My wife Jocelyn and our son Domenic J. Jr were supposed to go to Japan on April 2, 2020, return on April 10, 2020, and then I and my wife Jocelyn were going to France on May 21, 20202 but all trips were canceled due to the Global Coronavirus Pandemic. We called numerous times about getting our money back, we been told if we get our money back from the airline they would reimburse us which the airlines did.
We filed a claim and we were denied based on their policy which I don't understand because one of their claim forms is about this Coronavirus going on. All trips in the entire world were all canceled because of the Global Coronavirus Pandemic, As you see on those papers we send we described the reason why we are claiming to get our money back. Please help us, Thank You.
In March 2020 I was forced to cancel a trip because I became ill with a problem which requires complicated daily treatments. For the last month Trip Mate has labeled my claim as "paid" on the website, but no money has ever come. Twice I've contacted them only to be told that my checks are in accounting, waiting to be paid by email. They cannot give me information regarding when the email might be sent. I just get the same runaround every time I call. "I have no other information." "That information is not available."
Clearly, this company is stalling, unwilling or unable to pay its valid claims. Other people have filed very similar claims to mine with other web sites.
Now, I have two questions. 1) Has anyone filed a complaint with the Missouri Insurance Commission? In most states the commissioner requires every insurance company to show that it has adequate reinsurance in order to pay its claims in case of disaster.
2) Does anyone have any information regarding what reinsurance Trip Mate might have?
I received a declination on the first claim/leg 05/04/2020, even though I am specifically covered under two different clauses contained in the purchased policy regarding quarantine and airport shutdown. I believe strongly that noncompliant insurers, and all service providers, should be held accountable for their failure to deliver according to a contract.
Below you will find the declination email from Trip Mate, followed by my appeals letter.
DECLINATION FORM LETTER FROM TRIP MATE, INC. (relevant sections in bold)
Claims Administrator
9225 WARD PARKWAY, SUITE 200, KANSAS CITY, MO 64114 TEL: 844-777-6859 FAX: 816-523-3379
Worldwide Coverage For The Traveler
May 4, 2020
Ms. Jari Buck
RE: Trip Cancellation – Claim ID # 6908329
Dear Ms. Buck:
Thank you for your claim submission. You have requested reimbursement for the penalties assessed due to your trip cancellation. As we will explain below, we are unable to consider this to be a covered claim with the information currently on file.
We reviewed your claim according to the trip cancellation provision of the plan; we have included the definition of Sickness from the plan:
TRIP CANCELLATION
Benefits will be paid, up to the Maximum Benefit Amount shown in the Schedule of Benefits, to reimburse You for the amount of the unused non-refundable Prepaid Payments or Deposits You paid for Travel Arrangements when You are prevented from taking Your Trip due to:
…2. Your or a Family Member’s or a Traveling Companion’s or a Business Partner’s covered Sickness or Injury, which: a) occurs before departure on Your Trip; b) requires Medical Treatment at the time of cancellation resulting in medically imposed restrictions, as certified by a Legally Qualified Physician; and c) prevents Your participation in the Trip;
…provided such circumstances occur while coverage is in effect.
“Sickness” means an illness or disease of the body which: 1) requires examination and treatment by a Legally Qualified Physician; and 2) commences while Your coverage is in effect.
While the plan provides a benefit for a covered Sickness, the information on file does not indicate that you, your traveling companion, or a family member became ill while coverage was in effect. Therefore, you were not required to be examined and treated by a physician who certified the medical condition was so disabling it prevented you from being able to go on the trip. Because you did not cancel due to a Sickness as defined, but rather to avoid exposure to the Coronavirus, we are unable to consider this to be a covered claim.
