Insurance claim denied because of … air traffic?

Arthur Ruffino’s travel insurance claim is a real heartbreaker, for several reasons.

First, he did everything he could to make sure he was covered by his CSA policy, but was still denied.

Second, his well-reasoned appeal went nowhere. And finally, even though I agreed that his case should be granted another review, the insurance company dug in its heels.

“Passengers who think that they are buying peace of mind when they purchase trip interruption insurance should be forewarned that their claims may be denied — even if the interruptions are beyond their control, such as canceled or delayed flights,” says Ruffino.

The origin of the claim is a delayed Air China flight from Chengdu to Beijing. It caused him to miss his connection to an Air Mongolia flight, which considered him a “no show.” He had to buy a new ticket and flew to his final destination the following day.

“Despite the frustrations that I experienced, there was one consolation,” he says. “I had purchased travel insurance which covered trip interruption. Therefore, I knew that I would at least be reimbursed for the new airline ticket.”

But that’s not what happened.

When I returned home, I contacted CSA and informed the company of the incident.

I was sent a claim form to fill out. I accomplished the form and submitted it with the requested documents. Later, I was asked to provide a credit card statement showing that I had purchased a new ticket, despite the fact that I had already sent them a copy of the new ticket, as well as a document from Air China noting that my original flight had been canceled.

Some days later, I received a letter from CSA. I assumed it was a reimbursement check. Instead, to my shock, I learned that my claim had been denied.

The letter stated, “Two of your flights with Air China were delayed, causing you to miss your connecting flight with Air Mongolia. We spoke with a representative at Air China who advised us both delays were due to air traffic control….As the reason for your trip interruption was not due to a covered event, no benefits are payable for your claim.”

That seems like a gaping loophole. Under that scenario, CSA could conceivably deny almost any claim, because airlines routinely blame “air traffic” for delays that are caused by weather or mechanical problems. Even so, it shouldn’t matter — a delay is a delay, after all. Right?

Wrong. I contacted CSA and asked if they were certain of their decision.

They were. Here’s what a representative told me.

CSA’s policy clearly states coverage is afforded only in instances due to weather, strike or mechanical breakdown. I believe this is standard in most travel insurance policies.

Insurance plans are built to cover and exclude specific items. Because everything has to be spelled out in order to provide coverage, there are many items which are not covered and, unfortunately, air traffic control is one of those.

I’ve been mediating insurance disputes for many years and I have to admit, I was unaware of this exclusion, or that it was an industry “standard.” (Just because it’s a “standard” doesn’t make it right.)

Ruffino is unhappy with the response — as am I.

The fact remains that no reason has been provided by Air China for the action taken by air traffic control.

Could weather have been a factor? And is it possible that air traffic control is a convenient scapegoat for air problems in China?

How do visitors to China protect themselves? Certainly this gap in coverage needs to be addressed.

I agree. To have an adjuster call Air China and have a representative blame “air traffic” seems like a flimsy excuse to deny a claim made in good faith.

Ruffino thought he was protected, and that’s an assumption I would have made, too.

Should CSA have denied this claim?

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  • lost_in_travel

    With the “Fiscal Cliff” threat to cut FAA funding, “air traffic” is likely to become a common reason for delays. Do all insurance companies follow this “standard”?
    I cannot say that I have ever had a trip where insurance would have helped me, so I self insure. Maybe it is better to put the insurance premiums one would have paid into an envelope under the mattress for the time when one really needs it. Perhaps we all need to do this and skip the insurance that seems to grow new exceptions and loop holes just when it is needed.

  • BillCCC

    I had always assumed that a late flight was one of the main reasons to have travel insurance regardless of the reason for the flight being late. What exactly did ‘air traffic control’ do that caused the flight to be late? Route the plane around weather? Keep them in the air because of a mechanical problem on the ground? I am not exactly sure what CSA stands for but I don’t think that I will consider them for any type of insurance.

  • http://elliott.org Christopher Elliott

    I’ve been covering this industry for a while, and strangely, I had never heard about the air traffic exemption. That’s a pretty big loophole, if you ask me.

