It’s been almost two months since I was at the Mount Sinai West emergency room, on the day I was actually supposed to leave for our Thanksgiving European trip. Chris had to cancel and rebook train tickets. He also had to cancel hotel reservations, make new ones, and also change our outbound flight to Paris. It wasn’t fun for him, and just the flight change itself was extremely costly. But he realized that the credit card we used to book the original flight had travel insurance on it for trip cancellation/interruption, so I took photos of all my ER and Urgent Care forms and sent them in for consideration for our itinerary change costs due to my sudden illness.
You would think that given I was not only in the emergency room, but I also had extremely detailed documentation, that this would have been a smooth process that would have gotten approved relatively swiftly. Unfortunately, it was anything but. First, the contact details to file the travel insurance claim were not clear, likely by design. It’s not on Mastercard’s website. You have to call Mastercard, then get re-routed to a specific agent, who can then share the secret website you have to login to in order to submit all your claim details and proof forms. Then once you submit all of that, you wait. And wait. And then, for the first 8-10 days, I got no feedback. I simply saw “pending” as the status of my claim every time I logged into the portal. When I finally got in contact with the claims agent (a third party works for Mastercard to handle travel insurance), she grilled me about the time we left the apartment, when we would have needed to leave for the airport, what time I was admitted into Urgent Care and then ER, when I started having symptoms, etc. It felt extremely unempathetic, like she was simply looking for reasons to deny my claim. Chris copied and pasted literal paragraphs from their travel insurance policy stating why this was, in fact, applicable. I was shocked: wasn’t it clear that this was a very serious case, especially given all the details in the Urgent Care and ER forms? All of the forms had time stamps on them, so I wasn’t even sure why she was further grilling me. Did she even read any of the forms I submitted at all??
The claim was initially denied, as they originally said that my trip wasn’t cancelled, that we still went, so there was “nothing to claim” or get reimbursed for. I had to call them nearly every business day we were away in Australia, have at least 6-8 email back and forth communications with them, endless voice messages playing phone tag, and then finally a very annoying and painful phone call in the middle of the night, Australia time, to explain to them: what the hell else did they need to understand that I was genuinely sick, that I was in the ER for something that could have easily resulted in pneumonia or death, and that as a result of all that chaos, my outbound flight needed to be changed…?! It was clear that the claims agent barely read any of the documentation I sent. She may not have even opened them as far as I was concerned. I had to literally open each document, one by one, and point out to her where the time stamps or remarks around my illness were (e.g. “On the ER form, page 1, in the bottom left hand corner. do you see the time stamp that says ‘3:49pm’?”). It felt like I was instructing a small child instead of an adult. She finally realized after having her hand held by me that yes, this was a legitimate claim, and yes, it should be reimbursed. She reopened the claim for me as a “claim determination dispute,” then told me that at this point, the only reason it would be denied is if the manager thought I had some “pre-existing condition” back when the flight was booked. The flight was booked in July. You cannot have a pre-existing condition for a peritonsillar abscess; that’s just medically impossible and could easily be disproven. Plus, no one would have an abscess in their throat from July all the way to November!
I finally got an email notification last week that the claim dispute was accepted. I got my requested payment back today. While it was closure (and some much needed money back), it made me angry to think about how insurance works in this country. Insurance feels like it exists simply to exist and get money out of you. Then when you actually do need to use it, the insurance companies will do everything in their power to withhold money from you or even make you pay.
Not everyone would be as persistent as I was to get my money back. I made sure to call and email almost every day for over a month. Most people just let these things go. I’m sure they count on that happening. But no, I’m not getting screwed by all these stupid insurance companies as long as I can help it.
