The Travel Troubleshooter: Insurance claim denied after bike accident

Question: I recently booked a trip to Colorado Springs on American Airlines. I paid for the tickets with a credit I’d received after canceling a previous flight, plus $350 in fees. I bought travel insurance from Access America, which is offered through the American Airlines website.

I had a bicycling accident and we could not travel to Colorado. I sent a claim to Access America with complete documentation, including receipts from American Airlines. The receipt shows a payment of $601 plus $350 in fees.

Now Access America says they won’t pay the claim since we used the $601 credit from the earlier trip. Needless to say, I am upset because American advertises Access America on its site and the ticket agent when I rebooked said to call them. Can you help me get my money back? — John Frow, Plano, Texas

Answer: Access America should have refunded your entire ticket, regardless of how you paid for it. Unfortunately, insurance claims are often denied because of a misunderstanding, and that’s what appears to be happening to you.

A look at the terms and conditions of your policy on Access America’s site shows there should be no distinction between the cash and airline vouchers you used. The insurance company should compensate you for the ticket, period.

According to the U.S. Travel Insurance Association, 1 in 6 policy purchasers file a claim, and of those, fewer than 10 percent are turned down. Many denials are overturned on appeal. I’ve heard informal estimates from insurance experts that roughly 90 percent of appeals go the traveler’s way, although that’s hard to verify. So you could have written back to Access America, clarifying the circumstances of your claim and asking it to take a second look.

What responsibility does American Airlines have? The airline would probably argue that it doesn’t have any, and that it was simply selling an insurance product from its website. I’m not sure I would agree. By selling insurance on its site, American is offering a de facto endorsement, and bears some responsibility when you aren’t compensated under the insurance company’s own rules.

If your appeal had been rejected, your next step would have been to rope American into this case. Sometimes — and I’ve seen this happen — a travel company will step in when and insurance claim is denied to make things right. Maybe it would have issued some vouchers for future flights.

As it turns out, none of that would be necessary. I contacted Access America on your behalf, and it reopened your case.

“Because Mr. Frow used a previously obtained credit from American Airlines to book the flight he insured with us, we mistakenly thought that he did not incur a financial loss and initially denied his claim on that basis,” a representative told me.

After “further review” Access America refunded you $601, which is the limit of your coverage.

(Photo: Julien He ry/Flickr Creative Commons)

  • John

    Final step would have been to contact the State insurance board in the state the OP resides in. If it truely is insurance fraud, they can go after both AA (the licensed agent) and Access America (the insurance company).

  • cjr

    Gee, ANOTHER Access America denial of claim story. Imagine that.

  • Aaron

    Another option would’ve been to contact the Insurance Commissioner for your state. Insurance is regulated by the State Insurance Commissioner, who often has resources to help resolve insurance problems.

  • Michael K

    “According to the U.S. Travel Insurance Association, 1 in 6 policy purchasers file a claim, and of those, fewer than 10 percent are turned down.”
    —–
    Do they have that data available broken down by company? If the recent articles here and customer reviews posted elsewhere are any indication, that 10% number doesn’t seem remotely plausible for Access America.

  • Bill

    Just checked my next two trips.
    Niether is insured by Access America.

    That was lucky.

    Now I have a note to myself – Avoid Access America.

    Thanks for the heads up Chris.

  • bodega

    In our industry, it is well known that Access American usually turns down the first request and that a second submission is usually required. It is like a game with them and it is wrong.

    I have to say that we assist with all claims. Interesting how AA offers the insurance online, but certainly does assist a passenger with their claim, yet they made money on the sale of the insurance.

  • kwaked

    Access America- FTW! Your repuation is finally catching up to you.

  • Raven

    Acesss America: The most frequent scum bag insurance company featured on this site!

  • Ray Smith

    Dear Friends: I am continually saddened by the experiences that my fellow travelers have suffered through — I’m just ‘one of you,” and I’ve come up with a sure “fix.” It can be an travel insurance carrier, an airline, a hotel – -whatever. Here’s what I do:
    1. I keep a close PAPER TRAIL of a problem, and interface between me and the “whatever” I’m up against.

