravelEx offers them, I know). Other insurance policies have only a 60 day look-back clause for pre-existing. This is important to me because my father has a history of heart disease (two bypass surgeries 16 years apart), so I take that into account when buying travel insurance. 

  3. The last thing insurance companies want to do is pay out.  I am curious to know why she bought this plan?  We only provide insurance that waives pre-existing conditions if the policy is purchased ‘within’ the allowed time from the initial payment on a trip.My sympathies to the OP.  Dealing with her father’s death and then this must be very difficult.

    1. This is exactly what I was thinking! On my trip, just two months ago, the policy I purchased had a pre-existing condition waiver if purchased within 14 days of the original payment. 

      It seems like so many of these problems would be eliminated if people were more educated on travel insurance and knew that being subject to the pre-existing condition restrictions is very easily avoided. 

      I will say, I only learned of it because I was shopping for travel insurance for a big trip (>$11 k) and I have some minor health issues I could see being used against me should something happen on my trip. In the couple years of reading Chris’ blog I can’t recall once ever hearing mention that the pre-existing condition clause could be waived on policies like this.

      Thankfully, I didn’t need the insurance and everything went smoothly, but it was nice being able to worry about one less thing.

      1. I agree.  Chris Elliot is a smart guy.  Chris, why didn’t you ask if she purchased  a plan with the pre-ex waiver and if so, did she uprchase her plan to get pre-ex covg benefits?  You know that detail.  Why didn’t you bring it up?  If you are the “consumer advocate” you say you are, what aren’t you educating properly?  That is a very important point for consumers/your readers to know.  (same as terrorism and fnancial default)

        1. Hence the reason why Chris should have an
          AskAdvocateElliott site [or section].

          We keep on discussing all these problems AFTER they happen. How about preventing a couple of them from happening by simply being smart and buying or doing the right things? How about a guide, Chris?

          1. Although to be fair, hasn’t Chris done a series on how to buy travel insurance?

            Not to be snide, snarky, etc., but how do you imagine he’s going to answer the question:  “My dad’s been seeing the doctor for the past couple of months about his stomach pains.  How does that affect MY vacation and what kind of travel insurance should I buy?”

            If her dad is anything like my f-i-l or husband, he probably *didn’t* tell his daughter about his medical problems in any detail, preferring to downplay his condition.  In other words, Ms. Kamzik probably didn’t know what was going on with her dad until the cancer diagnosis was made. 

            My condolences to Ms. Kamzik.

          2. Jeanne,
            You’re right. I actually do remember the article that had the huge graphic  – a pie chart – about the reasons people buy travel insurance.
            However, I still believe people are confused, especially when it comes to buying for themselves.

            For example the OP thought she was covered, and then she was not. So she really wasted her money.

            Perhaps, if she could ask the forum ahead of time – what kind of insurance should I buy because … blah, blah, blah; then she could have gotten some or better advise.

            I think I made a mistake asking for a guide because as you said there are already guides out there. Maybe I should have just stuck to requesting for a place (forum) where folks can ask questions.

          3. Maybe Chris could add a tab to his site and place his guides there.  After they get “published” to an e-reader, that tab could be available to “Subscribers” for a nominal subscription – kind of like underwriters for his site.  Another tab could be for “AskElliott”, as you suggest.

            This thread is getting pretty skinny!  Wish Disqus didn’t do that.

    2. Just as an example, I put a deposit on a resort reservation. refused insurance at that time because I was uncertain I would use the reservation, then later decided to and purchased insurance to cover my WHOLE trip, airline and resort.  I did read the fine print and understood that a pre-existing condition would not be covered, but “knock on wood” I am healthy and plan on making the trip.

  4. Stomach pain for 1.5 months is obviously NOT normal. It’s too bad the OP didn’t know / realize this would void her insurance claim. I wonder if she would’ve cancelled anyway, had she known. Sounds like she’s going to be devoting lots of time fighting this anyway, which would probably be better spent with her father… I could see this case going either way. If it had been a singular bout with stomach pain, that would’ve been a different story… I hope she makes the most of the remaining time with her father.


    1. I’ve had benign ulcers that had the same symptoms.  There is absolutely no reason to believe that a pain is a terminal cancer.

      1. No, but a 45-day pain is an indicator of SOMETHING being wrong. The policy seems to exclude “pre-existing”, not “pre-diagnosed” conditions. If there was an indicator that there was something wrong and a diagnosis wan’t reached, for whatever reason (malpractice, patient choice, etc.), but the condition indicated ends up being the cause of the claim, I think the insurance company’s decision is correct.

        1. Do you have any seniors in your family?

          When the seniors in my family talk to each other, every single one of them is complaining about some ailment or another.  Access America would think that every one of them has a pre-existing condition 100% of the time.

