CSA Travel Protection and Insurance Services represents Generali U.SBranch as the administrator of the travel protection plan that was purchased by *** ***We are in receipt of your email dated August 02, 2016, with additional information provided by Ms***Ms*** states that the laminate in her kitchen is no longer in production, which is why she is requesting full replacement of the countertopsAccording to information provided by Ms***, she does not know the age of the existing countertops because they were in the house when she purchased it in This policy will cover the cost of repairs or replacement of the damaged property, which is the portion of the countertop that has the burn holeWe are unable to cover the cost to replace all of the 14-year old countertops in the kitchenWe await an estimate for the damaged countertop aloneUpon receipt, we can continue to process the claimIf you have any questions, please feel free to contact us at *** ***, by email at *** or by FAX at *** ***Please ensure the claim number is included with your responseSincerely,
*** ***
SrTechnical Claims Specialist
cc: Generali U.SBranch
*** *** / Director of Claims
December 10, *** *** I Revdex.com OF SAN DIEGOVIEWRIDGE AVE #200SAN DIEGO, CA *** and *** *** #* ***Claim Number: ***Policy
Number: ***Travel Dates: October 19, 2014- October 26, 2014Dear Ms***:
CSA Travel Protection and Insurance Services represents Generali U.SBranch as theadministrator of the travel protection plan that was purchasedWe are in receipt of your emaildated December 08, 2014, notifying us of the complaint filed by *** and *** ***We have reevaluated the claim and will afford coverage for the unused airfare of *** and*** ***The claims representative will reopen the file for continued processingIf you have any questions, please feel free to contact us at (800) 541-3522, by email [email protected] or by FAX at (877) 300-Sincerely,
*** ***
SrTechnical Claims Specialist
cc: General US Branch
*** ***/ Director of Claims
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below. We are not sure how the heck we were to know what might possibly be a hour delayWhat happens if we are traveling on the icy, snow covered roads,(which is what the travel map looked like on that route for the whole day) and they decided to close them while enroute? It isn't like there are a ton of places to stayTo think that you feel that you have the right to tell us to risk our lives, when you are sitting at your desk in San Diego, is ridiculousI think you should reconsider this againWhat you have given us is a piece of junk responseWe didn't have a crystal ball like you must have, to tell us more than what the travel maps and NM DOT stated on their website, to not travel
Regards,*** ***
*** ***/ Revdex.com OF SAN DIEGO September 11,
MURPHY CANYON ROAD #
SAN DIEGO, CA
*** *** #
Claim Number: ***
Policy Number:
***
Travel Dates: September 05, 2014- September 07,
Dear Ms***:
CSA Travel Protection and Insurance Services is the administrator of the travel protection plan that was purchasedWe are in receipt of your email dated September 09, 2014, notifying us of the complaint filed by Mr***
Mr*** booked airline tickets through AirTran Airways and purchased the travel insurance plan on August 26, At that time a Policy Confirmation letter and Description of Coverage, outlining the plan's coverage and coverage restrictions, were emailed to him
The trip was canceled because the Army canceled the scheduled drill that he was to participate inThe policy only provides benefits for specific, listed eventsAs the reason for this cancellation was not due to a listed, Covered Event, no benefits were payable for this claim
Our contact at AirTran Airways has informed us that they did refund Mr*** in full for his airline ticket
If you have any questions, please feel free to contact us at (800) 876-6903, by email at [email protected] or by FAX at (877) 300-
Sincerely,
*** ***
SrTechnical Claims Specialist
*** ***/ Director of Claims
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details are below I received no offer from CSA Travel beyond a repeated request to compel my grieving uncle to sign a form that would allow CSA access to restricted medical records. As I read between the lines of the
CSA response, it appears that the representative is of the opinion that my
purchase of the insurance was made in anticipation of the death and with an
unethical intent. Nothing can be further from the
truthThe insurance was paid for on the SAME date, at the SAME time that final
payment was made for the tour packageThis is what any reasonable person would
do The response also seems to assume
that I could anticipate the date of my relative's deathThat assumption is also
illogicalIf the death was anticipated, I simply would have cancelled my
reservation and NOT paid for the tour package. As it states in "Palliative Care
Perspectives by Dr*** ** ***:
"Cancers
of very different tumor types and locations often follow very similar dying
trajectories. In fact, the dying trajectory of cancer is one of the most
predictable trajectoriesMost patients with metastatic cancer remain quite
functional until approximately five to six months before their deathsTheir health
statuses then tend to slowly decline until the rate of decline begins to
accelerate rapidly two to three months before death.14 In ***
study one month prior to death more than percent of the cancer patients
studied had difficulty getting out of a bed or chairPrior to the period of
decline in the last few months of life, cancer patients may have various
symptom needs such as pain management but tend to remain at high functional
levelsDuring the rapid decline phase patients start to "take to their
beds." A good rule of thumb is that a patient with advanced cancer who has
taken to bed without a correctable cause will usually die in a matter
of weeks to a few months." (Emphasis added)
There is NO WAY I could have predicted
when my relative would die Unfortunately, it appears that CSA is
attempting to violate their written contractThis is a bad business practice
and that is why I am hoping to find redress through the Revdex.com
Regards,
*** ***
Dear Ms***,
CSA Travel Protection and Insurance Services is an administrator of travel protection plans and vacation rental damage protection plans sold through HomeAway.com and their subsidiary site VRBOWe are receipt of your follow- up correspondence on the above
referenced matter
As you've noted, some travel protection plans available in the marketplace include the coverage of Trip Interruption, which typically provides benefits if you are delayed beyond your scheduled departure date or if you are unable to continue on your trip due to a covered event
that occurs during your scheduled travel datesThe Cancellation Protection product you purchased through VRBO does not include this coverageWhile the terms "cancel" and "interrupt" may not be defined, the Travel Insurance Policy advises what benefits are available under
"TRIP CANCELLATION BENEFIT" if you are prevented from taking your trip due to a covered event that occurs prior to your departure
Formally, a claim has not been filed by you against this policyThe customer service information provided in the March 25th phone call, and our response to your Revdex.com of San Diego complaint, were not denials of insurance claims
If you wish for our Claims Department to review the facts of your loss and issue a formal determination, please access the following website to complete a claim form and review a list of the supporting documentation to submit:
***
For assistance with the forms and supporting documentation, you can reach our Claims Department toll-free at *** ***
Sincerely,
*** ***
Director of Compliance & Licensing
Enclosure/Attachment: Policy Confirmation Letter for #*** including
Travel Insurance Policy
Cc: Revdex.com of San Diego
*** *** Vice President of Operations
CSA Travel Protection
October 27,
*** ***/ Revdex.com OF SAN DIEGO
VIEWRIDGE AVE #
SAN DIEGO, CA
Complainant: *** *** #***/ Insured: *** *** and *** ***
Claim Number: ***
Policy Number: ***
Travel Dates: August 16, 2014- September 06,
Dear Ms***:
CSA Travel Protection and Insurance Services is the administrator of the travel protection plan
that was purchasedWe are in receipt of your email dated October 15, 2014, notifying us of the
complaint filed by Mr***
On July 02, 2014, Mr*** purchased airline tickets for his daughter and her spouse to travel to
the United StatesHe purchased the travel insurance plan on July 18, At that time a
