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Collecting on travel insurance is not smooth sailing

A couple who cancel a trip along the Danube River for medical reasons struggle to get Trip Mate to pay up.

David Lazarus

December 4, 2012

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When it comes to travel, especially involving something as pricey as a cruise, it's wise to take precautions. You never know when you may have to cancel your trip.

Bill and Sally Mathews paid $1,140 for travel insurance as part of about $12,600 they plunked down in March for a July cruise along the Danube River with Grand Circle Cruise Line.

"We've never had to use travel insurance," Bill Mathews, 85, of Redondo Beach told me. "It just always seems like a good idea to have it. We travel a lot."

This time, it turned out, the insurance was a good investment — or it would have been had the insurer, Trip Mate, made good on its policy right away. But that's where the Mathewses' trip up the Danube turned very blue indeed.

It could have been a lot of fun. Starting in the Black Sea, the ship was scheduled to travel to Hungary, Croatia, Serbia, Bulgaria and Romania.

"We'd never been to this part of the world," Mathews said, "so we were really looking forward to it."

Unfortunately, his wife, Sally, 81, had a flare-up of a condition called Mycobacterium avium, which is akin to tuberculosis and can cause intense coughing fits. She went to her doctor shortly after booking the cruise, and he prescribed the same drugs she'd required during prior episodes.

"The problem is, the medicines make her so weak she can barely get around," Mathews said. "They leave her thoroughly exhausted."

In May, he contacted Grand Circle and said they'd have to cancel their trip. As per Grand Circle's policy, the Mathewses were entitled to a refund of 60% of their ticket cost from the cruise line. Trip Mate was supposed to make up the difference.

"Grand Circle responded with sympathy and a check for $7,292," Mathews said. "From Trip Mate we heard nothing."

He contacted the company in July and was told a few weeks later that his claim had been denied. Trip Mate acknowledged that Sally had visited her doctor after the cruise was booked but insisted there was no evidence that her condition required cancellation of the trip.

"The plan states a covered sickness must necessitate medical treatment at the time of cancellation," the insurer said.

Mathews appealed the decision. His wife's doctor submitted a letter to Trip Mate in September affirming that she'd been treated for Mycobacterium avium and was prescribed several drugs with "significant and debilitating side effects."

The doctor said that Sally "was forced to cancel her trip with my complete concurrence."

But that wasn't good enough for Trip Mate. The company wrote to Mathews several weeks later saying that the appeal also had been denied.

Trip Mate's position was that, the letter from Sally's doctor notwithstanding, "the medical records on file do not document you received medical treatment at the time you canceled."

Mathews figured he could retain a lawyer to go after the roughly $5,000 he felt he was owed by Trip Mate, but that seemed like a relatively small sum for what probably would have resulted in thousands of dollars in legal bills. So he came knocking at my door instead.

I contacted Linda Finkle, Trip Mate's executive vice president, who agreed to look into the matter. A day later, I received an email reiterating that the information received from Sally's doctor "did not show that the plan requirements for trip cancellation due to a medical condition were met."

However, Finkle said Trip Mate "again contacted the medical provider … and information not previously included has just been received. Based upon this new information, we are in the process of advising Mr. and Mrs. Mathews that their claim will be paid."

Well, that's impressive — maybe.

I asked the Mathewses to contact Sally's doctor. They said the doctor told them he had not received any further communication from Trip Mate and had not submitted additional information.

Finkle's follow-up letter to the Mathewses, however, said Trip Mate had learned that Sally had been in telephone contact with her doctor prior to cancellation of the trip and thus "determined that benefits may be paid."

In any case, I'm glad the Mathewses will get the money they're rightfully owed. Hopefully, their next excursion to uncharted waters will go more smoothly.

Better business?

A Google search will turn up numerous complaints about Trip Mate. For its part, the Better Business Bureau said it has received 105 complaints about the company in the last three years.

Yet the bureau gives Trip Mate a rating of A+. As an "accredited business," Trip Mate pays the bureau hundreds of dollars in annual fees.

I reported last week that the bureau says no correlation exists between a company's rating and its accreditation.

That's about as believable as an insurer bending over backward to make sure all valid claims get paid.

David Lazarus' column runs Tuesdays and Fridays. He also can be seen daily on KTLA-TV Channel 5 and followed on Twitter @Davidlaz. Send tips or feedback to david.lazarus@latimes.com.