          The only part that should be relevant is this:

          each of my father’s doctors and had them confirm that my father’s symptoms were not related to his current condition (a terminal illness).

          1. What the article also said was: “His doctor sent in all the notes, explicitly stating that my father was very healthy prior to his cancer, and that any symptoms he had were not necessarily related to cancer.” 

            The “not necessarily” is key (it states uncertainty); that, combined with the initial note that the patient presented with symptoms two months prior, is reasonable grounds for a denial.

            If the original pain had been definitively diagnosed to be, say, gastric reflux, then the denial would be inappropriate.  But it’s a reasonable leap to connect long-term stomach pain with stomach cancer if there is no other explanation for the pain.

          2. It’s impossible to prove a negative.   You will never be able to prove with certainty that some prior symptom was not related to a subsequent illness.

            By that standard (“certainty”), you can deny every single claim.  

            I doubt that the insurer is in a better position to judge than the 2 doctors.  Not to mention that the insurer is the party with the greatest conflict of interest.

          3. The policyholders don’t have to definitively prove that the symptoms had nothing to do with the cancer.  But they DO have to show that the insurance company is taking an unreasonble leap to get from Point A to Point B.  The doctors finding some other reason for the stomach pain would have helped. 

            If the insurance company was denying a claim for a heart attack because a policyholder broke their ankle during the exclusion period, that would be unreasonable even if it would be theoretically possible to argue that the ankle was broken because of weakness during heart trouble.  But connecting persistent stomach pain to stomach cancer is not unreasonable.

          4. A headache could be brain cancer, but a prudent person cannot be expected to think that way.  

            It’s unreasonable to deny a claim solely with the benefit of hindsight when the doctors wouldn’t make the connection you’re suggesting with foresight, and EVEN WITH THE BENEFIT OF HINDSIGHT they’re still not convinced that there was a connection.

          5. Pre-existing condition exclusions aren’t written that way.  If you see a physician for symptoms, or experience symptoms that would cause a prudent person to seek care, a later diagnosis that can be reasonably connected to those symptoms is excluded.  (It has to be reasonable, not 100% certain.)

            It doesn’t matter what you thought could be the cause at the time; if the eventual diagnosis (that causes you to file a claim) can be reasonably connected to the earlier symptoms, than the earlier symptoms are excluding.

            Again, this is NOT unique to trip insurance, this is how pre-ex exclusions work.

          6. Then the policies  are worthless.

            Unless you get hit by a bus,  practically every illness was foreshadowed with the benefit of hindsight.

          7. But the doctors aren’t “not making the connection”. What they’re  admitting is that other things COULD have caused the pain, not that the cancer didn’t. If the doctors were 99% sure teh pain came from the cancer, their statement is still valid.

          8. The doctors don’t say that the symptoms aren’t related to the cancer, they say the symptoms aren’t NECESSARILY related the cancer. If they didn’t think they were related, they’d say so. 

          9. Re-read my post.  

            They’ll never be able to definitively say otherwise.  

            The body is very inter-connected.  Swollen toes might foreshadow a stroke or heart attack.

          10. But seeking treatment for over a month and a half of CONSTANT stomach pain, and then being diagnosed with STOMACH cancer is not the same a single incident.  She purchased the wrong coverage in this case, and since the doctors thought enough of the original pains to include it in their report, it is reasonable to assume they thought there might be a link.

          11. I did re-read your post and I think you’re making an assumption for which facts aren’t evident. You say the doctors aren’t convinced there was a connection but there’s no proof of this. They may very well be convinced yet still have to admit that there exists the possibility of other or additional causes for the pain. 

          12. Re-quoting:

            I went back to each of my father’s doctors and had them confirm that my father’s symptoms were not related to his current condition (a terminal illness).

          13. But the terms of the coverage DO say laying a groundwork for pre-ex is any treatment sought out, and /or change in treatment or medication.  As an asthma patient whose medications have changed several times, I am well aware of this, and ensure I immediately take out insurance with a pre-ex waiver.

          14. Which contradicts the note the physician sent in referring to the pre-existing stomach pains for over a month and a half.  Not a single incident, but ongoing.  That lays the groundwork for pre-existing condition.  Heart disease, asthma or diabetes conditions which have had changes in treatment within that 120 days ALSO qualifies for pre-ex.  That’s why I don’t believe she had a pre-ex waiver on her insurance, or this would not have been an issue.

        2. AB

          That’s not how you should read the language.  Pre-existing is defined.  It doesn’t matter if the cancer existed beforehand, but rather did he seek treatment for cancer or some indicia of cancer.  He did not, he sought treatement for stomach pains, which the OP stated her doctors said is unrelated to the cancer.

