Two days in sick bay cost me $5,929. Why won’t my travel insurance pay?

Will travel insurance pay for 2 days in the sick bay of his cruise?

Oceania hands Murray Cohen a bill for $5,929 after he’s hospitalized on a Mediterranean cruise. Why is his travel insurance company dragging its feet on his claim?

Question

I recently took a Mediterranean cruise on Oceania’s MS Marina. I bought Allianz Global Assistance Trip insurance through my travel agent, paying $789 for coverage for my wife and myself. The travel insurance includes $25,000 medical coverage for the cruise.

Three days before the cruise ended, I awoke shivering with a temperature of 103.1 F. The ship’s medical staff treated me with IV antibiotics and other medications and gave me a chest X-ray. I was in sick bay for two days.

I am over 65 years of age and have Medicare health insurance, which does not cover anything outside the U.S. That is one main reason I bought the trip insurance. I sent the medical records and invoice from Oceania to Allianz in late October after I returned from my cruise and started a claim. After two weeks I called and chatted with them online and they said the claim was still under review.

It’s been three weeks and they just sent me a request for an explanation of benefits from my primary and supplemental insurance. I sent them an email back letting them know there is no explanation of benefits, since I can’t file a claim from out of the country with Medicare.

How long can they drag this on? They advertise quick claim resolution, and state that they review claims in 7 to 10 days. I would consider that untrue. I paid Oceania $5,929 for two days of onboard medical care. Can you help expedite this claim? — Murray Cohen, Boca Raton, Fla.

Answer

Did you say you paid $5,929 for two days in sick bay? What did they do, give you a makeover? These expenses should have been covered by your travel insurance, of course — and quickly. When your insurance company started asking for more time, it should have explained why and given you an estimate on how much longer your claim would take. Unfortunately, travel insurance companies don’t always do that, so they leave you guessing.

You made the right call, buying insurance. Without your Allianz policy, you would have paid the $5,929 out of pocket with no hope for reimbursement.

How travel insurance works

Travel insurance works in a deliberate — often painfully deliberate — way. An adjuster needs to verify that you’re not covered by other insurance and complete other kinds of due diligence before cutting a check.

It appears Allianz had asked you to file a claim with your primary and/or supplemental health insurer and to contact it when your claim had been finalized. It also requested an explanation of benefits or a letter of denial of coverage, both of which are routine but can take some time. Travel insurance companies can fast-track claims of under $100, in my experience, but for something like this, they really need to cross the “t”s and dot the “i”s.

The good news

If you’d received a rejection or if the claims process had gone on another month, you might have reached out to one of the Allianz customer service executives. I list their names, numbers and email addresses on my consumer advocacy site.

I contacted Allianz on your behalf, and it paid your entire claim. So what was the hold-up? It really needed you to file a claim with your primary insurance carrier — Medicare — even though the claim would be denied. Rules are rules.

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