The plan lists the following non-medical covered causes of loss (i.e. “Other Covered Reasons”) for Trip Cancellation:
a. You or Your Traveling Companion being hijacked, quarantined, required to serve on a jury (notice of jury duty must be received after Your Effective Date), served with a court order to appear as a witness in a legal action in which You or Your Traveling Companion is not a party (except law enforcement officers);
b. Your or Your Traveling Companion’s primary place of residence or destination being rendered uninhabitable by fire, flood, burglary or other Natural Disaster. We will only pay benefits for Losses occurring within 30 calendar days after the Natural Disaster makes Your destination accommodations uninhabitable. Your primary place of residence or destination is uninhabitable if: (i) the building structure itself is unstable and there is a risk of collapse in whole or in part; (ii) there is exterior or structural damage allowing elemental intrusion, such as rain, wind, hail, or flood; (iii) immediate safety hazards have yet to be cleared such as debris on roofs or downed electrical lines; or (iv) the property is without electricity or water. Benefits are not payable if a storm, snow storm, blizzard or hurricane is named on or before the Effective Date of Your Trip Cancellation coverage;
c. a documented theft of passports or visas;
d. You or Your Traveling Companion being directly involved in a traffic accident, substantiated by a police report, while en route to Your scheduled point of departure;
e. unannounced Strike that causes complete cessation of services for at least 12 consecutive hours of the Common Carrier on which You are scheduled to travel;
f. Inclement Weather that causes complete cessation of services for at least 12 consecutive hours of the Common Carrier on which You are scheduled to travel;
g. mechanical breakdown that causes complete cessation of services for at least 12 consecutive hours of the Common Carrier on which You are scheduled to travel;
h. a government-mandated shutdown of an airport or air traffic control system for reasons other than terrorism or an act of war;
i. You or Your Traveling Companion is in the military and called to emergency duty for a national disaster other than war;
j. a Terrorist Incident that occurs within 30 days of Your Scheduled Departure Date in a city listed on the itinerary of Your Trip. Benefits are not provided if the Travel Supplier offers a substitute itinerary;
k. revocation of Your previously granted military leave or re-assignment due to war. Official written revocation/re-assignment by a supervisor or commanding officer of the appropriate branch of service will be required.
We certainly understand the decision made to cancel this trip in light of the threat presented by the Corona virus. However, because the information on file does not document that this cancellation resulted from one of the above listed covered reasons, this claim is not covered under the plan provisions. Please note a government order, such as a stay at home order or a state of emergency, is not a specific quarantine of you or your Traveling Companion. Consequently, we must respectfully decline your request for reimbursement.
Trip Mate, Inc. is the claims administrator for Plan F200B, which includes short-term travel insurance underwritten by United States Fire Insurance Company. We must process claims according to the plan provisions and the information on file. If you have additional information which you think will have a bearing on your claim, please forward that information to [email protected] indicating your claim ID # 6908329 and name in the subject line, and we will be happy to review our decision.
Sincerely,
S. Weiser
Claims Department
MY APPEALS EMAIL
TripMate,So, you “think” I was not quarantined in Ecuador? (from your denial letter) “Please note a government order, such as a stay at home order or a state of emergency, is not a specific quarantine of you or your Traveling Companion. Consequently, we must respectfully decline your request for reimbursement.”
According to Napavale Inc. v. United Nat. Idem. Co. (1959) 169 Cal. Ap. 2d 119, “where a particular phrase in an insurance policy is not defined, the understanding of an ordinary person and approved usage of words must be guides in construing the insurance contract.” Or put another way, when an insurer makes no attempt to define a term or phrase which is the subject of dispute, the meaning of the word most acceptable to the insured should be accepted. (1973) City of Kimball v. St. Paul Fire and Marine Ins. Co. 206 North West 2d 632.
Here is the definition/meaning of the word you chose NOT to define in your policy, “quarantine,” according to Dictionary.com at https://www.dictionary.com/browse/quarantine.
“noun
• a strict isolation imposed to prevent the spread of disease.
• a period, originally 40 days, of detention or isolation imposed upon ships, persons, animals, or plants on arrival at a port or place, when suspected of carrying some infectious or contagious disease.
• a system of measures maintained by governmental authority at ports, frontiers, etc., for preventing the spread of disease.
• the branch of the governmental service concerned with such measures.
verb (used with object), quar·an·tined, quar·an·tin·ing.
• to put in or subject to quarantine.
• to exclude, detain, or isolate for political, social, or hygienic reasons.”
Below I have provided published documentation PROVING my status as a quarantined individual in Ecuador. When I would be either immediately challenged and sent home and/or fined for leaving my current rental in Cuenca due to my age (69) per Cuenca city laws, disallowed to travel between provinces per Ecuador country laws, stopped outside Guayaquil (my airport departure destination) forcibly by trucks and police IN THE ROAD per Guayaquil city mandate and prevented from leaving the country or crossing borders per Ecuador country laws, YOU TELL ME HOW THIS DOES NOT CONSTITUTE A QUARANTINE!
I am ALSO covered under an additional “Other Covered Reason” of Plan F200B - "h. a government-mandated shutdown of an airport or air traffic control system for reasons other than terrorism or an act of war."