Policy Confirmation Letter and Description of Coverage, outlining the plan's coverage and
coverage requirements, were emailed to Mr***
The trip was canceled on August 05, 2014, because the state department would not issue a
tourist visa to *** ***'s spouseIn his complaint, Mr*** also indicated that there may
have been work-related issues that attributed to the trip cancellationThe travel insurance plan
provides Trip Cancellation benefits only for the specific reasons listed in the policyThe inability
to obtain the proper travel documents and/or business obligations are not covered events that
would allow payment of benefits
The plan does offer an Optional Cancel For Any Reason Benefit when certain requirements are
metThe policy states "If you purchased the Optional Cancel for Any Reason Benefit and
cancel your Covered Trip for any reason not otherwise covered by this plan, we will reimburse
you for the percentage of the prepaid, forfeited, non-refundable Payments or Deposits you paid
for your Trip provided:
your payment for this plan is received within hours of the date your initial deposit for your
Covered Trip is received"
The insurance plan was not purchased within hours of the date that Mr*** bought the
airline ticketsHe did not qualify for the Cancel For Any Reason Benefit, and the other reasons
for the trip cancellation are not covered events under the planRegretfully, we are unable to
provide benefits for this claim
If you have any questions, please feel free to contact us at ###-###-####, by email at
*** or by FAX at ###-###-####
Sincerely,
*** ***
SrTechnical Claims Speciakist
cc: *** ***/ Director of Claims
Dear Ms***;
5pt;">CSA Travel Protection and Insurance Services represents *** *** *** as the administrator of the travel protection plan that was purchasedWe are in receipt of your email dated October 27, 2015, notifying us of the complaint filed by Ms***Ms*** purchased a diving tour on August 07, The travel insurance plan was purchased on September 21, 2015, with a Trip Cancellation coverage effective date of September 22, At that time a Policy Confirmation Letter along with a link to her Description of Coverage, outlining the plan's coverage and coverage restrictions, was emailed to herOn September 21, 2015, the diving tour was cancelled by the tour company, *** *** ***, due to Weather conditionsWhile the plan purchased provides coverage for common carrier cancellations due to adverse weather, it specifically states: "We will not pay for any loss under this Policy, caused by, or resulting from [an] event or circumstance which occurs at a time when coverage is not in effect for you" and "any issue or event that could have been reasonably foreseen or expected when you purchased the coverage." Additionally, it states: "Trip Cancellation coverage will take effect at 12:A.Mlocal time at your location on the day after the date your premium payment is received by us or our authorized agent."
The tour cancellation occurred prior to the plan effective date and the adverse weather was reasonably foreseeable when the plan was purchasedTherefore, we are unable to provide benefits for this claim
If you have any questions, please feel free to contact us at *** ***, by email at *** or by FAX at *** ***Sincerely,
*** ***
*** ***
CSA Travel Protection and Insurance Services represents *** *** - U.S
Branch as the administrator of the travel protection plan that was purchasedWe are in receipt of your email dated May 05, 2016, notifying us of the complaint filed by Mr***Mr*** canceled his trip because his traveling companion, *** ***, was required to appear in Court as a party to a legal actionThe policy provides benefits for trip cancellation only when the reason is one of the plan's listed Covered EventsAs shown under the heading "TRIP CANCELLATION BENEFIT
Benefits will be paid if you are prevented from taking your Trip due to one of the following unforeseeable Covered Events that occur before departure on your Trip to you or your Traveling Companion, while your coverage is in effect under this PolicyBeing required to serve on a jury, or required by a court order to appear as a witness in a legal action provided you, a Family Member or a Traveling Companion is not a party to the legal action or appearing as a law enforcement officer"As Ms*** was a party to the legal action, which required her to appear in court, we are unable to provide benefits for this claimIf you have any questions, please feel free to contact us at *** ***, by email at *** or by FAX at *** ***Please ensure the claim number is included with your response,
Sincerely,
*** ***
SrTechnical Claims Specialist
cc: *** *** - U.SBranch
*** *** / Director of Claims
CSA Travel Protection and Insurance Services represents Generali Assicurazioni Generali S.P.A.
(U.S. Branch) as the administrator of the travel protection plan that was purchasedWe are in receipt of
your email dated February 27, 2014, notifying us of the complaint
filed by Ms***
Ms*** canceled her trip due to the surgery of her Traveling Companion's sonThe medical
condition that caused the surgery to be performed was present prior to the purchase of the policy.
However, the anxiety that resulted in a change to the surgery date occurred during the coverage
periodTherefore, we will afford coverage for this lossThe claim will be reopened for payment
processing
If you have any questions, please feel free to contact us at ###-###-####, by email at [email protected] or by FAX at ###-###-####
Sincerely,
*** ***
SrTechnical Claims Specialist
Revdex.com OF SAN DIEGO August 08,
ATTN: *** ***
MURPHY CANYON ROAD #
SAN DIEGO, CA
*** *** # ***
Claim Number: ***
Policy Number: ***
Travel Dates: May 31, 2014- June 07,
Dear Ms***:
CSA Travel Protection and Insurance Services represents Generali U.SBranch as the administrator of the travel protection plan that was purchasedWe are in receipt of your email dated August 04, 2014, providing us with additional information from Ms***
Ms*** contends that this was a trip cancellation instead of a trip interruption based on the May 31, departure date listed on the policyDue to the circumstance that caused the loss,
the trip departure date would not change the outcome of the claims decisionRegarding this loss, the Covered Events for Trip Cancellation Benefits and Trip Interruption Benefits are exactly the sameThe plan covers only "A documented theft of your passports or visas"
The cruise line may have agreed to accept a birth certificate instead of a passport for the child to board the ship, but the terms and conditions of the travel protection plan allows only specific Covered Events for a trip cancellationRegretfully, we are unable to change our decision
If you have any questions, please feel free to contact us at (800) 541-3522, by email at [email protected] or by FAX at (877) 300-
Sincerely,
*** ***
SrTechnical Claims SR cialist
cc: Generali U.SBranch
*** *** I Director of Claims
Revdex.com OF SAN DIEGO June 05, 2015ATTN: *** *** *** *** *** *** ** ***
Complaint ID Number: *** ***Claim Number: ***Policy Number: ***Travel Dates: April22, 2015- May 10,Dear MsGovas:CSA Travel Protection and Insurance Services represents *** *** ***h as theadministrator of the travel protection plan that was purchasedWe are in receipt of your emaildated June 02, 2015, regarding additional information submitted by Mr*** for reviewMr*** states that he found no place in the insurance contract that indicates not having avisa is a reason for non-payment of a claimMr*** also feels that at least a refund of$for the insurance cost of *** *** should be reimbursed to himA trip cancellation claim was filed for Traveling Companion *** ***Ms.*** did not obtain the visa required to enter England and was unable to take thescheduled tripThe Travel Insurance Policy purchased by Mr*** only provides Trip Cancellation Benefitsfor a loss caused by one of the Covered Events specifically listed in the planNone of theplan's Covered Events provides coverage for the failure to obtain the necessary traveldocuments for a tripThe plan does offer the opportunity for a premium refund as shown: "10-DAY RIGHT TOEXAMINE YOUR POLICY- If you are not satisfied for any reason, you may cancel coverageunder the Policy within days after receiptYour premium payment will be refunded, providedthat there has been no incurred covered expense and you have not left on your TripReturn thePolicy to us at the Program Administrators office or our authorized agentWhen so returned, thePolicy is void from the beginningAfter this 0-day period, the payment for this coverage isnonrefundable."
