Cash refund denied due to pre-existing condition

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Jul 15, 2018
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#1
We booked a cruise in February 2018 for a cruise to the Bahamas in April. My husband has COPD and we purchased the travel insurance when we booked the trip. Unfortunately, he was hospitalized a few weeks before the trip and we had to cancel the cruise.

Much to our surprise, after several weeks of uploading forms and waiting on additional information from his primary physician, Aon denied our claim for a full refund because he had been treated for his COPD within 60 days of the sail date, therefore, it was considered a preexisting condition. Looking back, I guess we should have read the "fine print".

Because my husband's chronic condition has worsened, he will not be able to travel. As his caretaker, I will not be able to go anywhere in the near future, so receiving a 75% cruise credit really does not help us. The $2,403.00 for the cruise, would, however.

I understand if we had not purchased travel insurance, we would not be receiving a credit of any kind, however, it seems to me that there should have been full disclosure up front from the cruise line that because of my husband's pre-existing condition, we would only be able to receive a cruise credit. Truthfully, we would have probably changed our plans and rented a house on the beach.

If anyone has advice to share, we would appreciate it.

nelsonlh
 
Feb 21, 2018
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88
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#2
My husband and I purchase travel insurance every time we cruise. Whenever we have purchased a policy, the full text with terms and conditions is made available to us at the time of purchase. Those terms will lay out the definition of a 'pre-existing condition' and when such a condition would prevent the payment of benefits.

Based on the purchase date and date of the cruise, I'm guessing you paid in full at the time of booking as you were already inside the final payment window? This can complicate getting a pre-existing condition covered.

Do you have the full policy with all the terms and conditions? Did you buy the cruise line's policy or a third-party policy?
 
Likes: Neil Maley

Carol Phillips

Moderator
Staff Member
Advocate
Dec 28, 2014
1,232
1,686
113
Coastal South Carolina
#3
I'm so sorry to hear that your husband's COPD precluded your being able to take the April cruise to the Bahamas. And your mind was in the right place when you decided to purchase the optional Vacation Protection Plan from Carnival. Unfortunately, various cruise line protection/insurance policies cover pre-existing conditions in different ways.

Carnival's website includes this: If you need to cancel for some of the most common reasons (severe weather, illness, etc.) you'll get 100% of the cost of your trip back, in cash. If you need to cancel for any reason not listed in the plan — any reason at all — you'll get 75% back in a Future Cruise Credit Certificate.

Pre-existing conditions are part of the "any reason not listed in the plan".

Despite the denial of the insurance claim for a cash refund, you received $2403 toward a future cruise, which is useless to you.

You can go to our Company Contacts https://www.elliott.org/company-contacts/carnival-cruise-lines/ and request an exception to the rule ... some of us call it "artful begging". Start with GuestCare and work your way up the ladder of executive contacts if needed. Remember, you are asking for an exception to their policy, and you are not the only one doing this. Hopefully your request will land on the desk of someone with authority to offer other than a Future Cruise Credit.

I'm sure others will be along to offer suggestions on HOW to write the letter, and WHAT to include in it. Generally, a short polite message brings the best results.

My best wishes that your husband's condition improves.
 

Neil Maley

Moderator
Staff Member
Advocate
Dec 27, 2014
12,789
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www.promalvacations.com
#4
We booked a cruise in February 2018 for a cruise to the Bahamas in April. My husband has COPD and we purchased the travel insurance when we booked the trip. Unfortunately, he was hospitalized a few weeks before the trip and we had to cancel the cruise.

Much to our surprise, after several weeks of uploading forms and waiting on additional information from his primary physician, Aon denied our claim for a full refund because he had been treated for his COPD within 60 days of the sail date, therefore, it was considered a preexisting condition. Looking back, I guess we should have read the "fine print".

Because my husband's chronic condition has worsened, he will not be able to travel. As his caretaker, I will not be able to go anywhere in the near future, so receiving a 75% cruise credit really does not help us. The $2,403.00 for the cruise, would, however.

I understand if we had not purchased travel insurance, we would not be receiving a credit of any kind, however, it seems to me that there should have been full disclosure up front from the cruise line that because of my husband's pre-existing condition, we would only be able to receive a cruise credit. Truthfully, we would have probably changed our plans and rented a house on the beach.