—————
• On March 16, [President] Moreno... announced the suspension of transport between provinces and of domestic flights starting in the evening of March 17 initially for 14 days, later extended through the month of April. Schools are also closed through April.
• On the evening of March 15, Moreno announced a series of measures, including the suspension of citizens’ movements within the country except to buy food, medicine, and basic goods.
From 23:59 (local time) on Sunday, March 15, all international arrivals to Ecuador by air will be suspended and all foreign nationals will be barred from entering the country at any of its air, land, or sea border crossings. Similarly, all Ecuadorean nationals will be barred from returning to Ecuador from 23:59 on Monday, March 16.
Due to the current nationwide quarantine and travel restrictions, U.S. citizens located outside of the Guayas province may not be able to travel to Guayaquil for flights departing from the Guayaquil airport....
• The Government of Ecuador has restricted movement throughout the country with very limited exceptions and imposed a curfew from 9 p.m. to 5 a.m. (changing to 7 p.m. to 5 a.m. starting Saturday, March 21). Local jurisdictions have enacted additional restrictions, as the curfew in Guayas province is from 4 p.m. to 5 a.m. These restrictions can change at any time. U.S. citizens should comply with all local laws and monitor local news for any updates.
• People who experience coronavirus symptoms during quarantine isolation – or at any time – should immediately report themselves to local health authorities, to activate corresponding health protocols. Individuals with symptoms may call 171 or 911.
Trip Mate, Inc. Reviews
My wife Jocelyn and our son Domenic J. Jr were supposed to go to Japan on April 2, 2020, return on April 10, 2020, and then I and my wife Jocelyn were going to France on May 21, 20202 but all trips were canceled due to the Global Coronavirus Pandemic. We called numerous times about getting our money back, we been told if we get our money back from the airline they would reimburse us which the airlines did.
We filed a claim and we were denied based on their policy which I don't understand because one of their claim forms is about this Coronavirus going on. All trips in the entire world were all canceled because of the Global Coronavirus Pandemic, As you see on those papers we send we described the reason why we are claiming to get our money back. Please help us, Thank You.
In March 2020 I was forced to cancel a trip because I became ill with a problem which requires complicated daily treatments. For the last month Trip Mate has labeled my claim as "paid" on the website, but no money has ever come. Twice I've contacted them only to be told that my checks are in accounting, waiting to be paid by email. They cannot give me information regarding when the email might be sent. I just get the same runaround every time I call. "I have no other information." "That information is not available."
Clearly, this company is stalling, unwilling or unable to pay its valid claims. Other people have filed very similar claims to mine with other web sites.
Now, I have two questions. 1) Has anyone filed a complaint with the Missouri Insurance Commission? In most states the commissioner requires every insurance company to show that it has adequate reinsurance in order to pay its claims in case of disaster.
2) Does anyone have any information regarding what reinsurance Trip Mate might have?
I received a declination on the first claim/leg 05/04/2020, even though I am specifically covered under two different clauses contained in the purchased policy regarding quarantine and airport shutdown. I believe strongly that noncompliant insurers, and all service providers, should be held accountable for their failure to deliver according to a contract.
Below you will find the declination email from Trip Mate, followed by my appeals letter.
DECLINATION FORM LETTER FROM TRIP MATE, INC. (relevant sections in bold)
Claims Administrator
9225 WARD PARKWAY, SUITE 200, KANSAS CITY, MO 64114 TEL: 844-777-6859 FAX: 816-523-3379
Worldwide Coverage For The Traveler
May 4, 2020
Ms. Jari Buck
RE: Trip Cancellation – Claim ID # 6908329
Dear Ms. Buck:
Thank you for your claim submission. You have requested reimbursement for the penalties assessed due to your trip cancellation. As we will explain below, we are unable to consider this to be a covered claim with the information currently on file.
We reviewed your claim according to the trip cancellation provision of the plan; we have included the definition of Sickness from the plan:
TRIP CANCELLATION
Benefits will be paid, up to the Maximum Benefit Amount shown in the Schedule of Benefits, to reimburse You for the amount of the unused non-refundable Prepaid Payments or Deposits You paid for Travel Arrangements when You are prevented from taking Your Trip due to:
…2. Your or a Family Member’s or a Traveling Companion’s or a Business Partner’s covered Sickness or Injury, which: a) occurs before departure on Your Trip; b) requires Medical Treatment at the time of cancellation resulting in medically imposed restrictions, as certified by a Legally Qualified Physician; and c) prevents Your participation in the Trip;
…provided such circumstances occur while coverage is in effect.