The 10-day free look period expired on July 09, Therefore, we are unable to provide apremium refundThe trip cancellation claim filed because Ms*** did not have therequired travel documents is not one of the plan's Trip Cancellation Covered Events that wouldallow payment of the claimA copy of the Policy Confirmation Letter and Travel Insurance Policy are enclosed for yourreviewIf you have any questions, please feel free to contact us at *** ***, by email at*** or by FAX at *** ***Sincerely,
*** ***SrTechnical Claims Specialis
cc: *** *** ***
*** *** I Director of Claims
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.If it were wall paper and it was no longer in production, would they pay to paper one wall unmatching? If it were a car door and the color were absolutely not available would they expect you to drive around with a car door not matching the rest of the car? This is the same situationIt would cost me more than them to get my kitchen matching and yes I get the counter tops are older but if they didn't have a burn hole they're would be no issue If they continue to be unwilling to do the appropriate thing after this response I will take them to small claims court and request an additional $to compensate me for my gas, hotel and days pay to attend court
Regards,
*** ***
Dear Ms***,
5pt;">CSA Travel Protection and Insurance Services is an administrator of travel protection and emergency assistance plans sold on HomeAway.com and affiliated sitesWe are in receipt of your complaint filed with the Revdex.com of San Diego on 9/24/regarding your above numbered Cancellation Protection planOur records indicate that this plan was successfully cancelled on 9/24/at your requestThe full plan cost of $74,Was refunded at that timeCSA is committed to providing optimal service to our customers and partners, and we appreciate the opportunity to audit our processesIf you have any questions, or require any further information, please do not hesitate to contact me directly
at *** *** or ***Sincerely,
*** *** Director of Compliance & Licensing
C?: Revdex.com of San Diego
Dear Ms***,
CSA Travel Protection and Insurance Services is an administrator of travel protection and emergency assistance plans sold on *** and affiliated sitesWe are in receipt of your complaint filed with the Revdex.com of San Diego on 9/24/regarding the above numbered Carefree Rental Guarantee planOur records indicate that you contacted *** directly on 9/25/and requested the dates on the Carefree Rental Guarantee plan be changed to reflect your December trip, as they were originally recorded as September*** confirmed on 9/30/that this change was made at your request and to your satisfaction, so we consider this matter closedCSA is committed to providing optimal service to our customers and partners, and we appreciate the opportunity to audit our processesIf you have any questions, or require any further information, please do not hesitate to contact me directly
at *** *** or ***Sincerely,
*** *** Director of Compliance & Licensing
Cc: Revdex.com of San Diego
Dear Ms***:
CSA Travel Protection and Insurance Services is the administrator of the travel protection plan
that was purchasedWe are in receipt of your email dated March 09, 2014, notifying us of the
additional information provided by Ms***
Based on the medical documentation, the patient was diagnosed with failure to thrive prior to the
purchase of the insurance planBenefits due to the illness of a Family Member can be provided if
the Sickness commences while the policy is in effectTherefore, we are unable to change our
determination of this claim
If you have any questions, please feel free to contact us at (800) 541-3522, by email at [email protected] or by FAX at (877) 300-
Sincerely,
*** *** ***
Claims Department Supervisor
Dear Ms***:
5pt;">CSA Travel Protection and Insurance Services represents *** *** *** as the administrator of the travel protection plan that was selectedWe are in receipt of your email dated November 13, 2015, notifying us of the complaint filed by Ms***Ms*** booked a trip with the scheduled travel dates of October 23, to November 08, The travel insurance was purchased on October 13, At that time a Policy Confirmation Letter and the Description of Coverage, outlining the plan's coverage and coverage restrictions, were emailed to Ms***On November 12, we received claim documents indicates Ms*** cancelled her trip on October 15, due to her family member's deathWhile the plan purchased provides trip cancellation coverage for your Family Member's death, it specifically states: "We will not pay for any loss under this Policy, caused by, or resulting from any issue or event that could have been reasonably foreseen or expected when you purchased the coverage." The death certificate provided indicates the death occurred on October 15, and lists the "Onset to Death" as two monthsThis specifies the conditions that caused the death began approximately August 15, 2015, prior to the purchase of this coverageFurthermore, the plan purchased states: "Trip Cancellation coverage will take effect at 12:A.Mlocal time at your location on the day after the date your premium payment is received by us or our authorized agent." As Ms*** paid for her insurance premium on October 13, 2015, her policy became effective at 12:A.Mon October 14, As her family member passed on October 15, 2015, the day after her policy became effective, additional medical documentation is needed to ensure the death was not foreseeable when the insurance was purchased,
Please note, we have not asked Ms*** to provide us with the deceased's medical records
We have only requested that she provide us with a Patient Authorization Form, signed by the deceased's authorized representative, allowing us to obtain the needed medical recordsFinally, in regards to Ms***'s request for a new claims representativeIt is our standard procedure for each claim to be processed by one representativeTherefore, we are unable to accommodate Ms***'s request for a new representativeIf you have any questions, please feel free to contact us at *** ***, by email at *** or by FAX at *** ***Sincerely,
*** ***
*** ***
cc: *** *** ***
*** *** / *** ** ***
December 10, *** *** I Revdex.com OF SAN DIEGOVIEWRIDGE AVE #200SAN DIEGO, CA
"">*** *** #*** I Insured: *** ***Claim Number: ***Policy Number: ***
Dear Ms***:
CSA Travel Protection and Insurance Services represents Generali U.SBranch as theadministrator of the travel protection plan that was selectedWe are in receipt of your emaildated December 05, 2014, notifying us of the complaint filed by *** ***Ms*** rented her property to *** *** with scheduled travel dates of October 08,to October 12, The Property Damage Protection coverage was purchased onOctober 01, At that time, a Georgia Travel Insurance Policy outlining the plan's coverageand coverage restrictions was emailed to our insured *** ***On October 30, 2014, we received claim documents from Ms*** indicating that Ms.*** had damaged furniture, a mattress, curtains, carpet, linens, along with pet hair throughoutthe house causing damage to the washing machine, and grease buildup in the kitchenTheclaimed amount was $for repairs to the washing machine and $for extra cleaningand suppliesWe contacted Ms*** to confirm that she and/or her guests had damaged thepropertyMs*** denied all the damages other than the possible damage to the washingmachineUnder the heading 'VACATION RENTAL DAMAGE COVERAGE", it states "If you occupy anAccommodation and you damage the real or personal property assigned to thatAccommodation during the Trip, we will reimburse you the lesser of the cost of repairs or theActual Cash Value of the property, up to the amount shown in the Schedule."
