Lazarus: A roadblock to collecting travel insurance benefits

Allianz insurance bends over backward to get the medical answer it wants to deny payment.

Barbara Butkus bought an airline ticket in November to fly from Palm Springs to Washington, D.C., a month later for a family reunion.

Just to be on the safe side, Butkus, 80, also bought travel insurance while booking her flight through Orbitz, the online travel agency. The coverage was from Allianz, a leading provider of travel insurance.

As it happened, Butkus had to cancel her trip for health reasons. She began experiencing shortness of breath in early December, and her doctor advised her not to travel. Butkus filed a claim with Allianz for a refund of her $451.20 airline ticket.

Allianz denied her claim last month, concluding that she had an existing medical condition when she bought her airline ticket.

To reach that conclusion, however, the insurer had to engage in some impressive sleight of hand, forcing Butkus' doctor to give it the answer it wanted.

"It's ridiculous," Butkus told me. "You buy insurance in case something happens. And when it does, you can't collect on it.

"I know my claim doesn't seem like a lot of money," she said. "But it's a lot to me. I live on Social Security payments and a small pension from working as a school secretary."

Nancy Kincaid, a spokeswoman for the California Department of Insurance, said officials are eager to take a close look at the case.

Butkus' experience highlights the lengths to which insurers sometimes go to deny what would seem to be a perfectly reasonable claim — a complete reversal from the friendly, sympathetic tone they adopt when selling policies.

"Life is unpredictable," Allianz says on its website. "Some trips need to be canceled. With travel insurance, travelers don't have to pay for a trip they are unable to take."

Butkus' $29.33 policy excluded coverage for existing medical conditions, which Allianz defined as any condition that involved seeking or receiving treatment within 120 days of making travel arrangements.

Butkus' cardiologist, Dr. Philip J. Patel, is chief of cardiology at Eisenhower Medical Center in Rancho Mirage. After advising Butkus not to travel, he submitted a statement to Allianz saying that her shortness of breath could be attributable to heart or kidney trouble.

She had a heart attack in 2003 and was diagnosed with high blood pressure in the 1990s. Both conditions are now under control thanks to medication and regular exams.

On his statement, Patel listed all of Butkus' visits to his office going back to March 2011. The most recent was in June 2012.

Patel was instructed by Allianz to circle the dates of any visits in which he treated Butkus for his diagnosis of possible heart or kidney trouble. No dates were circled.

At this point, you would think, the insurer would be satisfied that Butkus' trip cancellation was not caused by an existing condition, as per the terms of its policy. But Allianz wasn't finished.

The company sent a new form to Patel with a simple yes-or-no question: "Was the patient symptomatic of or receiving treatment for the primary or underlying conditions" in the four months before booking her trip?

In other words, was she being treated either for her current breathing troubles or for ongoing heart and kidney issues?

The doctor checked "yes."

Daniel Durazo, a spokesman for Allianz, said that "based on this information from her physician, we determined that the event which caused Ms. Butkus to cancel her trip was due to an existing medical condition."

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