“Sickness” means an illness or disease of the body which: 1) requires examination and treatment by a Legally Qualified Physician; and 2) commences while Your coverage is in effect.
While the plan provides a benefit for a covered Sickness, the information on file does not indicate that you, your traveling companion, or a family member became ill while coverage was in effect. Therefore, you were not required to be examined and treated by a physician who certified the medical condition was so disabling it prevented you from being able to go on the trip. Because you did not cancel due to a Sickness as defined, but rather to avoid exposure to the Coronavirus, we are unable to consider this to be a covered claim.
The plan lists the following non-medical covered causes of loss (i.e. “Other Covered Reasons”) for Trip Cancellation:
a. You or Your Traveling Companion being hijacked, quarantined, required to serve on a jury (notice of jury duty must be received after Your Effective Date), served with a court order to appear as a witness in a legal action in which You or Your Traveling Companion is not a party (except law enforcement officers);
b. Your or Your Traveling Companion’s primary place of residence or destination being rendered uninhabitable by fire, flood, burglary or other Natural Disaster. We will only pay benefits for Losses occurring within 30 calendar days after the Natural Disaster makes Your destination accommodations uninhabitable. Your primary place of residence or destination is uninhabitable if: (i) the building structure itself is unstable and there is a risk of collapse in whole or in part; (ii) there is exterior or structural damage allowing elemental intrusion, such as rain, wind, hail, or flood; (iii) immediate safety hazards have yet to be cleared such as debris on roofs or downed electrical lines; or (iv) the property is without electricity or water. Benefits are not payable if a storm, snow storm, blizzard or hurricane is named on or before the Effective Date of Your Trip Cancellation coverage;
c. a documented theft of passports or visas;
d. You or Your Traveling Companion being directly involved in a traffic accident, substantiated by a police report, while en route to Your scheduled point of departure;
e. unannounced Strike that causes complete cessation of services for at least 12 consecutive hours of the Common Carrier on which You are scheduled to travel;
f. Inclement Weather that causes complete cessation of services for at least 12 consecutive hours of the Common Carrier on which You are scheduled to travel;
g. mechanical breakdown that causes complete cessation of services for at least 12 consecutive hours of the Common Carrier on which You are scheduled to travel;
h. a government-mandated shutdown of an airport or air traffic control system for reasons other than terrorism or an act of war;
i. You or Your Traveling Companion is in the military and called to emergency duty for a national disaster other than war;
j. a Terrorist Incident that occurs within 30 days of Your Scheduled Departure Date in a city listed on the itinerary of Your Trip. Benefits are not provided if the Travel Supplier offers a substitute itinerary;
k. revocation of Your previously granted military leave or re-assignment due to war. Official written revocation/re-assignment by a supervisor or commanding officer of the appropriate branch of service will be required.
We certainly understand the decision made to cancel this trip in light of the threat presented by the Corona virus. However, because the information on file does not document that this cancellation resulted from one of the above listed covered reasons, this claim is not covered under the plan provisions. Please note a government order, such as a stay at home order or a state of emergency, is not a specific quarantine of you or your Traveling Companion. Consequently, we must respectfully decline your request for reimbursement.
Trip Mate, Inc. is the claims administrator for Plan F200B, which includes short-term travel insurance underwritten by United States Fire Insurance Company. We must process claims according to the plan provisions and the information on file. If you have additional information which you think will have a bearing on your claim, please forward that information to [email protected] indicating your claim ID # 6908329 and name in the subject line, and we will be happy to review our decision.
Sincerely,
S. Weiser
Claims Department
MY APPEALS EMAIL
TripMate,So, you “think” I was not quarantined in Ecuador? (from your denial letter) “Please note a government order, such as a stay at home order or a state of emergency, is not a specific quarantine of you or your Traveling Companion. Consequently, we must respectfully decline your request for reimbursement.”