If anyone has advice to share, we would appreciate it.

nelsonlh
There usually is. You usually must buy policy within 2 weeks to 21 days of making your deposit to have a pre-existing condition covered using a third party. When did you buy the policy?

Do you mean he was treated for his COPD within 60 days of when you BOOKED the cruise? That is what makes it Pre-ex, not because he was treated 60 days before the cruise. The only exception is if you paid for the insurance with your final payment, not when you first deposited for the cruise. That’s a little known hang up that can cause this- we warn our clients that buy their insurance with the cruise line that this can happen if the don’t pay for the insurance when they deposit.

Maybe the dr. mis stayed the dates on the form? Is it possible to appeal? I’ve seen doctors complete the forms incorrectly

What date did you book the cruise, what date did you pay for the insurance and was he treated for his COPD anytime within 3 months of when you deposited ?
 

Neil Maley

Moderator
Staff Member
Advocate
Dec 27, 2014
12,789
12,762
113
New York
www.promalvacations.com
#5
I'm so sorry to hear that your husband's COPD precluded your being able to take the April cruise to the Bahamas. And your mind was in the right place when you decided to purchase the optional Vacation Protection Plan from Carnival. Unfortunately, various cruise line protection/insurance policies cover pre-existing conditions in different ways.

Carnival's website includes this: If you need to cancel for some of the most common reasons (severe weather, illness, etc.) you'll get 100% of the cost of your trip back, in cash. If you need to cancel for any reason not listed in the plan — any reason at all — you'll get 75% back in a Future Cruise Credit Certificate.

Pre-existing conditions are part of the "any reason not listed in the plan".

Despite the denial of the insurance claim for a cash refund, you received $2403 toward a future cruise, which is useless to you.

You can go to our Company Contacts https://www.elliott.org/company-contacts/carnival-cruise-lines/ and request an exception to the rule ... some of us call it "artful begging". Start with GuestCare and work your way up the ladder of executive contacts if needed. Remember, you are asking for an exception to their policy, and you are not the only one doing this. Hopefully your request will land on the desk of someone with authority to offer other than a Future Cruise Credit.

I'm sure others will be along to offer suggestions on HOW to write the letter, and WHAT to include in it. Generally, a short polite message brings the best results.

My best wishes that your husband's condition improves.
How do you know it was Carnival?
 

Carol Phillips

Moderator
Staff Member
Advocate
Dec 28, 2014
1,232
1,686
113
Coastal South Carolina
#6
@Neil Maley - the thread I responded to was posted in the Carnival Forum. Apparently it was a duplicate post which Dwayne has since removed. If you search posts by Nelsonlh you'll see the two posts ... one in Carnival (now deleted from there) and one in Cruises (which is the current one people are responding to). Looks like Dwayne moved my response to the current thread, too....
 
Likes: jsn55 and mmb
Jul 15, 2018
7
0
1
61
#7
There usually is. You usually must buy policy within 2 weeks to 21 days of making your deposit to have a pre-existing condition covered using a third party. When did you buy the policy?

Do you mean he was treated for his COPD within 60 days of when you BOOKED the cruise? That is what makes it Pre-ex, not because he was treated 60 days before the cruise. The only exception is if you paid for the insurance with your final payment, not when you first deposited for the cruise. That’s a little known hang up that can cause this- we warn our clients that buy their insurance with the cruise line that this can happen if the don’t pay for the insurance when they deposit.

Maybe the dr. mis stayed the dates on the form? Is it possible to appeal? I’ve seen doctors complete the forms incorrectly

What date did you book the cruise, what date did you pay for the insurance and was he treated for his COPD anytime within 3 months of when you deposited ?
Mr. Maley - thank you so much for responding to my post. We did pay for the travel insurance when we booked the cruise, on January 10, 2018. We made the final payment for the cruise on February 7, 2018. Aon insurance explanation for the denial was that my husband saw a physician for his chronic condition between the dates of November 10, 2018 and January 10, 2018.
 
Jul 15, 2018
7
0
1
61
#8
I'm so sorry to hear that your husband's COPD precluded your being able to take the April cruise to the Bahamas. And your mind was in the right place when you decided to purchase the optional Vacation Protection Plan from Carnival. Unfortunately, various cruise line protection/insurance policies cover pre-existing conditions in different ways.