Ms*** denied responsibility for the damages claimed, except for the washing machineThispolicy only pays for damages caused by the Insured or their guestsWe issued payment to Ms.*** for the $repair cost of the washing machineBased on the terms of the policy,no additional benefits are payable for this claimIf you have any questions feel free to contact us at (800) 541-3522, by email at [email protected] or by FAX at (800) 300-Sincerely,
*** ***
SrTechnical Claims Specialist
cc: General US Branch
*** ***/ Director of Claims
This letter is the response of CSA Travel Protection and Insurance Services ("CSA") to the foll
complaint of Mr*** ***In Mr***'s second communication, there are raised three
additional issues not covered in his original complaint(The original response of CSA is adopted by
reference as a part of this responseContent of the prior letter will not be repeated as a part of this
communication.)
Why was there a passage of nine days before Mr*** was flown out of Mexico?
First of all, there is a difference between what Mr*** presumes as the obligation of CSA under its
travel protection contract and the actual language of that contractWe will try to clarify thisGSA's
primary responsibility was to reimburse claims for the movement of the patient to the closest facility with
proper capabilities to treat the pertinent injuriesMr*** was already a patient at a facility that
possessed such capabilities, and he needed to be treated and stabilized before any movement should
have occurredThat was done at the facility in MexicoAdditionally, it should also be noted that Mr
*** was moved for an MRI while at the facility, so the assumption that CSA was somehow
deficient in some supposed obligatory role by not moving him at all is not supported by the facts of this
matter
After Mr*** was treated and stabilized, CSA did pay for an air ambulance flight, largely because
of the distress shown by Mr*** and his relatives regarding the situationThat payment should be
recognized as an accommodation and not a reflection of necessity
CSA is prepared to make partial payment of the claim, but they have not stated what constitutes
partial payment
CSA makes payments under its insurance contracts as the claims are submitted and in accordance with
the procedures and limitations that are contained within that contractIt realizes that Mr*** or
providers may not have submitted all of the claims for this matter and, thus, it must describe the
payments that have been made as partial paymentsMr*** seems to have interpreted "partial" to
mean that claims already submitted are being paid in partThe correct interpretation is that payments
have been made for the claims submitted thus far regarding the matter
To date, GSA has issued payment to Mrand Mrs*** for $302.12, representing the two nights
missed on the cruise shipPayment was also issued directly to the hospital in Cozumel for $21,000.00,
to ensure treatment would be rendered for the injuries sustained by Mrand Mrs***Due to
policy exclusions, GSA was unable to reimburse for the cost of the damaged scooter and eyeglasses
CSA has prepared two more checks that should be mailed next week: $for Mrs***'s
medical expenses, and $3,for Mr***'s medical expensesThe medical claim remains
open pending additional bills and documents
I would like for CSA to agree to make reparations for pain and suffering
There is no contract provision in the policy for pain and suffering and there is no relationship between
GSA's payment actions and the accident experienced by Mr***It was an accident on a motor
bike that resulted in Mr***'s injuries, not his stabilization and treatment at a hospital and
subsequent flight to return horneThere is no reason for GSA to make such reparations
We trust that this reply sufficiently addresses the complaint of Mr*** and that he will understand
the nature of the policy coverages and exclusions that are contained in his contract
If you have any questions, please feel free to contact us at (800) 541-3522, by email at [email protected] or by FAX at (877) 300-
Sincerely,
*** ***
SrTechnical Claims Specialist
*** *** I Revdex.com OF SAN DIEGO
*** *** *** ROAD #
SAN DIEGO, CA
*** *** #* ***
Claim Number: ***
Policy Number: ***
Travel Dates: October 11,- October 14,
Dear Ms***:
GSA Travel Protection and Insurance Services represents Generali U.SBranch as the administrator of
the travel protection plan that was purchasedWe are in receipt of your email dated September 22,
2014, with additional information provided by Mr***
Mr*** states that the military will only give official approval of leave within days from wanting to
take leaveThe trip was booked several months prior to the scheduled departure date, and Mr***
did not have approved military leave at that timeMr*** canceled the trip in August 2014, because
he felt he would probably be deployed
At the time of the insurance purchase in April 2014, we sent the policy documents to Mr***The
Policy Confirmation Letter provides the Schedule of Insurance Coverages along with the telephone
number to contact our Customer Service Department with questions about the planThe Policy, which is
attached to the Policy Confirmation Letter, details the plan's covered events and restrictionsA 0-day
free look period is offered that allows a refund of the insurance cost if the plan does not meet the needs
of the purchaser
The terms and conditions of the policy were not met in regard to Mr***'s reason for cancellation
Coverage is only provided when you are prevented from travel due to "Your previously granted military
leave being revokedThe leave must be approved prior to your coverage becoming effective, and official
written revocation notice from your commanding officer will be required."
