If you make a trip insurance claim, you must prove you were actually on a trip

Tiffany Jones wasn’t worried about her upcoming trip to Albuquerque. After all, she’d purchased a World Nomads travel insurance policy.

She should have been worried.

When her bag went missing, the claim got stuck in some red tape — and she turned to our advocates for help. Jones’ story is a case study about the importance of paperwork and a positive attitude.

Jones initially complained to us that since filing her claim on May 11 with Trip Mate, the insurance company that wrote the policy through World Nomads, she’d received “nothing but generic replies.”

“When I called the customer service number, the representative just repeated what I can already see online for my claim, which are vague notes meant for the claims department and not the customer,” she says.

Now, that doesn’t sound good.

So why hadn’t Jones’ claim been settled? Before we get to that, let’s look what happened to her luggage.

Here’ what Jones said:

I was traveling on the rapid transit bus that serves the University of New Mexico. However, once I got off the bus and began walking, I realized one of my bags was missing. I called the transit lost and found, but the office was closed. So, I called again in the morning was told that nothing with my item descriptions had been handed in.

Worse still for Jones, “Most of my clothes and toiletries were in my luggage, and I needed to replace my lost items for use while I am traveling. I only had the clothes I was wearing when my luggage was lost or stolen!”

Because Jones wasn’t getting anywhere, she contacted not only us but also the Texas Department of Insurance, the Better Business Bureau (BBB) and an attorney.

Wow.

In fact, double wow.

I’ve seen Trip Mate’s response to the BBB, and it’s dated May 19. Yes, May 19, and observant readers will have noticed that Jones only submitted her claim on May 11.

Given the short period of time between submitting her claim to Trip Mate and her complaint to the BBB, I think she was acting just a tad prematurely — especially as her claim had not been declined at this point.

So why hadn’t Jones’ claim been settled or declined? Proof — or rather lack of it.

Under the policy that Jones had purchased, a “trip” is defined as “any class of scheduled trips, tours or cruises for which you request coverage and remit the required plan payment.”

Jones’ trip was by road rather than by air, and therefore Trip Mate required proof that she was actually on a trip.

You state that you do not have a Trip itinerary as you were on a road trip. In order to document that you sustained a loss while on a Trip, please provide documentation of your trip arrangements (i.e., bus ticket showing departure and destination cities and travel dates, accommodation arrangements, etc.).

In fairness to Trip Mate, it had been asking for the information for a while, and instead of giving the company wanted it needed, Jones tended to respond in a very adversarial way:

My drivers license is NOT needed for my claim. This is one of the many ways you are attempting to stall my claim. As the fine print states, you must ask for information WITHIN REASON. This is not. I will be contacting the Texas Department of Insurance about your business practice.

Our advocate reminded Jones that when contacting a company, you want to make the company want to help you, so being adversarial doesn’t help. Most importantly, she told Jones that the insurance company could reject the claim if the required proof wasn’t provided.

In Jones’ case, Trip Mate was simply trying to determine if she really was on a scheduled trip, and as part of doing that, it needed to confirm where she lived. The fact that the address on her driver’s license was out of date didn’t help.

Finally, after Jones provided all proof available to her to show that she was on a trip, the claim was rejected. Why? Well, Jones was able to provide an invoice for a room at the casino hotel at which she stayed. But the hotel was less than four miles from her residence — where she was actually living, not the address on her driver’s license. It appears Jones was staying at the hotel and then going on day trips, returning late at night.

The fact that she was only going on day trips may have been enough for the claim to be rejected. In the end, though, it was rejected because in order for coverage to be triggered under the policy, Trip Mate said an individual had be on a domestic trip of 100 miles or more from their home.

The story doesn’t quite end there. Jones plans to provide more information to Trip Mate and appeal.

Will she be successful? I don’t know. What I do know is that when dealing with an insurance company, you want it to have a positive attitude toward you so it will want to help you. And you do that by being polite and nonadversarial and by providing the information it requests.

Otherwise, just as in this story, you might find that your claim is filed under “Case Dismissed.”

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