Is my insurance claim lost in translation?

Question: I am having a difficult time — no, make that an impossible time — collecting a claim for a trip insurance policy. My husband and I bought a policy through Access America for a trip to China. It covered trip interruption and medical expenses, among other things.

Unfortunately, we had a medical emergency while we were away, and my husband was hospitalized. We filed a claim and submitted receipts, including medical reports and documentation from our tour group.

Access America requested a copy of the original invoice, which I sent the next day. Three weeks later, the company informed me that the paperwork was fine, but was still “in translation.”

We’ve been assigned three different claims adjusters since we started the process. It has been three months since the claim was filed, and I feel the company is being uncooperative with us. Could you please look into this? — Suzanne Baxter, Fair Oaks, Calif.

Answer: Once it had all of your forms, Access America should have processed your claim in a week or less. At least that’s what a company representative told me when I called it to ask about the average processing time for a claim. Normally, it would cut you a check five to seven days after receiving all of your paperwork.

Now, you need to factor in some time for translating the Chinese documents. By your account, there were two short reports in Chinese, both sent to the company as soon as it requested them. Three months seems like more than enough time to process a claim — even for a trip to China.

Access America could have done a better job processing your claim expeditiously and keeping you informed of the progress. But you could have also avoided this situation. When it became apparent that you were getting the runaround from your insurance company (probably when you were assigned the second adjuster) you might have sent a brief, polite e-mail to the company, expressing your concern with the process.

Phone calls aren’t as effective, because there isn’t always a record of your conversation. Even when you hear that “calls may be recorded for training purposes” it’s no guarantee that what an agent promises on the line is what will actually happen. Not so with an e-mail. Everyone can see what the company said, and what you wrote, and an e-mail chain can be forwarded to anyone.

Like, say, the insurance commissioner for your state.

Here’s how I might have handled this: After a week, I would have sent a very polite note to Access America, reminding it of its commitment to processing claims in a week or less. After another week, I would have sent a cordial e-mail expressing your concern about the timing of your refund. Copy your state’s insurance commissioner. You can reach California’s insurance commissioner online at this site.

You don’t want to threaten Access America. Just copying the commissioner alone is enough to underscore the seriousness of your complaint.

After a month, I would have sent another, more forcefully worded note (but still polite) copying your attorney and me. By the three-month mark, you should be in small claims court, asking a judge to rule in your favor.

For what it’s worth, I don’t think Access America was dragging its feet intentionally. At the time of your case, it was probably dealing with a lot of other China claims from the Olympics and its translators were overworked. Not that that’s an excuse for stringing you along. But it would explain the long delay.

I contacted Access America on your behalf. Two weeks later, you received a $2,098 check for your claim.

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