          1. If you read the first statement from the OP you’ll see that she states the doctor’s note indicated that the symptoms “were not necessarily related to cancer”. It’s only in her response to the insurance company’s second denial that she says the doctors say the symptoms and cancer are entirely unrelated. Since it sounds as if she’s changing the details of the story to make it more favorable to her side, I’m more inclined to believe her first statement and that a month and a half’s constant stomach pain for which he sought treatment is, indeed, an indica of cancer.

          2. I feel terrible for the OP and think the terms of the policy are horrible. Unfortunately, that doesn’t mean they’re not enforceable. By the time she started arguing that months of stomach pain were somehow unrelated to stomach cancer, I think she’d already lost. 

            To prove they were unrelated, the pains would need to have a definitive cause other than the cancer. If her doctors can prove that, then I think she should collect. However, I think she would have mentioned that if there was a definitive diagnosis of something else.

    2. After my mother died from her terminal cancer, I had abdominal pain for 3 months – it was a severe stress reaction.  I have no cancer or ulcers – it’s just my GI system is where I feel my stress.

      Not that extended stomach pain is normal, but how is a daughter who doesn’t live with her father to know that he has an extended stomach ache?  My parents didn’t/don’t share their extended aches and pains with me.  Ms. Kamzik bought the insurance in good faith and this is ridiculous.

      AA needs to pay the woman her $1,400 and  be done with it.

      1. The crux is really establishing definitively whether the stomach pains were related to the stomach cancer. Not related? Pay up! Related? The OP gets nothing (unfortunately!) If she didn’t know about the condition before cancelling, then that would definitely suck and I can understand her frustration at buying a policy that in the end didn’t help her at all.

        1. Still not buying it.

          My mother’s colon cancer came with not a lick of lower abdominal pain that didn’t actually come from pre-existing conditions she had.  Because it stayed small in her colon and metastasized like wildfire.

          Her particular cancer was such a monster that a routine abdominal scan 16 months before her diagnosis (a regular scan done to check on one of those pre-existing conditions) showed a clear abdomen. When they diagnosed it, the same type of scan showed her abdomen was utterly filled.

          The worst pain she had came from the metastasis; her right shoulder gave her pain as her liver had been nearly doubled in size. The utter weight of it was pulling down on all the muscular structure of her shoulders.  That’s ALWAYS the first place you look for colon cancer.  *snort*

          It must be nice to sit back, look at a medical history and say “Oh, well, yeah, NOW it’s obvious s/he had cancer.”  But when you’re in the middle of a diagnostic process (which could take as long as six weeks with the state of the US healthcare system), it’s utter BS to say “sorry, it’s pre-existing”.  Real-life medicine is not an episode of “ER” or “House”; real medicine is filled with things that have to be ruled out.

          It hadn’t been diagnosed by a medical professional.  Medical professionals admit they were slow to diagnose.  That should be enough.

          1. The exclusions are there for a reason:  What the insurance company doesn’t want to happen (because it’s very expensive and would drive up premiums):  Previously-healthy [Relative] has been bedridden with weakness for the past week and heart disease runs in the family… while it COULD just be the flu, let me go and purchase a trip insurance policy today before she goes to the doctor tomorrow, because she might be diagnosed with a heart condition. 

            This is called “adverse selection” and if not prevented, makes insurance so expensive as to be unaffordable (since it’d be too expensive for healthy policyholders to want to purchase.)

            If a reasonable (if not certain) connection can be made between symptoms serious enough to seek medical treatment and a later serious diagnosis, then it is excluded.  Certainty is required for neither the insurance company nor the policyholder.  (i.e. If you sprain your ankle, and then later suffer from a heart attack, while it’s theoretically possible that the two are connected, it’s not reasonable to exclude on that basis.)  1 1/2 months of otherwise-unexplained stomach pain CAN be reasonably connected to a later diagnosis of cancer.

            The thing is, if you (or somebody in your family) is in poor health, it is literally trivial, and often free, to avoid pre-ex exclusions with trip insurance.

            All you have to do is be able to travel on the day you buy the policy, purchase the policy within a certain window, and cover your whole trip.  The purchase time limits limit adverse selection enough to keep the premiums reasonable.

      1. Unfortunately, their legalese gives them outs in both directions. In your example, they likely would have denied the OP’s claim because a relative having an ulcer isn’t serious enough to warrant a cancellation. As this case played out, they denied the claim because medical assistance was sought and it turned out to be cancer. The only way she was going to collect was if her father had never went to the doctor.  Not agreeing with it, but that’s what the terms spell out.

  5. If she actually has notes from 2 doctors saying symptoms were unrelated to the cancer diagnosis, I am with the OP on this one. However, in an earlier email Chris quoted, she stated they weren’t “necessarily” related. I think the answer hinges on this question.

  6. Hmmm… this is a toughie.  As a layman, I can understand that 1 1/2 months of stomach pain followed soon after by a diagnosis of stomach cancer looks suspicious.  Certainly there may have been no reason to suspect stomach cancer based on the initial complaint, but that’s not the way the exclusion reads.

