Troubleshooters: Refund for cruise never sailed

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Trip insurance gives a lot of consumers peace of mind. But one local family contacted the Action News Troubleshooters for help, saying the trip insurance they bought for a cruise, didn't help them - in fact it did the opposite. (WPVI)

Back in February, video captured the Royal Caribbean's Anthem of the Seas when it got caught in the eye of a violent storm.

But it's not just the passengers who were on board who are complaining about the cruise.

Joanne Peak booked a cruise on Anthem of the Seas for herself, her husband, Milton, and their daughter on Oct. 16.

The invoice shows she purchased trip insurance.

The Peaks tell me about two weeks before the cruise, Milton Peak underwent what was supposed to be a routine procedure on his heart, but something went wrong.

"The doctor said to me, 'I think now you'll have to cancel the trip,' " said Joanne Peak.

The couple says they cancelled their cruise about 12 days prior, with the understanding they'd get a full refund thanks to their travel protection plan.

But the insurance company, Aon Affinity, denied the Peaks a cash refund, offering a 75 percent credit for a future cruise instead.

The couple says after they appealed, Aon submitted a request for more information from Peak's doctor.

"He submitted 80 pages worth of documentation," said Joanne Peak.

But the Peaks' claim was denied again.

Aon saying, "You did have symptoms which caused you to seek diagnosis, care or treatment on November 16th, 2015, which occurred during the pre-existing period which is 60 days before you purchased this waiver."

"And it wasn't a pre-existing condition. It wasn't that a condition had worsened. He was never sick before for that," said Joanne Peak.

Fed up, the Peaks contacted the Action News Troubleshooters.

"And it was within five days, I received a phone call from Royal Caribbean saying we've decided to honor your claim," said Joanne Peak.

Yes, thanks to the Troubleshooters, the Peaks got their refund for $2,641.

"I was elated. It was really a comforting feeling to know that I could call you guys and it worked," said Joanne Peak.

The Peaks tell me they'll now research outside insurance companies that aren't recommended by the cruise line or airline they're booking with.

And they'll compare the fine print before choosing a policy.

Meantime, Aon Affinity says it "cannot speak to the details of any passenger's claim but can confirm that the customer was reimbursed in full."

It also says many travel insurance programs "include a Cancel for Any Reason provision... to provide additional flexibility beyond the traditional plan benefits" like pre-existing conditions.

For Aon's full response see the information below:

"...She had to cancel her cruise on January 27th because her husband fell ill and his condition would not be improved by the time the cruise was to depart. She says - and says her doctor confirms - this was NOT due to any pre-existing condition. But her claim for a refund was denied twice by Aon Affinity. Can you explain why?"

We cannot speak to the details, medical or otherwise, of any passenger's claim, but we can confirm that this customer was reimbursed in full.
In general, if a customer submits information with a claim, which supports what the plan defines as a pre-existing condition, then the claim is not payable under that specific benefit. Many cruise line travel insurance programs also include a Cancel for Any Reason provision for this very reason - to provide additional flexibility beyond the traditional plan benefits. So even if a passenger was forced to cancel due to a pre-existing condition, they could still receive some form of reimbursement.

"But do you have any advice for our other viewers on how to avoid this situation?

Be familiar with terms and limitations of the plan you are purchasing. Ask questions and if you have concerns about a particular situation, be sure to provide full details to get an accurate answer.
Make special note of:
When the plan becomes effective.
What specific benefits/limits are included in the plan (and the details regarding each benefit).
Concerns you may have regarding pre-existing medical conditions. Learn how that plan responds and what protection may still be provided.

For example
Many plans can still cover a pre-existing condition if it is considered stable (e.g., blood pressure or diabetes that is controlled by medication, with no recent changes).
Plans can also typically cover you if a customer is forced to cancel because of the health of a non-traveling family member who has a pre-existing condition If a Cancel for Any Reason provision is included, get familiar with those terms.
Always remember that each claim is processed based on the information provided by the traveler/customer, so be sure to document and submit as much relevant information as possible.

"And can you explain how this policy works?"

In general, travel protection works by protecting consumers from the unforeseen. Three primary categories are to protect: the financial investment, their health, and their belongings. Typically, the first two (money and health) are the most important for travelers.

Most plans provided to cruise line passengers protect typical vacations from before departure until return.

If forced to cancel before ever departing, plans can provide cash reimbursement or future cruise credits, up to specified limits. Airfare, activities or excursions booked through and prepaid to the cruise line may be protected as well.

If a passenger departs on their trip but has covered expenses related to being forced to return home early, medical accidents, emergencies, theft or damage to personal belongings, coverage can help reimburse some or all of those costs. Examples of covered expenses could range from reimbursing you for the portion of the trip you miss, seeing a doctor for a minor accident, up to arranging and reimbursing for a medical evacuation which could cost in excess of $100,000.

"Do you have advice for consumers on what they should look for and do before buying trip insurance?"

Always contact the plan administrator for detailed questions on specifics for that particular plan.
Some travel insurance plan benefits, such as trip cancellation, may only be triggered for "named perils" - which simply means that the eligible reasons to cancel would be listed in the policy.

However, cancel for any reason provisions may also be included. Check if your plan includes a "Cancel for Any Reason" provision and:
Be sure you understand the terms of your cancel for any reason feature.
Note what percentage of the trip might be either refunded in cash or returned in the form of travel credits if you need to cancel, as those terms can vary dramatically.
Check if you need to pay for the plan within a certain period of time. Some cancel for any reason terms require that the customer pay for the plan at trip booking or within a short window of time after in order to be eligible for the cancel-for-any-reason benefit. So consumers may want to make sure the plan is paid for as early as possible in order to get the most out of that program.

Travel protection can provide some very important benefits. Before you book, ask yourself such questions as:

Can I easily bear the full financial risk of losing my vacation investment if something goes wrong due to illness, weather or other unforeseen circumstances?
If I have to cut my trip short because of an emergency, would I benefit from reimbursement for the cost of a return airline ticket home?
If my health insurance does not cover me away from home and in foreign countries and I become ill or am injured while traveling, could I use help with those medical bills?
If my bags are lost or I have to spend an extra night because of weather-related problems, would I benefit from being reimbursed for buying replacement necessities and/or paying for extra lodging?

If you answered 'Yes' to any of the above questions, chances are that travel insurance may be a wise investment.
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