    2. I send a courteous, firm and totally informational e-mail or letter (certified mail, if it is by letter- -return receipt requested), telling the “miscreant company’ that they have one opportunity to resolve this matter properly (I am always willing to seriously consider their position and situation). I give them fifteen business days to resolve the matter, and if not, I will immediately take them to court. If nothing is resolve, or I don’t hear from them – -whatever — on the 16th day, I immediately commence a small claims action (thank heavens my claims never came close to my state’s small claim’s limit of $5,000.00), and INCLUDE my lost time, and any other damages I can think of. You have no idea how quickly I receive a response — and I have always come out ahead – -and of course the “whomever” I’ve sued must pay for all the court costs and ancillary expenses. It works folks. Don’t horse around with these people, and don’t become frustrated. Remain calm. Keep close records, and you’ll do just fine. Oh by the way, if I do get a “timely” response, and they tell me they need an additional 30-days or whatever to investigate etc., I tell them that the fifteen day time limit stands!. I might add that I have had to do this four times in the past 10-years – -and I travel extensively, so the “failure” rate is quite low — at least for me. By the way kudos to Mr. Elliott and his good work on behalf of the consumer. Believe me, when Mr. Elliott “calls,” these people DO LISTEN!
    Sincerely,
    Ray
    Ray

  • Ed

    “Unfortunately, insurance claims are often denied because of a misunderstanding”
    Actually, I think that most travel insurance claims are often denied for the sheer reason that they just don’t want to pay out! And they can get away with it because the vast majority of the people will bow to the company’s will and just back away with their tails between their legs.

    You know, this site seems to have quite a number of regular travelers…I’m *SURE* that the people reading this blog have taken insurance…do we have *ANY* success stories where the claimant received a payout on their first attempt against their travel insurance?

  • Les

    “According to the U.S. Travel Insurance Association, 1 in 6 policy purchasers file a claim, and of those, fewer than 10 percent are turned down.”

    Well, that’s their story. Industry associations exist to spin the facts (read; “lie”?) in favor of their sponsors, of course. But strangely we keep hearing from that wronged ten percent, both through this column and anecdotally. Hmmmmm.

    Chris, do you suppose any of the state insurance commissions keep records of this kind of complaint? Any way to find out?

    When I was shopping for travel insurance this year my web searches in that area weren’t helpful.

  • Mary Graham

    Geez I purchased Access American insurance because they’re a sponsor of this site, which I trust. Hopefully, I won’t have any troubles and will never find out how good or bad they are.

  • Charles

    @Mary Graham Be careful about ever assuming that the advertising on a site is in any way endorsed by the site. I’m sure Elliott will clarify, but I know he has underwriters and has clearly endorsed them in the past and they are clearly indicated in several places. But often other advertising is provided by a service and the site has no control over what is advertised. Elliott, please correct me if I am wrong about your site in particular.

    I recently was being bombarded with spam advertising medical transcription training, something that is often a scam. I found a page that described the many scams in this area. Guess who the advertisers on the page were? Most advertising is sold by services that have automatic systems that look at the page source and match advertising to the theme. Sometimes that match is a tad bizarre.

  • http://www.elliott.org Christopher Elliott

    @Charles and @Mary, I can’t control Google/TAN ads (banners) that you see. As you know, and as I’ve disclosed several times, Access America sponsored a series on travel insurance that ran on this site last week. It had no editorial control over what I wrote. It is not currently an underwriter of this site.

  • Eric

    The insurance company probably has an unwritten policy that the first claim gets turned down, in hopes the claimant will go away. It’s a zero risk gamble on their part. Perhaps a good law would be to require a 10% penalty payment, over and above the actual claim amount, to the claimant when the claim is unjustly denied.

  • Arizona Road Warrior

    @ Michael K – “If the recent articles here and customer reviews posted elsewhere are any indication, that 10% number doesn’t seem remotely plausible for Access America.”
    - – - – — – - – - – — – - –
    As I commented on Thursday on the other article about Access America, I won’t purchase a travel insurance policy from them. There are too many complaints about them.

    On the other hand, Squaremouth has a Zero Complaint Policy – “”If any one of our clients has a complaint against an insurance provider that cannot be fairly resolved to our satisfaction, we will remove the carrier from our site until the complaint is satisfactorily completed.” They had this policy since the company started in 1/2001.