    If the doctors cannot conclusively state that the stomach pain was unrelated to the cancer (and it appears they cannot), then the claim fails. This is a straighforward application of pre-ex exclusion clauses.

    All this said, I make sure I get a policy with a pre-existing condition waiver for ALL trip insurance I buy (meaning pre-ex’s are irrelevant.)  Pre-ex exclusions are a bone of contention with pretty much all types of insurance, (health, travel, life, disability, etc.) and and area ripe for dispute.  Do yourself a favor and get a policy where they don’t matter…

    Also, the policies of some insurance providers do not apply pre-ex exclusions to non-traveling family members. I believe TravelEx is one of them, and I know there are others. Their pre-ex’s are waived no matter when you purchase the policy.

      1. The insurance company doesn’t have to prove that the stomach pains were caused by the cancer.  His own doctor’s can’t say with any confidence at all that they aren’t (and appear to be leaning towards the conclusion that they were), and it’s a reasonable leap for the insurance company to make that they likely were.  It doesn’t have to be a definitive diagnosis to be a pre-existing condition.

    1. Where does it say he had 1.5 months of continuous pain?  It said he had been seen two months ago for stomach pain.  My father has stomach pain pretty frequently, and it’s always something he ate.  Old people have these problems.  If the Dr. Note said he had 1.5 months of continuous pain and it turned out to be cancer, the insurance company has a valid reason to deny it.  If he was seen two months ago for stomach pain and was in perfect health, but now has cancer, which is what it sounds like happened, there is no way to prove or disprove if it was a preexisting condition or not.  People have stomach aches.  There is no way to say with 100% certainty it was the cancer, and no way to say with 100% certainty it wasn’t.  A Dr. will never write that it was 100% unrelated, because then they open themselves up to multiple lawsuits, so they simply state the facts which are that it was not necessarily related, meaning it more than likely is not related.

      1. In the insurance company’s reply after reviewing the denial…

        “A review of Ms. Kamzik’s father’s physician’s notes from July 28 indicate that he had constant stomach pain for the past one and a half months.”

      2. “A review of Ms. Kamzik’s father’s physician’s notes from July 28
        indicate that he had constant stomach pain for the past one and a half

        1 1/2 months of constant stomach pain in an otherwise-healthy man for which no other diagnosis was ever found (stress, gastric reflux, ulcer due to a bacterial infection, celiac disease, whatever…) it sounds quite reasonable to connect it to a diagnosis of stomach cancer soon afterwards.

        And exactly who would be suing the doctor if they stated the stomach pain was unrelated to the cancer?  And what would the doctor be sued for?

        Neither the insurance company nor the policyholder has to prove anything 100%.  But it sounds like here where the doctor states: “It wasn’t necessarily related” sounds like it was more likely to be connected than not.

        1. So it’s the insurance company saying it was constant for 1.5 months.  Not Chris’s client.
          I have a few doctors in the family and their malpractice insurance policies forbid them from ever saying anything with certainty or they will not be covered should they be sued as a result.  If the doctor says the stomach pain is not related, the travel insurance company could sue the Dr. for making an absolute statement.  Or the OP could sue the insurance company and the Dr. will be subpoenaed.  Ask any Dr. and I guarantee you they will tell you that they will never write a note that says anything with absolute certainty.  They will only use words like not necessarily related, or most likely related.  Those are how they say yes and no.  Not necessary means more than likely not, most likely means, probably related.

          1. No, it’s the doctor’s notes saying it’s constant for 1.5 months. 

            And in my experience when a doctor says “not necessarily”, they usually follow it up with “but to be on the safe side” which indicates (to me) belief. When they say “not likely”, they’re trying to convince me against a course of action. But I’m guessing that varies from doctor to doctor.

    1. I agree…Access America and Travel Protection Plans should be avoided.  Go to Squaremouth or InsuredMyTrip to buy a real travel insurance policy.

  7. This is what is wrong with our country.  This is clearly a scam that large businesses continue to perpetuate.  Yet insurance companies get bailed out?  This is just screwed up.
    I have a cousin who worked for an insurance company, and his job was to deny claims.  Didn’t matter if they were valid or not, they were denied.  It was up to the policy holder to appeal and fight and legally prove they are entitled to be paid.  And the insurance company has a lot of lawyers and red tape to try to stop them, and most of them gave up.
    I am all for government staying out of people’s lives, but I think they need to step in when an entire industry is scamming people as a way to make money.  These companies make huge profits, by ripping people off, and when they make bad investments with their billions, the US government bails them out.
    My father is currently in an acute rehab facility for a stroke.  Every week the Dr. has to write a letter to his insurance company to justify why he should stay one more week, and every week the insurance company determines if they will pay for 1 more week.  Why is an insurance company deciding whether or not my father needs medical treatment? 
    So now if I get an upset stomach, possibly from over eating my Mom’s tasty pasta, I can’t buy travel insurance in the next 120 days?  It’s all one big scam!
    Ok, rant over.