  • Alecdjm

    Yeah, cases like this make the whole concept of trip insurance even less attractive (begins to feel like the whole extended warranty thing)

  • http://www.facebook.com/asiansm Dang Ph

    I had been late and missed connection by air traffic delays, all my expenses are reimbursed (Hotel, Meals, Long Distance calls, etc…) . I think CSA insurance is a fraud if they exclude that.

  • Linda

    I had been considering CSA for an upcoming flight/cruise. They’re off my list now!

  • http://www.facebook.com/people/Alan-Gore/100000957978287 Alan Gore

    The increasing multiplicity of ‘gotchas’ make travel insurance, in most cases a waste of money.

    When you nest one separately-booked trip inside another trip, your best insurance is to never schedule the “inside” departure or return too close to the other booking. When you book a flight to meet a cruise, give yourself two or three extra vacation days in Miami rather than buying insurance which might let you down.

  • emanon256

    I voted no. These travel insurance companies are making me sick. It’s no longer insurance in my mind, it’s a flat out money grab. I know there are some good ones, or at least I often hear that there are, but I am too worried to even consider insurance after all these stories.

  • emanon256

    ATC is probably my most common delay. And usually it’s due to weather. I.E. ATC has issued a ground delay due to low visibility.

  • Nikki

    After reading this, I’m left wondering what is the point of travel insurance. Just seems like you’re damned if you do, and you’re damned if you don’t.

    Makes me wish they had built highways connecting the continents. I’d probably have better luck driving – less hassle and no boneheads out there trying to take my money (other than gas stations).

  • TonyA_says

    Missed Connection Benefits

    The Insurer will pay up to the amount in the schedule should you miss your cruise or tour departure as the result of the cancellation or delay of 3 or more hours of your regularly scheduled airline flights due to inclement weather. For this benefit, Covered Expenses means additional transportation expenses incurred to join the departed cruise or tour, reasonable additional accommodation and meal expenses incurred en route to catch up to the cruise or tour, and nonrefundable cruise or tour payments for the unused portion of your land or water travel arrangements. This coverage is available if no other coverage is provided by a Common Carrier or another party at no cost to you or as covered elsewhere in this policy.

    Seems pretty clear to me. Is it to you?
    What’s the problem? Failure to read and understand?

  • emanon256

    So it won’t even cover the flight if it was weather? Sounds like it just covers the missed cruise or tour. It is a little confusing to me. Also, what if weather was the reason for the ATC delay? Either way, after reading that I would never buy that policy.

  • http://twitter.com/johntbaker John Baker

    Instead of contacting Chris, the OP should have contacted the department in their state that handles regulation of insurance products. Unlike most of the other products that are discussed on this site, insurance is regulated and, therefore, the OP has more options than anywhere else.

  • TonyA_says

    But what does it really cover? You can eat, sleep, make calls, take a cab but it does not look like you can buy a new ticket on simple Carrier Delays. You must use the Missed Connection Benefit.

    Travel Delay.
    If your Covered Trip is delayed for 6 hours or more, we will reimburse you, up to the amount shown in the Schedule for reasonable additional expenses incurred by you for hotel accommodations, meals, telephone calls and local transportation while you are delayed. We will not pay benefits for expenses incurred after travel becomes possible. If your Covered Trip is delayed for 6 hours or more, we will reimburse you, up to the amount shown in the Schedule for reasonable additional expenses incurred by you for hotel accommodations, meals, telephone calls and local transportation while you are delayed. We will not pay benefits for expenses incurred after travel becomes possible.

    Travel Delay must be caused by or result from:
    a. Common Carrier delay; or
    b. loss or theft of your passport(s), travel documents or money; or
    c. quarantine; or
    d. hijacking; or
    e. natural disaster or adverse weather; or
    f. a documented traffic accident while you are en route to departure; or
    g. unannounced strike; or
    h. a civil disorder; or
    i. your, a Family Member traveling with you or a Traveling Companion’s Injury or Sickness;
    j. or a Family Member traveling with you or a Traveling Companion’s death.