According to Napavale Inc. v. United Nat. Idem. Co. (1959) 169 Cal. Ap. 2d 119, “where a particular phrase in an insurance policy is not defined, the understanding of an ordinary person and approved usage of words must be guides in construing the insurance contract.” Or put another way, when an insurer makes no attempt to define a term or phrase which is the subject of dispute, the meaning of the word most acceptable to the insured should be accepted. (1973) City of Kimball v. St. Paul Fire and Marine Ins. Co. 206 North West 2d 632.
https://books.google.com/books?id=TytqDmFZWlAC&pg=PA5&lpg=PA5&dq=what+guides+a+word+definition+in+insurance+policy+when+not+defined&source=bl&ots=YnC0d5FFbo&sig=ACfU3U14G40OIosFX-v_XsbMq1jni4TvNw&hl=en&sa=X&ved=2ahUKEwiNgrOXxJvpAhWflnIEHdFsDZ0Q6AEwDHoECA0QAQ#v=onepage&q=what%20guides%20a%20word%20definition%20in%20insurance%20policy%20when%20not%20defined&f=false
Here is the definition/meaning of the word you chose NOT to define in your policy, “quarantine,” according to Dictionary.com at https://www.dictionary.com/browse/quarantine.
“noun
• a strict isolation imposed to prevent the spread of disease.
• a period, originally 40 days, of detention or isolation imposed upon ships, persons, animals, or plants on arrival at a port or place, when suspected of carrying some infectious or contagious disease.
• a system of measures maintained by governmental authority at ports, frontiers, etc., for preventing the spread of disease.
• the branch of the governmental service concerned with such measures.
verb (used with object), quar·an·tined, quar·an·tin·ing.
• to put in or subject to quarantine.
• to exclude, detain, or isolate for political, social, or hygienic reasons.”
Below I have provided published documentation PROVING my status as a quarantined individual in Ecuador. When I would be either immediately challenged and sent home and/or fined for leaving my current rental in Cuenca due to my age (69) per Cuenca city laws, disallowed to travel between provinces per Ecuador country laws, stopped outside Guayaquil (my airport departure destination) forcibly by trucks and police IN THE ROAD per Guayaquil city mandate and prevented from leaving the country or crossing borders per Ecuador country laws, YOU TELL ME HOW THIS DOES NOT CONSTITUTE A QUARANTINE!
I am ALSO covered under an additional “Other Covered Reason” of Plan F200B - "h. a government-mandated shutdown of an airport or air traffic control system for reasons other than terrorism or an act of war."
—————
• On March 16, [President] Moreno... announced the suspension of transport between provinces and of domestic flights starting in the evening of March 17 initially for 14 days, later extended through the month of April. Schools are also closed through April.
• On the evening of March 15, Moreno announced a series of measures, including the suspension of citizens’ movements within the country except to buy food, medicine, and basic goods.
https://www.as-coa.org/articles/where-coronavirus-latin-america#ecuador
—————
From 23:59 (local time) on Sunday, March 15, all international arrivals to Ecuador by air will be suspended and all foreign nationals will be barred from entering the country at any of its air, land, or sea border crossings. Similarly, all Ecuadorean nationals will be barred from returning to Ecuador from 23:59 on Monday, March 16.
https://www.garda.com/crisis24/news-alerts/322931/ecuador-government-to-close-all-borders-due-to-covid-19-march-15-16-update-1
—————
Due to the current nationwide quarantine and travel restrictions, U.S. citizens located outside of the Guayas province may not be able to travel to Guayaquil for flights departing from the Guayaquil airport....
• The Government of Ecuador has restricted movement throughout the country with very limited exceptions and imposed a curfew from 9 p.m. to 5 a.m. (changing to 7 p.m. to 5 a.m. starting Saturday, March 21). Local jurisdictions have enacted additional restrictions, as the curfew in Guayas province is from 4 p.m. to 5 a.m. These restrictions can change at any time. U.S. citizens should comply with all local laws and monitor local news for any updates.
• People who experience coronavirus symptoms during quarantine isolation – or at any time – should immediately report themselves to local health authorities, to activate corresponding health protocols. Individuals with symptoms may call 171 or 911.
https://johnlewis.house.gov/media-center/press-releases/coronavirus-information-americans-abroad
—————
Ecuador has closed its borders entirely to both visitors and returning citizens.
https://www.forbes.com/sites/jamesasquith/2020/04/02/april-update-coronavirus-travel-update-90-of-countries-have-travel-restrictions/#68a764663024
We were going to travel on Viking Cruises. I passed out and broke my arm and my hip. Then I had a major heart attack.
Viking was very gracious and refunded a considerable amount of the pre-paid trip.
Its insurance company, Trip Mate, sent us a perfunctory $200, even with all the medical reports sent to them.
We are very disappointed with what we consider to be a ripoff. And a bad ad for Viking cruises also.
Thank you.