  8. How many stories of travel insurance not paying out do people have to read to understand its a game you aren’t going to win. 

    Also interesting how may trip insurance scam artists, er, companies, underwrite this blog.

    1. Considering the good that Chris has accomplished in putting real scam insurance companies out of business, this isn’t a fair statement.

    2. Currently, in my years of traveling, I’m well ahead in premiums paid vs. claims collected.  Trip insurance is not inherently a scam.

      The reason for denial here, a pre-existing condition, is fairly common amongst virtually all types of insurance: medical, life, disability, workmens comp, and yes, travel insurance.  Of note here is that you can buy your way around pre-ex exclusions with trip insurance; you just have to buy a policy that waives them.  They are not difficult to find, nor are they necessarily more expensive.

    3. Insurance provides coverage for a multitude of conditions, one of them being medical care when the insured is out of the country on a trip.  That alone is enough peace of mind to warrant the purchase.

    4. That sounds great until you have to use it. Friends of mine, senior citizens, took an Alaskan cruise. He had a heart attack in the middle of the cruise, had to be evacuated off the ship in port, then had heart surgery and a couple weeks of convalescence in the hospital in Alaska. Their travel insurance paid for it all, including flying a family member up to assist the couple when it came time to fly home. I don’t know who their policy was through, but my friend said they were very easy to work with. 

  9. I would file a complaint with the Insurance Commissioner (or whatever is the regulating body for insurance providers) of the state Ms. Kamzik lives in.  Never had to do that with travel insurance, but had an issue with health insurance and after the complaint was filed the insurance company was very happy to help me.  Go figure 😉

  10. It wouldn’t hurt to take Access America to small claims court.  I did that a couple of years ago and won.  Collected every cent of my claim too from them. 

  11. People go to the doctor all the time. Especially older people. The travel insurance company can find just about anything to use as an excuse to deny a claim based on medical records. My mother is 82 years old. If I planned a trip, bought travel insurance from Access America, and my mother passed just prior to my trip and I had to cancel, would they consider her old age a “pre-existing” condition? 

  12. Thanks for this story Chris. Based on this report and others, I’ve added Access America to my list of companies to avoid doing business with and have shared that information with my traveling friends.

  13. I’ve been burned by Access America in the past and learned my lesson.  Last time I bought travel insurance I went thru Squaremouth.  They told me they refuse to carry Access America because of all the customer complaints.  

  14. Access sells several different travel policies. If she bought the “basic” she has no claim. If she bought the “classic” within 2 weeks of her original deposit, pre-existing conditions should be covered. If she bought this from the computer, then she did not know what she was doing, then tough luck to another self made travel agent. If she bought from a real live agent, and this was not explained, then the agent is responsible for any losses. This one is black and white once you give the necessary facts.

  15. I think it is another sign that buying a travel insurance policy is not as “transparent” as one would hope. You need to read through the provisions BEFORE you buy it, not after.  My sympathies to someone who has to deal not only with the gravity of a personal situation, but the absurdity of the insurance company.

  16. So now Access America is a doctor?  They knew before the man’s doctor did that it was stomach cancer?  Wow…  They should be in a diagnostic center instead of an insurance office.  Imagine the lives they’d save with their abilities of precognition!

  17. Never, never, never buy travel insurance unless you get a pre-existing medical condition exclusion waiver! We’ve bought from Travelguard for years. As long as you purchase the insurance within two weeks of booking the travel, the pre-existing medical condition clause is waived. And, the cost is about the same.

    1. You may be correct, but I’m curious about whether you’ve ever had the opportunity (if you call it that) to test what you, versus the insurance company thinks is covered? Really, the Devil is in the details. I had a policy with the late, but not lamented Trip Assured several years ago, and I thought that I was fully covered in the event that my Mother’s health deteriorated…until my Mother passed away, and Trip Assured disagreed with my right to claim reimbursement.

    2. For TravelGuard, I believe you need to buy at least the SILVER plan to get the waiver as part of it (if you pay within 15 days of the initial trip payment). Otherwise, you need to buy the waiver as extra.

  18. God forbid any of Axxess America’s insured need to make a claim.  A “stomach pain” is not a medical diagnosis, and they seem to have gone past what is reasonable to deny this claim. 

  19. Who sold her the Access America Travel Insurance?

    If you buy an airline ticket [or vacation package] through an Online Travel Agency (OTA), you’ll probably get an opt-in box for travel insurance. The problem is that this is usually the worst policy to buy.

