Those who have perfect recall can skip ahead a few paragraphs, but here’s the background for those in need of a refresher. The woman had paid $29.33 for travel insurance for a flight from L.A. to Washington, D.C. She later began experiencing shortness of breath and her doctor said she was not medically fit to fly.
She attempted to make a claim, hoping to get a refund of the full $451 airfare. Her cardiologist provided Allianz, the insurer, with a statement explaining that her shortness of breath could be attributable to heart or kidney trouble, and included a list of all her visits to his office for more than a year. He further indicated that none of these visits involved this latest diagnosis of possible heart or kidney trouble.
But then Allianz sent a second form, asking, “Was the patient symptomatic of or receiving treatment for the primary or underlying conditions” in the four months before booking her trip? It was a simple yes or no question, and it was worded so generally that the cardiologist could not answer anything but “yes,” even though that could be — and was — interpreted as indicating that the patient suffered from a pre-existing condition, which would void her claim.
“I had to say, ‘Yes,'” the cardiologist told the L.A. Times’ David Lazarus. “What else can you say?”
However, since Lazarus’ story was published, Allianz decided that maybe it should allow the doc a chance to explain the difference between an underlying condition and a pre-existing condition.
“It is unfortunate that this information was unable to be conveyed to you during your decision-making for [the woman’s] insurance claim,” the cardiologist wrote in his subsequent explanation to Allianz. “The form letters that were sent me did not offer a chance for a proper explanation.”
After presumably pretending to listen to the doctor and just wishing this story would go away, Allianz decided to refund the $451 to the woman.
“We apologize for any inconvenience she may have experienced while we worked to obtain more information from her doctor,” a company rep tells Lazarus, “but we’re glad that we could provide coverage in this circumstance and we wish her the best in her future travels.”
But, as Lazarus points out, the Allianz rep declined to answer whether this incident would give the insurer any reason to re-think its claims approval process.
Just keep this all in mind when deciding whether or not to buy travel insurance, especially for your tickets to outer space.