  • Wayne Dayton

    I agree with Linda…screw CSA…I will never deal with them. They are not worthy of the term “insurance company”

  • deemery

    “Air traffic delay” could have been caused by a couple of things, it’s a symptom not a root cause.
    1. weather
    2. mechanical problems with ATC people
    3. labor problems with the controllers

    ALL of those strike me as covered under the explicit terms of the policy.

  • http://www.facebook.com/people/Chris-Johnson/669239199 Chris Johnson

    Has anyone ever successfully been paid for a claim from a travel insurance company? This just all seems like one big scam to me.

  • commentfromme

    I have a claim ready to be mailed to CSA today and I am shaking just thinking about what loophole they will find to deny the claim.

  • LTMG

    Be ready for frequent “air traffic control” delays in China. I’ve had several first flights of the day out of an airport in China delayed due to heavy traffic in the airways. What are the more precise reasons? PLA Air Force missions or VIPs on government passenger planes in the airways that take precedence over commercial flights. These can happen at any time and with no warning. Different country, different written and unwritten rules.

    Travel insurance companies cannot possibly be aware of all of these possibilities, therefore their actuaries are unable to set insurance rates based on the probabilities of events they don’t know about.

  • deemery

    I think Mr Ruffino should take this to small claims court, by the way.

  • http://twitter.com/johntbaker John Baker

    @TonyA_says:disqus Here’s my concern. In my experience, most of the time my flight is actually delayed due to ATC controls (like Ground Stops & Ground Delays) implemented due to weather conditions and not weather itself. If this insurance company wants to use this route, it basically means that the benefit is not collectible because they can state that most delays are due to ATC controls and not weather. If you don’t believe me, wait until the first snow storm of the year at a hub. You’ll see that most flights are held due to ATC actions than are late due to the weather.

  • http://elliott.org Christopher Elliott

    Yes. I have actually visited a major travel insurance company and I’ve spoken with its customers. It does happen.

  • TonyA_says

    Sounds like the OP had no idea what he was buying. He kept harping about Trip Interruption when that had nothing to do with the claim. He missed a connection, period.
    Now remember if you buy separate tickets [ I do not know if this is the case here ] then the insurance will argue that the flights were not even connected in the first place.
    Travel planning to remote places should be arranged by a local destination expert.
    I use local travel companies myself. They will tell you what you need.

  • TonyA_says

    To claim what? That is the issue. Delay will only buy you a meal, phone calls, perhaps a room and a cab to the hotel. Not new airline tickets.

  • technomage1

    I’d love to know percentages of claims actually paid out, though. Granted, I’m sure some claims are fraudulent and should not be paid out, but it does seem as if they look for any reason not to pay.

  • TonyA_says

    Yeah but we are arguing about a cause that has no bearing on this case.
    He cannot claim the cost of new airline tickets based on travel delay.

  • TonyA_says

    Did you read a sample CSA policy? So what now that there was a delay. What can you actually claim for reimbursement? That is the problem and not the cause of the delay.

  • http://www.facebook.com/steven.meitz Steven Meitz

    Loophole indeed, as a thirty year ATCer I can tell you that 90% of delays that the airline attribute to Air Traffic Control are weather related. It’s tough to understand when the departure airport and the destination airport appear to be in good weather but there may be heavily used routes impacted, wet runways that reduce arrival and departure rates and turbulence that remove usable flight levels enroute. Gate agents used the “ATC delay” as a cover-all that removes any blame from the airline. Years ago, I was in the terminal of the airport I worked at and overheard the agent blame a late departure on ATC. The fact was the crew arrived late the night before due to a mechanical delay and had not had their required rest between flights. I made them retract the statement on the PA.

  • emanon256

    After reading the policy my point has become pointless.

  • TonyA_says

    Same problem with other SE Asian airports. Flights always delayed during peak hours. Too many flights due to high growth of air traffic. Their economies are too successful and many new low cost carriers are now flying:-)

  • TonyA_says

    For what?

  • http://twitter.com/johntbaker John Baker

    @facebook-669239199:disqus I help people file all the time. I’ve never seen a denied claim except for a single case where it wasn’t covered (in black and white in the policy as an exclusion).

  • http://elliott.org Christopher Elliott

    That’s really interesting. Is there even an accepted definition of ATC delays? Or do airlines just make it up as they go along?