    When human travel agents (TAs) quote travel insurance, they have to enter the State, Date of Birth, Travel, Purchase and Deposit Dates and purchase price, etc. Only after these are entered will the quotes for different kinds of policies come out. The cost of the policy is so dependent on the age of the insured (especially above 60). Most of the plans sold
    by regular TAs often have pre-existing medical condition waivers if they are paid for in full within ~14-15 days. In addition, the TA will usually upsell the better plans if the passenger needs them.

    However, the OTA websites obviously don’t have the time to interview the passenger so IMO they just sell the cheapest [and most profitable] plans. IMO they don’t even take into consideration the age of the passenger [even if they ask for it for the TSA’s Secure Flight Data]. So, because of this wholesale “click the box” approach to selling travel insurance, there is a huge chance the passenger is not buying the correct insurance.

    Also I noticed that “bundled” travel protection or insurance plans usually have the same “defect”. Take the case of that 78 year old lady who bought the Vantage India tour with the Tripmate travel protection. Linda Bator made an excellent recommendation – call your travel insurance first whenever you have a problem. If the passenger bought insurance from TravelGuard, she could have called 24/7 and use their Emergency Travel Assistance to rebook her flights . I checked Tripmate’s website, while they offer a 24/7 One Call Solution, it does not say they will help rebook your flights.


    So the 78 year old lady hit a dead end. Vantage didn’t answer their phones and even if she called Tripmate, they might not offer flight re-bookings. No wonder she just went back home to FLL.
    The lesson learned here is that not all sellers of travel insurance will offer the travel insurance you need. Next time talk to a human being who sells a good one.

    1. 🙂  And I have sold TravelGuard and TravelEx and seem them cover all SORTS of claims – from missed flights, missed connections, catch up flights for a cruise, changes due to a need to return home when a loved one fell ill, medical evacuations and even re-patriation of remains with a death abroad.  But a lot of claims are for lost or delayed baggae, stolen or lost items, etc.  So NOT all travel insurance is the scam most folks here think it is – it is just that some folks do not purchase the correct poliy, or utilize the company as soon as there is a problem.  I really feel sorry for this lady and her father. 

    1. I think all insurance is a rip off but it seems to be a fact of life in today’s world.  With travel insurance, purchasing ‘the right’ coverage is very important.  Do your homework before hand as after the fact you are SOL.

  20. Hold on a minute.  When I bought travel insurance I thought that “preexisting conditions” referred to MY preexisting conditions.  Do I now have to be concerned about the preexisting conditions of my immediate family members?  Sheesh.  How about old age?  Is that considered a preexisting condition? 

    1. You ‘thought’ or you ‘know’?  Did you read your policy before posting?  Does it have preexisting coverage just for you or for family members as noted in the policy?  Did you call the insurance company before you purhcased the policy and ask questions? After the purchase is not when you start to question your coverage.

  21. *sigh* This is all such BS.  It’s like if anyone in your family is sick with anything, you can’t get trip insurance.  

    My in-laws are planning a brief trip to WDW with my brother-in-law and his kids in March.  My MIL was thinking she would buy trip insurance, because the elderly relative they live with (but who isn’t going on the trip) could conceivably get sick.  Reading up on it, we convinced her it probably wasn’t worth it, as I’m sure they could just pore over the medical history of the relative and call anything pre-existing.  When you’re 90, just about anything is pre-existing.

    Maybe you should just appeal to decency and common sense.  That worked when my mother got sick (well, halfway – NWA completely refunded fares my parents had bought a week or two before her diagnosis without hesitation and well-wishes for my mother’s health; the same act shamed UA into doing the same after they first offered vouchers, despite the fact my mother probably wouldn’t be able to fly ever again).  Bureaucracy will always find a box to check to protect their derrière.

    1. “anyone” is defined in each policy under family members.  If the family member type isn’t listed, then no, coverage would not be applicable.  But if the family member type is listed, taking a policy out ‘within’ the allowed time for pre-exisiting coverage would work.  Now many policies are priced based on the amount of the travel paid and age. As we get older, these policies can get very expensive.

    2. My MIL was thinking she would buy trip insurance, because the elderly relative they live with (but who isn’t going on the trip) could conceivably get sick.

      The elderly relative must be a Family Member as described in the policy. Example (from TravelGuard)…

      “Family Member” means the Insured’s or Traveling
      Companion’s spouse, Domestic Partner, Child, daughter-in-law, son-in-law, brother, sister, mother, father, grandparents, grandchild, step-child, step-brother, step-sister, step-parents, parents-in-law, brother-in-law, sister-in-law, aunt, uncle, niece, nephew, legal guardian, Caregiver, foster child, ward, or legal ward, or spouse or Domestic Partner of any of the above.

      Usually (better check), if the Insured must cancel or interrupt his/her Trip due to Injury or Sickness of a Family Member not traveling with the Insured, it must be because their condition is lifethreatening, as certified by a Physician or because they require the Insured’s care.