It is not possible to highlight each situation that may or may not be covered by the plan on the Policy
Confirmation LetterHowever, we do appreciate the complainant's feedback and we have relayed it to
the insurance company for consideration
If you have any questions, please feel free to contact us at (800) 541-3522, by email at [email protected] or by FAX at (877) 300-
Sincerely,
*** ***
SrTechnical Claims Specialist
CSA Travel Protection and insurance Services represents Generali U.SBranch as the
administrator of the travel protection plan that was purchasedWe are in receipt of your email dated March 22, 2016, notifying us of the complaint filed by Mrs***We understand that the trip was canceled due to the risk of Mr*** contracting the Zika virus and the World Health Organization warning about travel to specific regionsThe policy only provides benefits for cancellations for specific covered eventsPlease refer to the Description of Coverage, where you will see a complete list of Covered EventsUnfortunately, the risk of contracting an illness is not one of the plan's listed Covered EventsA copy of the Description of Coverage is enclosed for your reviewThe reason that the trip was canceled is not one of the Covered Events that would allow payment of benefitsTherefore, regretfully, we are unable to provide payment for this claimIf you have any questions, please feel free to contact us at *** ***, by email at *** or by FAX at *** ***Please ensure the claim number is included with your responseSincerely,
*** ***
SrTechnical Claims Specialist
CC: Generali U.SBranch
Scott Crabtree / Director of Claims
CSA Travel Protection and Insurance Services represents Generali U.SBranch as the administrator of the travel protection plan that was purchased by *** ***We are in receipt of your email dated August 02, 2016, with additional information provided by Ms***Ms*** states that the laminate in her kitchen is no longer in production, which is why she is requesting full replacement of the countertopsAccording to information provided by Ms***, she does not know the age of the existing countertops because they were in the house when she purchased it in This policy will cover the cost of repairs or replacement of the damaged property, which is the portion of the countertop that has the burn holeWe are unable to cover the cost to replace all of the 14-year old countertops in the kitchenWe await an estimate for the damaged countertop aloneUpon receipt, we can continue to process the claimIf you have any questions, please feel free to contact us at *** ***, by email at *** or by FAX at *** ***Please ensure the claim number is included with your responseSincerely,
*** ***
SrTechnical Claims Specialist
cc: Generali U.SBranch
*** *** / Director of Claims
December 10, *** *** I Revdex.com OF SAN DIEGOVIEWRIDGE AVE #200SAN DIEGO, CA *** and *** *** #* ***Claim Number: ***Policy
Number: ***Travel Dates: October 19, 2014- October 26, 2014Dear Ms***:
CSA Travel Protection and Insurance Services represents Generali U.SBranch as theadministrator of the travel protection plan that was purchasedWe are in receipt of your emaildated December 08, 2014, notifying us of the complaint filed by *** and *** ***We have reevaluated the claim and will afford coverage for the unused airfare of *** and*** ***The claims representative will reopen the file for continued processingIf you have any questions, please feel free to contact us at (800) 541-3522, by email [email protected] or by FAX at (877) 300-Sincerely,
*** ***
SrTechnical Claims Specialist
cc: General US Branch
*** ***/ Director of Claims
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below. We are not sure how the heck we were to know what might possibly be a hour delayWhat happens if we are traveling on the icy, snow covered roads,(which is what the travel map looked like on that route for the whole day) and they decided to close them while enroute? It isn't like there are a ton of places to stayTo think that you feel that you have the right to tell us to risk our lives, when you are sitting at your desk in San Diego, is ridiculousI think you should reconsider this againWhat you have given us is a piece of junk responseWe didn't have a crystal ball like you must have, to tell us more than what the travel maps and NM DOT stated on their website, to not travel
Regards,*** ***
*** ***/ Revdex.com OF SAN DIEGO September 11,
MURPHY CANYON ROAD #
SAN DIEGO, CA
*** *** #
Claim Number: ***
Policy Number:
***
Travel Dates: September 05, 2014- September 07,
Dear Ms***:
CSA Travel Protection and Insurance Services is the administrator of the travel protection plan that was purchasedWe are in receipt of your email dated September 09, 2014, notifying us of the complaint filed by Mr***
Mr*** booked airline tickets through AirTran Airways and purchased the travel insurance plan on August 26, At that time a Policy Confirmation letter and Description of Coverage, outlining the plan's coverage and coverage restrictions, were emailed to him
The trip was canceled because the Army canceled the scheduled drill that he was to participate inThe policy only provides benefits for specific, listed eventsAs the reason for this cancellation was not due to a listed, Covered Event, no benefits were payable for this claim
Our contact at AirTran Airways has informed us that they did refund Mr*** in full for his airline ticket
If you have any questions, please feel free to contact us at (800) 876-6903, by email at [email protected] or by FAX at (877) 300-
Sincerely,
*** ***
SrTechnical Claims Specialist
*** ***/ Director of Claims
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details are below I received no offer from CSA Travel beyond a repeated request to compel my grieving uncle to sign a form that would allow CSA access to restricted medical records. As I read between the lines of the
CSA response, it appears that the representative is of the opinion that my
purchase of the insurance was made in anticipation of the death and with an
unethical intent. Nothing can be further from the
truthThe insurance was paid for on the SAME date, at the SAME time that final
payment was made for the tour packageThis is what any reasonable person would
do The response also seems to assume
that I could anticipate the date of my relative's deathThat assumption is also
illogicalIf the death was anticipated, I simply would have cancelled my
reservation and NOT paid for the tour package. As it states in "Palliative Care
Perspectives by Dr*** ** ***:
"Cancers
of very different tumor types and locations often follow very similar dying
trajectories. In fact, the dying trajectory of cancer is one of the most
predictable trajectoriesMost patients with metastatic cancer remain quite
functional until approximately five to six months before their deathsTheir health
statuses then tend to slowly decline until the rate of decline begins to
accelerate rapidly two to three months before death.14 In ***
study one month prior to death more than percent of the cancer patients
studied had difficulty getting out of a bed or chairPrior to the period of
decline in the last few months of life, cancer patients may have various
symptom needs such as pain management but tend to remain at high functional
levelsDuring the rapid decline phase patients start to "take to their
beds." A good rule of thumb is that a patient with advanced cancer who has
taken to bed without a correctable cause will usually die in a matter
of weeks to a few months." (Emphasis added)
There is NO WAY I could have predicted
when my relative would die Unfortunately, it appears that CSA is
attempting to violate their written contractThis is a bad business practice
and that is why I am hoping to find redress through the Revdex.com
Regards,
*** ***
Dear Ms***,
CSA Travel Protection and Insurance Services is an administrator of travel protection plans and vacation rental damage protection plans sold through HomeAway.com and their subsidiary site VRBOWe are receipt of your follow- up correspondence on the above
referenced matter
As you've noted, some travel protection plans available in the marketplace include the coverage of Trip Interruption, which typically provides benefits if you are delayed beyond your scheduled departure date or if you are unable to continue on your trip due to a covered event
that occurs during your scheduled travel datesThe Cancellation Protection product you purchased through VRBO does not include this coverageWhile the terms "cancel" and "interrupt" may not be defined, the Travel Insurance Policy advises what benefits are available under
"TRIP CANCELLATION BENEFIT" if you are prevented from taking your trip due to a covered event that occurs prior to your departure
Formally, a claim has not been filed by you against this policyThe customer service information provided in the March 25th phone call, and our response to your Revdex.com of San Diego complaint, were not denials of insurance claims
If you wish for our Claims Department to review the facts of your loss and issue a formal determination, please access the following website to complete a claim form and review a list of the supporting documentation to submit:
***
For assistance with the forms and supporting documentation, you can reach our Claims Department toll-free at *** ***
Sincerely,
*** ***
Director of Compliance & Licensing