  • emanon256

    Had he purchased tickets on the same carrier, or tickets on multiple carriers sold by one of them (Isn’t that called interline), I believe the airline would have paid for his onward transportation after the delay.

  • TonyA_says

    NO your point about delays is important. ATC delays are so prevalent that they are not that UNFORSEEABLE. Insurance companies will go under if they have to pay on delays. No wonder European carriers have complained a lot about EC261. In Europe the airlines pay for delay compensation but not the kind the OP is claiming for.

  • http://twitter.com/travelinsreview Damian Tysdal

    I think CSA should take another look at this claim and make an exception. In terms of the policy language they are correct in denying the claim. However, “air traffic control” can easily become the default reason for many situations.

    Bad weather? Air Traffic Control kept the plane on the ground. Mechanical breakdown? Air Traffic Control directed the plane to stay on the ground.

    The essence of travel insurance is to protect against unknown, unexpected, and uncontrollable circumstances that cause a financial loss. Mr. Ruffino had no control over these events, and should be reimbursed.

    I believe this is a case where the insurance company is technically correct as their policy states what is covered and what is not, but not only should an exception be made here but they should consider updating their policies to cover what travelers expect it to cover.

  • TonyA_says

    Exactly! Insurance is no substitute for good travel planning.

  • http://twitter.com/laurenbear lauren bear

    Has the traveler written to their state’s Attorney General? Sounds like it might be a good idea.

  • cruisemagic

    I have sold travel along with travel insurance (Allianz/Access America) for 15 years and none of my clients have ever had their claim denied.

  • Richard Gordon

    Post your problem on Facebook.
    Ask every one who receives it to forward it to some one else.

  • pradcliffe

    Wait, am I missing something here? Flights are delayed because of ATC controls “implemented due to weather conditions and not weather itself.” So if you call a horse by another name, it’s not a horse?

  • IGoEverywhere

    I am forwarding this column to my insurance underwriter, TravelGuard. It really sounds flimsy to me. I would instantly forward all of this information to my State’s Attorney General and file a claim against CSA immediately!

  • http://twitter.com/dotcah dotcahill

    travel insurance is a JOKe it seems to be never covered for whatever reason.it needs to be revamped or heaven forbid some legalor yuck government intervention since the gov is taking over our healthcare with the obamacare TAX system why not travel as it si so gov regulated anyway

  • jerryatric

    Everyone keep this in mind & NEVER use CSA!

  • http://www.facebook.com/profile.php?id=5802764 Megan Kelly

    That is because it is not industry standard. Mediate it!

  • TonyA_says

    John, did the OP miss a tour or cruise (that is part of the insurance) because of a 3 or more hour delay due to weather, YES or NO?
    That is the question. Let’s stick to the policy in question.

  • BillCCC

    You have me at a disadvantage since you seem to have a copy of the OP’s policy.

  • TonyA_says

    Just go their website and read a couple of their policies. They are pretty straightforward (in their favor) :-)

  • http://twitter.com/johntbaker John Baker

    @5ebb8253b22ca04b35519a9b1f5eccb5:disqus And that’s my concern… If this insurance company want to use the excuse here, what keeps an airline from saying that a delay due to a ground stop was an ATC control problem and the insurance company denying your claim.

  • pradcliffe

    I am seeing two issues here: First, the stated basis for the denial of the OP’s claim for the new ticket was that the delay was caused by air traffic control problems, not a covered cause, such as weather. Second, there is a good deal of discussion indicating that the policy would not have covered the new tickets anyway because the trip interruption insurance only covers telephone calls, meals, a hotel room. If the first is true, than CSA or perhaps the entire industry are frauds and need far better regulation. All CSA or any insurer has to do is put every problem under the ATC heading to avoid any claims it wants. If the second is true, why didn’t CSA state that and make it clear in the policy? Once again, why isn’t this industry better regulated?

    The bottom line for me is that I along with 96% of the voters on this
    issue believed the OP was covered. We all can’t be idiots nor can we
    all spend hours researching the meaning of “weather conditions” versus
    air traffic control problems caused by weather conditions.”