    After every trip where I purchased a travel insurance policy from them, they contacted me to see if I had a claim to file, etc. That is customer service in my book!

    If you do a Google Search and type “Access America travel”…one of the pre-filled searches is “Access America travel insurance complaints”. The consumers’ reviews, ratings, etc. of Access America are low on websites like travelinsurancereview, travelinsurancereviewer, consumeraffairs, complaintsboard, pissedconsumer, epinions, etc.

    For example, there are 101 reviews at travelinsurancereviewer website on Access America and only 9 reviewers will recommend the company\policy; however, 92 reviewers won’t recommend the company\policy. I can understand that you can’t please everyone, etc. but 91% won’t recommend the company\policy tell me that there is a problem.

    IHMO, there are much better travel insurance policies issued by several different insurance companies that one can purchase at SquareMouth.

    Given the bad reviews, compliants, etc. against Access America, I was surprised to see Chris to accept them as an underwriter. My concern was that it would have been seen as an endorsement by some of the readers of this blog just like Mary did.

  • Charles

    I’ve looked for travel insurance reviews in the past. But, the problem with travel insurance reviews is that few feel a need to post a positive review, so the sites tend to be dominated with negative reviews. TripAdvisor has managed to create a wonderful environment where people feel a desire to review both good and bad. AngieList seems to do the same for local services. But, most people don’t feel a need to review their travel insurance unless they have a bone to pick. For the most part, I don’t think about my travel insurance much after I have purchased it unless there is a claim (and I’ve never had one).

    I’ve seen http://www.travelinsurancereviewer.com. There are very few reviews for other providers. I get the impression that most of the reviews are from ticked off Access America customers who searched for a place to complain and found this site. So, the complaints feed on themselves. Personally, I would not buy a policy from Access America, having heard other negative comments in many other places, but I also pretty much discount what I see on that site as unrepresentative of the customer base.

  • Dan

    Hmmm…..1 in 6 file a claim, and 90% of those are paid. That comes out to 15% of travel insurance purchasers get paid. To cover overhead and make a profit I guess the insurance providers must be charging at least 20% of the value of your trip, eh? I don’t think so. I just got a quote from a travel insurance aggregator site for an imaginary trip and the prices are in the neighborhood of 5%.

    This tells me that these industry numbers are very very misleading, if not a flat out lie.

  • Erica

    Access America to my surprise actually paid for my daughters stolen IPOD last year on her overseas trip to Israel. The hitch was having to go to a police station and getting a police report filed, and then translated into English. A little work, but received a check in the mail within a month and a half of starting the process. Having said that, I am concerned about using them for another trip this coming tuesday which will be up to 3 month stay in Israel. My daughter travels a lot and was wondering if there is a better way to insure her without insuring every trip. This will be the fourth overseas trip to various international destinations. Any input of who I should go with this time around? I want medical, flight, emergency evacuation, the whole works. Also, a friend in Israel offered to put her on his plan which allows for visitors up to 3 months, but only covers basic medical, hospitalization etc. Can I have both,a travel insurance by one of the underwriters as well as another insurance coverage from her friends policy? Any input would greatly be appreciated . Erica

  • Marcelmeth

    My wife and daughter had planned a trip to visit my recently
    widowed sister-in-law in Minnesota.  My sister-in-law has two young
    children, so my wife was planning on taking her sister’s family for a vacation
    in Minnesota.  We purchased tickets from Delta airlines and reserved rooms
    in a country Inn.  At the same time, we purchased travel insurance from
    Access America.

     

    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.  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.  Furthermore, even if it was, 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.   When I called up and complained to the agent, they said that
    I could appeal the decision.  I asked the agent to email me the
    information on how to proceed.  She promised to do it within the day.

     

    A day passed and there was no email from Access
    America.  I called again.  Again the agent promised to send me the
    information before the end of the day.  Again no email.  Finally I
    got on the web site, and emailed my request.  AFter 5 days, I finally received an email address to ask for an appeal of my case.  (ClaimAppeals@accessamerica.com)

     
    I have been waiting for a week to even receive an acknowledgement of my email.

    I feel that the insurance is useless and would discourage
    anyone from purchasing insurance from Access America.