When Rela Geffen was hospitalized after suffering from congestive heart failure recently, she assumed her airline would take care of her. She was in Georgia on a business trip, but she’d paid an extra $19 for trip interruption insurance on her US Airways tickets.

And this is one of those times when I’m happy to say that the insurance came through for her. US Airways charged her a $125 change fee and a fare difference to fly back to Philadelphia a few days after her originally-scheduled flight, plus a $25 fee for making the change by phone, and her insurance picked up the tab.

“They were great and paid the $325 promptly after I returned home,” she says.

But that wasn’t the problem.

Her cardiologist told her she could only travel if she was accompanied by someone, so she asked her son to fly down on US Airways to help her get back home. But walk-up fares can be pricey, and his would set him back $677.

I was very upset. I asked if there wasn’t a special accommodation for illness or hardship cases.

The representative said — in not a very nice tone — that “people pretend to be sick all the time”.

She then went on to tell me to have my son complain to customer service with documentation after we got home.

What could I do? I had to get home and I had to be accompanied – so I paid.

After Geffen returned to Philadelphia, she sent US Airways all the documentation, including her son’s ticket and a note from her cardiologist saying that she needed to be accompanied.

The response from US Airways? A form letter saying sorry, there’s nothing we can do.

“I feel that the airline took unfair advantage of my situation,” she says.

In a sense, she’s absolutely right. Like other airlines US Airways prices its tickets to extract the most money from people who travel at the last minute. It assumes — often incorrectly — that these passengers are business travelers on an expense account. Cost-conscious leisure travelers, on the other hand, buy their tickets two weeks in advance and stay over a Saturday night, they assume.

Airlines will bend these rules on occasion, but it really has to be a special circumstance, like the death of a relative or a change in military orders.

On the other hand, US Airways wasn’t her only option. She and her son might have been able to discard her return ticket and buy a new, cheaper ticket on a different airline. But in the heat of the moment, and when you’re being your own travel agent and you’re hospitalized, you don’t necessarily think about all of your options.

Point is, US Airways didn’t have to do anything for her son. But maybe it should have.

I’m most troubled about Geffen’s exchange with the US Airways reservations agent. Suggesting to someone who is hospitalized that she might be pretending to be sick is really insensitive. I’m sure the agent had heard it all before — and yes, passengers do try to get around the system because the system can be unfair.

Her son wasn’t trying to get to Atlanta to sign a million-dollar business deal. He was coming to take his recovering mother back home.

But I’m on the fence about mediating her case, and here’s why: Technically, US Airways was following its own rules. I can imagine the same scenario repeating itself at any one of the legacy airlines. It is under absolutely no obligation to help Geffen, at least according to the terms of her purchase.

Cases like this really depress me. If the US Airways agent had only been a little more compassionate and asked a supervisor to help a passenger in need, then I wouldn’t be struggling with what to do next.

(Site: resp 14/Flickr)