Enclosure/Attachment: Policy Confirmation Letter for #*** including
Travel Insurance Policy
Cc: Revdex.com of San Diego
*** *** Vice President of Operations
CSA Travel Protection
October 27,
*** ***/ Revdex.com OF SAN DIEGO
VIEWRIDGE AVE #
SAN DIEGO, CA
Complainant: *** *** #***/ Insured: *** *** and *** ***
Claim Number: ***
Policy Number: ***
Travel Dates: August 16, 2014- September 06,
Dear Ms***:
CSA Travel Protection and Insurance Services is the administrator of the travel protection plan
that was purchasedWe are in receipt of your email dated October 15, 2014, notifying us of the
complaint filed by Mr***
On July 02, 2014, Mr*** purchased airline tickets for his daughter and her spouse to travel to
the United StatesHe purchased the travel insurance plan on July 18, At that time a
Policy Confirmation Letter and Description of Coverage, outlining the plan's coverage and
coverage requirements, were emailed to Mr***
The trip was canceled on August 05, 2014, because the state department would not issue a
tourist visa to *** ***'s spouseIn his complaint, Mr*** also indicated that there may
have been work-related issues that attributed to the trip cancellationThe travel insurance plan
provides Trip Cancellation benefits only for the specific reasons listed in the policyThe inability
to obtain the proper travel documents and/or business obligations are not covered events that
would allow payment of benefits
The plan does offer an Optional Cancel For Any Reason Benefit when certain requirements are
metThe policy states "If you purchased the Optional Cancel for Any Reason Benefit and
cancel your Covered Trip for any reason not otherwise covered by this plan, we will reimburse
you for the percentage of the prepaid, forfeited, non-refundable Payments or Deposits you paid
for your Trip provided:
your payment for this plan is received within hours of the date your initial deposit for your
Covered Trip is received"
The insurance plan was not purchased within hours of the date that Mr*** bought the
airline ticketsHe did not qualify for the Cancel For Any Reason Benefit, and the other reasons
for the trip cancellation are not covered events under the planRegretfully, we are unable to
provide benefits for this claim
If you have any questions, please feel free to contact us at ###-###-####, by email at
*** or by FAX at ###-###-####
Sincerely,
*** ***
SrTechnical Claims Speciakist
cc: *** ***/ Director of Claims
Dear Ms***;
5pt;">CSA Travel Protection and Insurance Services represents *** *** *** as the administrator of the travel protection plan that was purchasedWe are in receipt of your email dated October 27, 2015, notifying us of the complaint filed by Ms***Ms*** purchased a diving tour on August 07, The travel insurance plan was purchased on September 21, 2015, with a Trip Cancellation coverage effective date of September 22, At that time a Policy Confirmation Letter along with a link to her Description of Coverage, outlining the plan's coverage and coverage restrictions, was emailed to herOn September 21, 2015, the diving tour was cancelled by the tour company, *** *** ***, due to Weather conditionsWhile the plan purchased provides coverage for common carrier cancellations due to adverse weather, it specifically states: "We will not pay for any loss under this Policy, caused by, or resulting from [an] event or circumstance which occurs at a time when coverage is not in effect for you" and "any issue or event that could have been reasonably foreseen or expected when you purchased the coverage." Additionally, it states: "Trip Cancellation coverage will take effect at 12:A.Mlocal time at your location on the day after the date your premium payment is received by us or our authorized agent."
The tour cancellation occurred prior to the plan effective date and the adverse weather was reasonably foreseeable when the plan was purchasedTherefore, we are unable to provide benefits for this claim
If you have any questions, please feel free to contact us at *** ***, by email at *** or by FAX at *** ***Sincerely,
*** ***
*** ***
CSA Travel Protection and Insurance Services represents *** *** - U.S
Branch as the administrator of the travel protection plan that was purchasedWe are in receipt of your email dated May 05, 2016, notifying us of the complaint filed by Mr***Mr*** canceled his trip because his traveling companion, *** ***, was required to appear in Court as a party to a legal actionThe policy provides benefits for trip cancellation only when the reason is one of the plan's listed Covered EventsAs shown under the heading "TRIP CANCELLATION BENEFIT
Benefits will be paid if you are prevented from taking your Trip due to one of the following unforeseeable Covered Events that occur before departure on your Trip to you or your Traveling Companion, while your coverage is in effect under this PolicyBeing required to serve on a jury, or required by a court order to appear as a witness in a legal action provided you, a Family Member or a Traveling Companion is not a party to the legal action or appearing as a law enforcement officer"As Ms*** was a party to the legal action, which required her to appear in court, we are unable to provide benefits for this claimIf you have any questions, please feel free to contact us at *** ***, by email at *** or by FAX at *** ***Please ensure the claim number is included with your response,
Sincerely,
*** ***
SrTechnical Claims Specialist
cc: *** *** - U.SBranch
*** *** / Director of Claims
CSA Travel Protection and Insurance Services represents Generali Assicurazioni Generali S.P.A.
(U.S. Branch) as the administrator of the travel protection plan that was purchasedWe are in receipt of
your email dated February 27, 2014, notifying us of the complaint
filed by Ms***
Ms*** canceled her trip due to the surgery of her Traveling Companion's sonThe medical
condition that caused the surgery to be performed was present prior to the purchase of the policy.
However, the anxiety that resulted in a change to the surgery date occurred during the coverage
periodTherefore, we will afford coverage for this lossThe claim will be reopened for payment
processing
If you have any questions, please feel free to contact us at ###-###-####, by email at
[email protected] or by FAX at ###-###-####
Sincerely,
*** ***
SrTechnical Claims Specialist
Revdex.com OF SAN DIEGO August 08,
ATTN: *** ***
MURPHY CANYON ROAD #
SAN DIEGO, CA
*** *** # ***
Claim Number: ***
Policy Number: ***
Travel Dates: May 31, 2014- June 07,
Dear Ms***:
CSA Travel Protection and Insurance Services represents Generali U.SBranch as the administrator of the travel protection plan that was purchasedWe are in receipt of your email dated August 04, 2014, providing us with additional information from Ms***
Ms*** contends that this was a trip cancellation instead of a trip interruption based on the May 31, departure date listed on the policyDue to the circumstance that caused the loss,
the trip departure date would not change the outcome of the claims decisionRegarding this loss, the Covered Events for Trip Cancellation Benefits and Trip Interruption Benefits are exactly the sameThe plan covers only "A documented theft of your passports or visas"
The cruise line may have agreed to accept a birth certificate instead of a passport for the child to board the ship, but the terms and conditions of the travel protection plan allows only specific Covered Events for a trip cancellationRegretfully, we are unable to change our decision
If you have any questions, please feel free to contact us at (800) 541-3522, by email at [email protected] or by FAX at (877) 300-
Sincerely,
*** ***
SrTechnical Claims SR cialist
cc: Generali U.SBranch
*** *** I Director of Claims
Revdex.com OF SAN DIEGO June 05, 2015ATTN: *** *** *** *** *** *** ** ***
Complaint ID Number: *** ***Claim Number: ***Policy Number: ***Travel Dates: April22, 2015- May 10,Dear MsGovas:CSA Travel Protection and Insurance Services represents *** *** ***h as theadministrator of the travel protection plan that was purchasedWe are in receipt of your emaildated June 02, 2015, regarding additional information submitted by Mr*** for reviewMr*** states that he found no place in the insurance contract that indicates not having avisa is a reason for non-payment of a claimMr*** also feels that at least a refund of$for the insurance cost of *** *** should be reimbursed to himA trip cancellation claim was filed for Traveling Companion *** ***Ms.*** did not obtain the visa required to enter England and was unable to take thescheduled tripThe Travel Insurance Policy purchased by Mr*** only provides Trip Cancellation Benefitsfor a loss caused by one of the Covered Events specifically listed in the planNone of theplan's Covered Events provides coverage for the failure to obtain the necessary traveldocuments for a tripThe plan does offer the opportunity for a premium refund as shown: "10-DAY RIGHT TOEXAMINE YOUR POLICY- If you are not satisfied for any reason, you may cancel coverageunder the Policy within days after receiptYour premium payment will be refunded, providedthat there has been no incurred covered expense and you have not left on your TripReturn thePolicy to us at the Program Administrators office or our authorized agentWhen so returned, thePolicy is void from the beginningAfter this 0-day period, the payment for this coverage isnonrefundable."