      Generally, if the 2 above conditions are met, and she buys a travel insurance policy that waives pre-existing medical conditions, then cancellation and trip interruption will protect her.

      1. exactly what is an aunt or an uncle or a cousin?  How far down the list would they go to avoid paying?  My Third cousin on my grandmother-in-law side has diabetes, thus, since a family member had a pre-ex we are not paying your claim? 

        The way their ‘policy’ reads they COULD do that – because it does not state that the REASON for canceling needs to be related to the relative with the pre-ex condition . . . think about that one for a minute. . ..

        1. Joe, all they are doing is defining who is a family member. If that family member gets deathly sick, the insured passenger(s) can claim cancellation or interruption so that they can come home to be with or take care of the sick family member. Of course the sick family member should not have a pre-existing medical condition during the look back period. That’s the catch!

          That’s the reason they denied the OP’s claim for trip cancellation. Her Dad (who was not traveling) got terribly sick but the insurance claimed he had a pre-existing condition so they denied her claim.

        2. They refer to what is considered a “family member” (not a friend, a pet or neighbor – you’d be surprised how many would jump on that!) you could claim as a cancellation reason (due to thier life-threatening illness or injury).  They don’t mean if a third cousin has diabetes they will deny YOUR health claim – need to learn to read, dude!

    3. I appreciate the info from both of you, but I’m cynical.

      For example, say the relative – in this case an aunt who has lived with them for 30+ years and is marginally independent these days; a different BIL will come stay with her while my in-laws are out of town – suffers a severe stroke.  Which if you asked any doctor, would be life-threatening for a 90 year old.  My in-laws are the ones who manage her medical care, making sure she sees her doctors on schedule and takes the drugs prescribed for her.

      But I’m betting the insurance agency could easily argue that my husband’s aunt – who lives in the area – could act as caregiver.  Because she’s in the area and she’s family.  (They, however, have her sister, 88 years old and a recovered stroke victim in their home already.)  And if she survives the stroke, well, then it wasn’t “life-threatening” was it? *sarcasm alert*

      Like I said, being cynical.  Does anyone EVER get their money back from trip/travel insurance?

      1. Well, if you don’t trust INSURANCE then it won’t work for you. Insurance is suppose to be there when you need it. So if you can’t trust it then don’t buy it.

        Just have enough money to buy a quick return trip ticket.

        1. Um, are you trying to be snarky with the INSURANCE?  Because as Count de Monet said in “History of the World, Part I” – “Don’t get saucy with me, Bernaise!

          Okay, seriously – below, you are pointing out the trip insurance industry routinely sells policies that aren’t actually adequate coverage.  And you – and other TA’s (are you a TA?  you seem to have this close to hand, which is why I ask) had to dig up a portion of the contract to illustrate where, why when and how coverage is extended.  You have to know how to navigate the maze, and most people don’t know how to do that.

          And lord knows, Chris has covered more than one story where trip insurance hasn’t helped travelers – true, sometimes it’s because they didn’t read the fine print (I’m thinking the story earlier this week where the 78 year old abandoned her trip – I can see where abandoning your trip would not qualify for a payout).  But sometimes because the agency appears to get out of paying out a claim via a loophole.

          (I really feel as if that is what’s going on here.  Most people who have a persistent symptom will usually wait it out at least a few weeks, just to make sure they don’t have a virus.  It’s not like you are healthy, wake up with a stomach ache one morning, and immediately call your entire family to tell them you think you have stomach cancer so make sure to get that pre-existing condition waiver if they’re planning on buying trip insurance.)

          But you seem to think, then, that my cynicism is unmerited.  But from what I can tell, it’s not.  This whole post and thread – where we have to have a dissertation on modern diagnostic process, how we self-diagnose a stomach-ache and how it relates to the travel industry – would seem to support my attitude at the very least.

          1. Snarky? No. That honor goes to Raven. I can’t possible compete with him.

            Seriously, the reason to buy travel insurance is to protect yourself from surprise expenses. If you can easily afford to buy another ticket, book extra hotel days, or have a good medical or homeowner’s insurance then why buy travel insurance?

            I’m just a skeptical as anyone here. If I feel all insurance companies will wiggle out of paying any of my claims, then I won’t buy travel insurance. It’s that simple.

          2. I also believe that the travel industry is full of gotchas. That is the by product of the internet, IMO.

            Nice looking websites, SEO tactics, and the pay to play (pay per click) antics don’t really do anything positive for consumers. We really need a dumbed-down, no questions asked consumer to buy that many travel products by simply clicking online. So I am cynical, too.

      2. To answer your last question, yes. 

        There are other benefits to travel insurance and if you don’t think you would be covered, even after speaking to the company, don’t buy it.  I don’t like insurance but took it out for my own travels recently.  I hope I won’t have to use it.

