Case dismissed: “I feel that the insurance is useless”

Marcel Meth’s wife and daughter had plans to visit his recently widowed sister-in-law in Minnesota. As a precaution, they bought a travel insurance policy through Access America.

But they bought the wrong policy.

“Four days before my wife and daughter were to leave for Minnesota, my sister-in-law called us and told us that her son was hospitalized and that he would be remaining in the hospital for a week or more,” he says. “In response to this, my wife needed to cancel the vacation. We obtained all the necessary documentation and filed it with the Access America. They immediately denied the claim, saying that the reason for hospitalization was not covered by the policy.”

I know what you’re thinking. Ah, yet another cautionary tale about travel insurance!

But I think this one is worth taking a closer look at, for a few reasons. First, it exposes the limits of the average policy. And second, it raises questions about the overall effectiveness of travel insurance.

First things first. Why did Access America say “no” after the initial claim? Apart from the unspecified medical reason (more on that in a moment) there was the issue of who was covered, according to Meth.

The insurance would only cover my wife, but not my daughter, since the relative was my daughter’s cousin.

Cousins are not covered on the policy, according to the insurance agent.

That’s an issue I don’t run into very often with travel insurance, and certainly worth taking note of. The lesson? Read that policy carefully and make sure you make a claim only when it’s a relative covered by the policy.

For the second issue, I had to ask Access America. What kind of medical reason wouldn’t be covered in the policy? I couldn’t think of one, offhand.

So I asked Access America for a few details. Here’s its response:

The travel insurance policy that Mr. Meth purchased is a “named perils” insurance policy that covers only the specific situations that are “covered reasons” to cancel a trip.

Canceling a trip for any reason other than a “covered reason,” would not trigger coverage under Mr. Meth’s insurance policy.

In addition, like all insurance products, Mr. Meth’s policy included a list of general and specific exclusions for coverage. Among the exclusions listed in Mr. Meth’s policy is “a mental or nervous health disorder (like anxiety, depression, neurosis, psychosis and others) or any related physical complications (physical complication means any physical symptom).”

Exclusions for mental or nervous health disorders are fairly standard in travel insurance policies.

Meth isn’t happy with that explanation.

“I feel that the insurance is useless and would discourage anyone from purchasing insurance from Access America,” he says.

But it isn’t so much that Meth had a useless policy. He may have just had the wrong policy. A more expensive “cancel for any reason” policy, either from Access America or another insurance provider, might have covered this cancellation.

As much as I hate having to move any grievance into the “case dismissed” file, I have no choice on this one. His policy didn’t cover him.

This is yet another good reason to shop carefully for a travel insurance policy. A review of Meth’s policy should have shown that a likely claim would probably not be honored.

That’s too bad. I hate having to tell anyone that they’re out of luck.

(Photo: ktsp/Flickr)

  • Mbods2002

    Why isn’t hospitalization, due to a mental condition covered?  Sounds totally discriminating to me….

  • Anonymous

    Simply wrong, as Michael K below itemizes.  In Florida, you cannot read the policy until you have filled out all forms and given them your credit card number.  Huh?  The Florida Form is 30 pages.  It says in Section 3 that you aren’t covered unless Section 2 (13 pages itself) says you are covered.  So a natural disaster “such as hurricane” in Section 3 is excluded, but weather in Section 2 is included.  An on and on.  Gobbledy gook.  Only a contract lawyer can read this junk and resolve conflicts.  Further, here is a classic exclusion:  “any problem or event that could have reasonably been foreseen or expected when you
    purchased your plan.”

    This stuff is just consumer fraud.  Section two says weather delays are included, Section three says hurricanes are excluded, but then Section two governs.  So why is does Section 3 exclude hurricanes?

  • Blake

    Technically you are right.
    But this is the kind of small-time chiseling that is taken for granted in this time.
    It shows contempt for the customers who don’t bother to to don’t know how to read the small print.
    Most people who buy insurance don’t know what they are buying, And when a claim comes up they are surprised to find that they are not covered.

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

    Everytime I read one of these I think of the “mayhem” commercials for Allstate.

    Just like in those commercials. You get what you pay for. You buy cut rate car insurance and you won’t be covered for everything.

    Buy cut rate travel insurance and have the same issue. 

  • Bodega

    One thing isn’t clear on this is if both passengers took out the coverage or just the man’s wife.  If both took it out, the daughter may have been able to use the insurance, if the coverage reason was allowed, as she was having to cancel due to the mother’s nephew being sick.  If a travel companion can not travel, you can cancel, but again, the need for the cancellation must be a covered reason.

    I hate all insurance companies and policies, but they are a necessarily evil in this day and age.  I provide clients with the company name, phone number, website, but I won’t do much more than that.  There are too many what ifs and I will not be the go between to figure it out. 

    Travel insurance, health insurance, car insurance have too many exclusions.  We rarely sell insurance for nonrefundabel tickets because the cost is usually close to the change fee and most will reuse the funds for another flight.  If they are medically unable, we write the carrier and refunds are usually given.   