The 10-day free look period expired on July 09, Therefore, we are unable to provide apremium refundThe trip cancellation claim filed because Ms*** did not have therequired travel documents is not one of the plan's Trip Cancellation Covered Events that wouldallow payment of the claimA copy of the Policy Confirmation Letter and Travel Insurance Policy are enclosed for yourreviewIf you have any questions, please feel free to contact us at *** ***, by email at*** or by FAX at *** ***Sincerely,
*** ***SrTechnical Claims Specialis
cc: *** *** ***
*** *** I Director of Claims
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.If it were wall paper and it was no longer in production, would they pay to paper one wall unmatching? If it were a car door and the color were absolutely not available would they expect you to drive around with a car door not matching the rest of the car? This is the same situationIt would cost me more than them to get my kitchen matching and yes I get the counter tops are older but if they didn't have a burn hole they're would be no issue If they continue to be unwilling to do the appropriate thing after this response I will take them to small claims court and request an additional $to compensate me for my gas, hotel and days pay to attend court
Regards,
*** ***
Dear Ms***,
5pt;">CSA Travel Protection and Insurance Services is an administrator of travel protection and emergency assistance plans sold on HomeAway.com and affiliated sitesWe are in receipt of your complaint filed with the Revdex.com of San Diego on 9/24/regarding your above numbered Cancellation Protection planOur records indicate that this plan was successfully cancelled on 9/24/at your requestThe full plan cost of $74,Was refunded at that timeCSA is committed to providing optimal service to our customers and partners, and we appreciate the opportunity to audit our processesIf you have any questions, or require any further information, please do not hesitate to contact me directly
at *** *** or ***Sincerely,
*** *** Director of Compliance & Licensing
C?: Revdex.com of San Diego
Dear Ms***,
CSA Travel Protection and Insurance Services is an administrator of travel protection and emergency assistance plans sold on *** and affiliated sitesWe are in receipt of your complaint filed with the Revdex.com of San Diego on 9/24/regarding the above numbered Carefree Rental Guarantee planOur records indicate that you contacted *** directly on 9/25/and requested the dates on the Carefree Rental Guarantee plan be changed to reflect your December trip, as they were originally recorded as September*** confirmed on 9/30/that this change was made at your request and to your satisfaction, so we consider this matter closedCSA is committed to providing optimal service to our customers and partners, and we appreciate the opportunity to audit our processesIf you have any questions, or require any further information, please do not hesitate to contact me directly
at *** *** or ***Sincerely,
*** *** Director of Compliance & Licensing
Cc: Revdex.com of San Diego
Dear Ms***:
CSA Travel Protection and Insurance Services is the administrator of the travel protection plan
that was purchasedWe are in receipt of your email dated March 09, 2014, notifying us of the
additional information provided by Ms***
Based on the medical documentation, the patient was diagnosed with failure to thrive prior to the
purchase of the insurance planBenefits due to the illness of a Family Member can be provided if
the Sickness commences while the policy is in effectTherefore, we are unable to change our
determination of this claim
If you have any questions, please feel free to contact us at (800) 541-3522, by email at
[email protected] or by FAX at (877) 300-
Sincerely,
*** *** ***
Claims Department Supervisor
Dear Ms***:
5pt;">CSA Travel Protection and Insurance Services represents *** *** *** as the administrator of the travel protection plan that was selectedWe are in receipt of your email dated November 13, 2015, notifying us of the complaint filed by Ms***Ms*** booked a trip with the scheduled travel dates of October 23, to November 08, The travel insurance was purchased on October 13, At that time a Policy Confirmation Letter and the Description of Coverage, outlining the plan's coverage and coverage restrictions, were emailed to Ms***On November 12, we received claim documents indicates Ms*** cancelled her trip on October 15, due to her family member's deathWhile the plan purchased provides trip cancellation coverage for your Family Member's death, it specifically states: "We will not pay for any loss under this Policy, caused by, or resulting from any issue or event that could have been reasonably foreseen or expected when you purchased the coverage." The death certificate provided indicates the death occurred on October 15, and lists the "Onset to Death" as two monthsThis specifies the conditions that caused the death began approximately August 15, 2015, prior to the purchase of this coverageFurthermore, the plan purchased states: "Trip Cancellation coverage will take effect at 12:A.Mlocal time at your location on the day after the date your premium payment is received by us or our authorized agent." As Ms*** paid for her insurance premium on October 13, 2015, her policy became effective at 12:A.Mon October 14, As her family member passed on October 15, 2015, the day after her policy became effective, additional medical documentation is needed to ensure the death was not foreseeable when the insurance was purchased,
Please note, we have not asked Ms*** to provide us with the deceased's medical records
We have only requested that she provide us with a Patient Authorization Form, signed by the deceased's authorized representative, allowing us to obtain the needed medical recordsFinally, in regards to Ms***'s request for a new claims representativeIt is our standard procedure for each claim to be processed by one representativeTherefore, we are unable to accommodate Ms***'s request for a new representativeIf you have any questions, please feel free to contact us at *** ***, by email at *** or by FAX at *** ***Sincerely,
*** ***
*** ***
cc: *** *** ***
*** *** / *** ** ***
December 10, *** *** I Revdex.com OF SAN DIEGOVIEWRIDGE AVE #200SAN DIEGO, CA
"">*** *** #*** I Insured: *** ***Claim Number: ***Policy Number: ***
Dear Ms***:
CSA Travel Protection and Insurance Services represents Generali U.SBranch as theadministrator of the travel protection plan that was selectedWe are in receipt of your emaildated December 05, 2014, notifying us of the complaint filed by *** ***Ms*** rented her property to *** *** with scheduled travel dates of October 08,to October 12, The Property Damage Protection coverage was purchased onOctober 01, At that time, a Georgia Travel Insurance Policy outlining the plan's coverageand coverage restrictions was emailed to our insured *** ***On October 30, 2014, we received claim documents from Ms*** indicating that Ms.*** had damaged furniture, a mattress, curtains, carpet, linens, along with pet hair throughoutthe house causing damage to the washing machine, and grease buildup in the kitchenTheclaimed amount was $for repairs to the washing machine and $for extra cleaningand suppliesWe contacted Ms*** to confirm that she and/or her guests had damaged thepropertyMs*** denied all the damages other than the possible damage to the washingmachineUnder the heading 'VACATION RENTAL DAMAGE COVERAGE", it states "If you occupy anAccommodation and you damage the real or personal property assigned to thatAccommodation during the Trip, we will reimburse you the lesser of the cost of repairs or theActual Cash Value of the property, up to the amount shown in the Schedule."