Carnival's website includes this: If you need to cancel for some of the most common reasons (severe weather, illness, etc.) you'll get 100% of the cost of your trip back, in cash. If you need to cancel for any reason not listed in the plan — any reason at all — you'll get 75% back in a Future Cruise Credit Certificate.

Pre-existing conditions are part of the "any reason not listed in the plan".

Despite the denial of the insurance claim for a cash refund, you received $2403 toward a future cruise, which is useless to you.

You can go to our Company Contacts https://www.elliott.org/company-contacts/carnival-cruise-lines/ and request an exception to the rule ... some of us call it "artful begging". Start with GuestCare and work your way up the ladder of executive contacts if needed. Remember, you are asking for an exception to their policy, and you are not the only one doing this. Hopefully your request will land on the desk of someone with authority to offer other than a Future Cruise Credit.

I'm sure others will be along to offer suggestions on HOW to write the letter, and WHAT to include in it. Generally, a short polite message brings the best results.

My best wishes that your husband's condition improves.

Thank you for your reply Ms. Phillips - I apologize for my posts being in the wrong place. I am new at this - :) I will definitely send a letter to Carnival as well.
 
Jul 15, 2018
7
0
1
61
#9
My husband and I purchase travel insurance every time we cruise. Whenever we have purchased a policy, the full text with terms and conditions is made available to us at the time of purchase. Those terms will lay out the definition of a 'pre-existing condition' and when such a condition would prevent the payment of benefits.

Based on the purchase date and date of the cruise, I'm guessing you paid in full at the time of booking as you were already inside the final payment window? This can complicate getting a pre-existing condition covered.

Do you have the full policy with all the terms and conditions? Did you buy the cruise line's policy or a third-party policy?
Thank you for your response. I do have a copy of the policy - We purchased the insurance through Carnival, Aon Insurance Co. I did not see anything specific about pre-existing conditions, but I am going to have another look. Also, we paid for the insurance when we booked the cruise in January. The final payment was due the end of February, we paid the balance on February 7, 2018.
 

Carrie Livingston

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Advocate
Jan 6, 2015
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St Louis
#10
Thank you for your reply Ms. Phillips - I apologize for my posts being in the wrong place. I am new at this - :) I will definitely send a letter to Carnival as well.
Your originally had two posts. I asked one of the other staff members to combine the responses. Not sure where it ended up.
 

Neil Maley

Moderator
Staff Member
Advocate
Dec 27, 2014
12,789
12,762
113
New York
www.promalvacations.com
#12
The problem with these policies from the cruise line is they do not cover pre-ex conditions for a cash refund. Since the pre-ex isn't covered, you fall into their Cancel for Any Reason coverage, which gives you back 75% in the form of a cruise credit. Did you use a travel agent to book this?

Here is what you bought:
https://affinitytravelcert.com/document/pdfs/Carnival_NY_COI_v3.pdf

In life, you never really know what may happen… but you can rely on the Vacation Protection trip cancellation. If you need to cancel for some of the most common reasons (severe weather, illness, etc.) you'll get 100% of the cost of your trip back, in cash. If you need to cancel for any reason not listed in the plan — any reason at all — you'll get 75% back in a Future Cruise Credit Certificate.

There is what they consider pre-ex:
Pre Existing Condition means an illness, disease, or other condition during the sixty (60) day period immediately prior tothe Effective Date for which the Insured, Traveling Companion or Family Member booked to travel with the Insured: 1)exhibited symptoms which would have caused one to seek care or treatment; or 2) received or received a recommendation for a test, examination, or medical treatment or 3) took or received a prescription for drugs or medicine. Item (3) of this
definition does not apply to a condition which is treated or controlled solely through the taking of prescription drugs or medicine and remains treated or controlled without any adjustment or change in the required prescription throughout the sixty (60) day period before the Effective Date.


And here is where they say they do not cover Pre_exisiting conditions:
The following exclusions apply to Trip Cancellation, Trip Interruption, Trip Delay, Emergency Evacuation and Repatriation of Remains:
Pre- Existing Conditions, as defined in the Definitions section (except Emergency Evacuation and Repatriation of
Remains)


So what happened? You didn't understand what you bought. Most cruise lines policies do not cover pre-exisitng conditions.