      3. I sell travel insurance WITH the waiver to over 90% of my clients – and believe me, I’ve seen them pay out on clients who had to return due to a father’s heart attack, a mother’d failing mental health (caused her hospitalization), lost or delayed baggage, stolen items, etc.  It works if you take the right one, and submit the claim with all the neccessary paperwork (I always help by starting my cleints’s claims, include all neccessary paperwork for them, then just have them fill in the various sections of the claim)

  22. Does anyone know of any case where someone developed a terminal illness, without any prior symptoms whatsoever that might be construed to be linked to the illness with the benefit of hindsight?

    I imagine it’s theoretically possible, but extraordinarily rare in practice.  

    How many people tend to be private about discussing their health in general, even with those who are close to them?  And doubly so when it comes to bringing attention to what are typically symptoms of very minor ailments?  

    Does Access America really expect their insured travelers to interrogate every single member of their family about every ache and pain before they plan a trip and take out a policy?  

    I understand that there are pre-existing condition waivers available.  

    In that case, how dare they sell policies that advertise family member illness protection without a pre-existing condition waiver?  If the pre-existing condition clauses are interpreted as narrowly as Access America interprets them in this case, then the clause is  practically worthless and no one would ever buy this insurance product if they actually understood how it would be interpreted.

  23. This is an unfortunate circumstance and I can see both sides.  It is so hard to get through the fine print on travel insurance carriers only to be denied when needed.

    Side note:  I would like to know if there is a company that based on your travel plans can tell you which insurance carrier would be best for your needs.  There are people that can go over a hospital bill for you and find all kinds of unnecessary charges, so knowing all the different kinds of travel insurance’s available would be nice.  Is there such a “clearing house?”  I’ve used the website that Chris has available, but it is still difficult to get through all the fine print on each policy.

    I always buy insurance because you just never know and if my 79 year old mother is with us I want to make sure we have all the insurance needed in case of an emergency. 

  24. There’s an endless discussion here of whether a stomach pain is a pre-existing medical condition. I wanna go back to what Bodega said – if she simply bought a policy with a waiver for pre-existing medical conditions, then she wouldn’t have wasted her money. End of story?

    1. Why are they advertising and selling the policy without the waiver?  Why would anyone who truly understood it and wanted family member illness protection ever buy it?

      1. Why would they sell it? Because they can.
        If you want to package a real cheap travel insurance policy that still pays a big commission to the seller, you’ll strip out all the goodies. Then you can sell it to unsuspecting clients online using a check-box opt-in system.
        Why would anyone buy it? Because they (buyers) don’t know any better. Knowledge ain’t cheap.

      2. They may have purchased it outside the time allotted, or purchased it for travel delays, med-evac for themselves, lost or delayed luggage, fear of bad weather – LOTS of reasons.  But to cover pre-existing – MUST purchase the proper policy with in the proper time frame.

        1. That’s fine.  I’m suggesting it’s dishonest for them to advertise that it covers cancellations for the illness or death of a family member.  Because about 95% of the time it won’t.

    1. Waste of time – every time and everywhere.  Whats so special about the ‘Better Business Bureau?”  Thats so 1950’s as to be laughable today.

    1. What?  Allianz?  That’s the parent company.  They’re the largest insurance company in the world.

      You’ll have to avoid the other companies they own, including Allianz Life, Pacific Investment Management Company, or Fireman’s Fund.

  25. I’m a  physician and Access America should have indeed covered this claim. I would not use or recommend anyone use Access America for travel insurance of any type. If they act like this on a legitimate claim they will certainly do the same on others.

  26. Insurance companies and pharmaceutical companies will rip you any way they can. Look at the money they make annually. How many insurance or pharmaceutical companies have you seen go out of business during the downturn in our economy? None I would imagine. They really don’t give a damn about us, they just want our money. When it comes time for them to pay out they try to find the loop holes to prevent having to pay. It should be illegal. 

  27. Hello everyone,

    I wanted to personally thank you for your support and understanding of the situation. I allowed Chris to write about my particular situation because of the “fine lines” involved with insurance companies — Mondial Assistance especially. For those who were wondering, I bought this travel insurance as a precationary measure — just in case our bags got lost, for example. I was not living with my father, and had absolutely 0 idea that he had been having stomach pain, let alone visiting a doctor. The thing is — my father was 54 years old. The last thing on anyone’s mind was that he would be diagnosed with a terminal illness.

    Sadly, my father passed away at the end of January after having been diagnosed only 6 months before. Mondial Assistance still refused to refund my money — however, kudos to the kind people at Continental Airlines who understood my plight and refunded my tickets in full.

    I wanted to share my story to warn others of giving business to a company as immoral as Mondial Assistance. I understand the need for strict regulation, but there is a fine line between following regulation, and providing INSURANCE to your customers. If an insurance company does not provide insurance, what in the world are they for? 

    Good luck and best wishes to all,

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