Ms*** denied responsibility for the damages claimed, except for the washing machineThispolicy only pays for damages caused by the Insured or their guestsWe issued payment to Ms.*** for the $repair cost of the washing machineBased on the terms of the policy,no additional benefits are payable for this claimIf you have any questions feel free to contact us at (800) 541-3522, by email at [email protected] or by FAX at (800) 300-Sincerely,
*** ***
SrTechnical Claims Specialist
cc: General US Branch
*** ***/ Director of Claims
This letter is the response of CSA Travel Protection and Insurance Services ("CSA") to the foll
complaint of Mr*** ***In Mr***'s second communication, there are raised three
additional issues not covered in his original complaint(The original response of CSA is adopted by
reference as a part of this responseContent of the prior letter will not be repeated as a part of this
communication.)
Why was there a passage of nine days before Mr*** was flown out of Mexico?
First of all, there is a difference between what Mr*** presumes as the obligation of CSA under its
travel protection contract and the actual language of that contractWe will try to clarify thisGSA's
primary responsibility was to reimburse claims for the movement of the patient to the closest facility with
proper capabilities to treat the pertinent injuriesMr*** was already a patient at a facility that
possessed such capabilities, and he needed to be treated and stabilized before any movement should
have occurredThat was done at the facility in MexicoAdditionally, it should also be noted that Mr
*** was moved for an MRI while at the facility, so the assumption that CSA was somehow
deficient in some supposed obligatory role by not moving him at all is not supported by the facts of this
matter
After Mr*** was treated and stabilized, CSA did pay for an air ambulance flight, largely because
of the distress shown by Mr*** and his relatives regarding the situationThat payment should be
recognized as an accommodation and not a reflection of necessity
CSA is prepared to make partial payment of the claim, but they have not stated what constitutes
partial payment
CSA makes payments under its insurance contracts as the claims are submitted and in accordance with
the procedures and limitations that are contained within that contractIt realizes that Mr*** or
providers may not have submitted all of the claims for this matter and, thus, it must describe the
payments that have been made as partial paymentsMr*** seems to have interpreted "partial" to
mean that claims already submitted are being paid in partThe correct interpretation is that payments
have been made for the claims submitted thus far regarding the matter
To date, GSA has issued payment to Mrand Mrs*** for $302.12, representing the two nights
missed on the cruise shipPayment was also issued directly to the hospital in Cozumel for $21,000.00,
to ensure treatment would be rendered for the injuries sustained by Mrand Mrs***Due to
policy exclusions, GSA was unable to reimburse for the cost of the damaged scooter and eyeglasses
CSA has prepared two more checks that should be mailed next week: $for Mrs***'s
medical expenses, and $3,for Mr***'s medical expensesThe medical claim remains
open pending additional bills and documents
I would like for CSA to agree to make reparations for pain and suffering
There is no contract provision in the policy for pain and suffering and there is no relationship between
GSA's payment actions and the accident experienced by Mr***It was an accident on a motor
bike that resulted in Mr***'s injuries, not his stabilization and treatment at a hospital and
subsequent flight to return horneThere is no reason for GSA to make such reparations
We trust that this reply sufficiently addresses the complaint of Mr*** and that he will understand
the nature of the policy coverages and exclusions that are contained in his contract
If you have any questions, please feel free to contact us at (800) 541-3522, by email at
[email protected] or by FAX at (877) 300-
Sincerely,
*** ***
SrTechnical Claims Specialist
*** *** I Revdex.com OF SAN DIEGO
*** *** *** ROAD #
SAN DIEGO, CA
*** *** #* ***
Claim Number: ***
Policy Number: ***
Travel Dates: October 11,- October 14,
Dear Ms***:
GSA Travel Protection and Insurance Services represents Generali U.SBranch as the administrator of
the travel protection plan that was purchasedWe are in receipt of your email dated September 22,
2014, with additional information provided by Mr***
Mr*** states that the military will only give official approval of leave within days from wanting to
take leaveThe trip was booked several months prior to the scheduled departure date, and Mr***
did not have approved military leave at that timeMr*** canceled the trip in August 2014, because
he felt he would probably be deployed
At the time of the insurance purchase in April 2014, we sent the policy documents to Mr***The
Policy Confirmation Letter provides the Schedule of Insurance Coverages along with the telephone
number to contact our Customer Service Department with questions about the planThe Policy, which is
attached to the Policy Confirmation Letter, details the plan's covered events and restrictionsA 0-day
free look period is offered that allows a refund of the insurance cost if the plan does not meet the needs
of the purchaser
The terms and conditions of the policy were not met in regard to Mr***'s reason for cancellation
Coverage is only provided when you are prevented from travel due to "Your previously granted military
leave being revokedThe leave must be approved prior to your coverage becoming effective, and official
written revocation notice from your commanding officer will be required."
It is not possible to highlight each situation that may or may not be covered by the plan on the Policy
Confirmation LetterHowever, we do appreciate the complainant's feedback and we have relayed it to
the insurance company for consideration
If you have any questions, please feel free to contact us at (800) 541-3522, by email at
[email protected] or by FAX at (877) 300-
Sincerely,
*** ***
SrTechnical Claims Specialist
CSA Travel Protection and insurance Services represents Generali U.SBranch as the
administrator of the travel protection plan that was purchasedWe are in receipt of your email dated March 22, 2016, notifying us of the complaint filed by Mrs***We understand that the trip was canceled due to the risk of Mr*** contracting the Zika virus and the World Health Organization warning about travel to specific regionsThe policy only provides benefits for cancellations for specific covered eventsPlease refer to the Description of Coverage, where you will see a complete list of Covered EventsUnfortunately, the risk of contracting an illness is not one of the plan's listed Covered EventsA copy of the Description of Coverage is enclosed for your reviewThe reason that the trip was canceled is not one of the Covered Events that would allow payment of benefitsTherefore, regretfully, we are unable to provide payment for this claimIf you have any questions, please feel free to contact us at *** ***, by email at *** or by FAX at *** ***Please ensure the claim number is included with your responseSincerely,
*** ***
SrTechnical Claims Specialist
CC: Generali U.SBranch
Scott Crabtree / Director of Claims