But here is a question - When your husband saw his Doctor in November - was it a routine visit? Did he change any of his meds or did he note your husband's conditions changed since the last visit?

If it was a routine visit and the dr. did not make any changes to your husbands meds, or his condition hadn't changed - you might be able to appeal the denial. Your dr. may have to re-do the paperwork because it is his paperwork and what he says that can cause a denial or an approval\.
 
Jul 15, 2018
7
0
1
61
#13
The problem with these policies from the cruise line is they do not cover pre-ex conditions for a cash refund. Since the pre-ex isn't covered, you fall into their Cancel for Any Reason coverage, which gives you back 75% in the form of a cruise credit. Did you use a travel agent to book this?

Here is what you bought:
https://affinitytravelcert.com/document/pdfs/Carnival_NY_COI_v3.pdf

In life, you never really know what may happen… but you can rely on the Vacation Protection trip cancellation. If you need to cancel for some of the most common reasons (severe weather, illness, etc.) you'll get 100% of the cost of your trip back, in cash. If you need to cancel for any reason not listed in the plan — any reason at all — you'll get 75% back in a Future Cruise Credit Certificate.

There is what they consider pre-ex:
Pre Existing Condition means an illness, disease, or other condition during the sixty (60) day period immediately prior tothe Effective Date for which the Insured, Traveling Companion or Family Member booked to travel with the Insured: 1)exhibited symptoms which would have caused one to seek care or treatment; or 2) received or received a recommendation for a test, examination, or medical treatment or 3) took or received a prescription for drugs or medicine. Item (3) of this
definition does not apply to a condition which is treated or controlled solely through the taking of prescription drugs or medicine and remains treated or controlled without any adjustment or change in the required prescription throughout the sixty (60) day period before the Effective Date.


And here is where they say they do not cover Pre_exisiting conditions:
The following exclusions apply to Trip Cancellation, Trip Interruption, Trip Delay, Emergency Evacuation and Repatriation of Remains:
Pre- Existing Conditions, as defined in the Definitions section (except Emergency Evacuation and Repatriation of
Remains)


So what happened? You didn't understand what you bought. Most cruise lines policies do not cover pre-exisitng conditions.

But here is a question - When your husband saw his Doctor in November - was it a routine visit? Did he change any of his meds or did he note your husband's conditions changed since the last visit?

If it was a routine visit and the dr. did not make any changes to your husbands meds, or his condition hadn't changed - you might be able to appeal the denial. Your dr. may have to re-do the paperwork because it is his paperwork and what he says that can cause a denial or an approval\.
Good morning - we booked the cruise ourselves. My husband was hospitalized in December of last year, which was within the 60 days period prior to booking the cruise in January of 2018.
 

Neil Maley

Moderator
Staff Member
Advocate
Dec 27, 2014
12,789
12,762
113
New York
www.promalvacations.com
#14
Oh- that’s an issue unfortunately and I don’t think that any policy with pre-ex coverage would have covered that unless you had booked and paid for the insurance before he had been hospitalized.

You don’t have much choice - you at least had the coverage for a future credit. If you had booked a third party policy without this CFAR you wouldn’t have received anything back.
 
Likes: krisseye
Jul 15, 2018
7
0
1
61
#15
Oh- that’s an issue unfortunately and I don’t think that any policy with pre-ex coverage would have covered that unless you had booked and paid for the insurance before he had been hospitalized.

You don’t have much choice - you at least had the coverage for a future credit. If you had booked a third party policy without this CFAR you wouldn’t have received anything back.
I really appreciate you sharing your expertise. This has been a learning experience for sure.
 

Neil Maley

Moderator
Staff Member
Advocate
Dec 27, 2014
12,789
12,762
113
New York
www.promalvacations.com
#16
I hope your husbands condition will stabilize so that perhaps you can take this trip at a future date. Some insurance companies will count back 60 days, some longer but if he is stable for awhile you might be able to rebook.

And it’s something both of you would be able to relax and enjoy. Find a good travel agent who can help you with the insurance
 
Jul 15, 2018
7
0
1
61
#17
I hope your husbands condition will stabilize so that perhaps you can take this trip at a future date. Some insurance companies will count back 60 days, some longer but if he is stable for awhile you might be able to rebook.

And it’s something both of you would be able to relax and enjoy. Find a good travel agent who can help you with the insurance
Thanks again