  • Tony A.

    Was buying travel insurance for a domestic flight the right decision?
    I assume that the reason they bought insurance in the first place was because they already had an inkling that something might come up forcing them to cancel the trip. Having said that, why not buy a last minute ticket? At least you are sure you’re gonna use it.

  • DesrtDrmr

    We buy, and have bought from Access America, travel insurance several times.  We think they are great!  However, we need policies that are “cover for any reason” in case my husband is called to work or to testify in court.  We pay a LOT more for this type of insurance.  If you do not read carefully, you might choose the least expensive, and not realize that you are not covered for anything other than is specified in the policy.  This is a definite Buyer Beware type of thing.  When we did have to cancel a trip, and had the “cover for any reason” type of policy, the company honored it and covered our expenses pleasantly and promptly.  I’m sorry these folks had troubles, but they really need to be more careful in their choice of insurance.

  • Linda Bator

    Actually, I have DOZENS of stories that would argue that case.  But as with ANY insurance coverage, it is good for covered reasons only, and when you purchase a policy with limited coverage, you can be left out in the cold.  But when you get the right policy, it can save you THOUSANDS – had all sorts of claims (that were honored in short time, too) for illnesses, injuries, deaths, lost or delayed luggage, stolen goods, etc.  Believe me, you think you don’t need it – but just like health insurance, when you DO need it, the cost of out-of-pocket if you don’t have coverage can bankrupt you.  (Do you have $35,000 for a medivac flight for illness or injury?) 

  • Linda Bator

    Because mental illness isn’t an unforeseen illness or injury, and is a long-term disability.  Problems are ongoing, and as such are considered a permanent condition requiring treatment at any time, whether changes in medication or hospitalization.  (That pre-existing condition!) 

  • PUGPSYCH

    I BOUGHT ACCESS AMERICA INSURANCE FOR A PLANNED TRIP TO EUROPE. WEEKS BEFORE I WAS TO LEAVE, MY SON’S MOTHER-IN-LAW DIED, SUDDENLY, AND I HAD TO STEP IN TO CARE FOR MY GRANDSON WHILE HIS MOTHER LEFT .  I HAD PURCHASED FLIGHTS, CAR RENTAL, TRAINS AND HOTELS AND THEY DENIED ALL OF THEM.  I THINK THEIR INSURANCE IS TERRIBLE AND WOULD NOT USE THAT COMPANY AGAIN!!

  • Sasha

    I voted yes.  Most of us are not frequent travelers and most travel agents don’t take the time or even know what the insurance policy reads.  I have a homeowners policy and a auto policy that I understand gives me full  coverage as well as replacement coverage on my home and my auto however, I have not read every word on these policies and I am sure that even if I did that I would then understand what the coverage means.  Why would anyone want a travel policy that covers less that cancel for any reason?

  • Silver Jewelry Jaipur

    nice and beautiful view i like it a lot

  • Vacaygirl

    There are trip protection policy’s out there that allow you to “cancel for ANY reason” up to an hour before departure. Why would you buy anything else?

  • Steve R

    We don’t know the details of this case, but why assume that all mental illness is a pre-existing condition? It has to start somewhere. Maybe the cousin has been in treatment for years, or maybe this was the first incident.

    The way the policy is written, it sounds like it doesn’t matter whether it was a pre-existing condition – it wouldn’t be covered. Again, in this case I’m fine with that because the primary issue was that the cousin wasn’t covered on the policy, as he was not actually taking the trip.

  • gertie 629

    I bought insurance through Travel Guard for an upcoming trip after spending time reading up on policies from several different companies.  One thing that was covered under the policy was having to cancel because you were now required to work during the scheduled trip.  It didn’t require purchasing the extra cancel for any reason.  I haven’t had to use the policy, but you may want to look into them next time.

    What I discovered in reading the policies is that everyone had a different definition of relative, or pre-existing condition and who was covered under it.  I selected the policy I did because my FIL is in poor health due to a pre-existing condition and this policy will cover us if something happens to my FIL and we have to cancel.  The pre-existing condition waiver covers not only the travelers, but travelers relatives not traveling.  Not all plans do!  It just goes back to you have to read the policy.

  • Rvgauerke

    I guess that like with any other purchases, there are varying degrees of quality.  Spending more to get more comprehensive coverage is an option sa is just wagering that nothing will happen and skipping the insurance.
    certainly, read the policy and know what you are getting.
    Topron

  • Deserttarone

    Chris’s right, you need to check all the coverage information included in a policy before buying it.  Insuremytrip and Quotewright are good web pages that compare companys’ policies and prices in easy to read language with more detailed information available.  We have had to make claims on two occasions in the past (one with AcessAmerica) and have had positive experiences.  We never travel without insurance now that we are a little older and travel is not as reliable as in the past, but we always know ahead of time what we are covered for and what not.