A Need to Get Trip Insurance Procedures Straight

It was going to be their first trip to Europe.

Thanks to Corsair, the French charter operator with which they signed up, six March days in Paris including air, hotel and trip insurance would have cost this Whittier couple just $1,226.

But on Jan. 23 Paul Maurice, 60, fell off his bicycle on an Orange County bike path and was severely injured. That night in Los Alamitos Medical Center he suffered a massive brain hemorrhage, and three days later he died.

“I called New Frontiers [the tour company that owns Corsair] and canceled the trip,” related Phyllis Maurice in an e-mail to me on May 1. “It took me a while. I was in a state of shock and denial. But, with my daughter’s help with phone calls and faxes, both New Frontiers and the travel insurance company [Insure America] were informed.”

But, Maurice added, two months after canceling, she had yet to receive any refund.

“The paperwork we have regarding this claim is becoming gigantic,” she wrote in her e-mail. “I am being stonewalled by both the airline company and the insurance company. They may think I will go away, after weeks of rejection. I will not. . . . Will you help me?”

Fortunately for Maurice and her daughter, Paula Larson, they had a good paper trail, all the documents from the moment the trip was first purchased to now. Also, their cancellation of the scheduled March 20 trip had come before a 14-day deadline set by the tour company.

As Jean Patrick Mouflard, general manager in the U.S. for New Frontiers, explained when I went to see him in his office near LAX, his company has a policy that any of its passengers can cancel and get a refund for any reason, as long as they do so at least 14 days before their trip would have begun.

There is a 20% penalty, Mouflard said, but if they have purchased insurance from Insure America, and their cancellation falls within the coverage that company offers, then the insurer will pay the penalty and New Frontiers/Corsair will pay the rest. If the cancellation occurs within 14 days of the flight, the insurance company pays.

Since Paul Maurice’s death fell within the coverage of the insurance policy, Mouflard said, Insure America would pay $240, and New Frontiers would pay $986. In short, Phyllis Maurice would get a 100% refund.

But Maurice said that when she and her daughter called New Frontiers, they were told only that the payment would come through the insurance company, and two different representatives said nothing about New Frontiers refunding anything.

This set mother and daughter on a frustrating series of calls to Insure America, which demanded as proof of Paul Maurice’s death either a coroner’s report or a death certificate.

This took too long a time. The Orange County coroner’s report was not issued until April 11, two and a half months after the death, and Maurice was informed that the state of California would take about as long again to produce a death certificate. In the meantime, she sent a confirmation from the funeral home of the death, but that was not adequate from the insurance company’s viewpoint.

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Larson said she and her mother were told by the insurers to send written notice of the cancellation to New Frontiers, which they did by certified mail, but they didn’t learn until late April that the tour company would be paying anything.

I called Mouflard for an explanation.

“I’m not going to rule out that a couple of [our] people didn’t follow through,” he declared. “They [Maurice and Larson] probably got the wrong information, and they went to the insurance company. I’m not ruling out that whoever they talked to wasn’t informed and didn’t follow through perfectly.”

This amounts to quite an admission, I thought.

Mouflard, in our earlier meeting, said it would take several weeks to send Maurice a check. Now, however, he told me, “The check is going out today.”

On Wednesday afternoon, Maurice got two checks--$240 from Insure America and $1,060 from New Frontiers, a little more than was actually owed.

Still, Larson said, “I can’t believe this. People cancel all the time. They should have their procedures straight. My father died, and this was really sad. My poor mom! The public needs to know.”

Maurice was pleased with the checks and philosophical about the experience.

As for her refund appeals to the tour company and the insurance company, she said, “I believe if I were a male I probably could have been more aggressive. I tried to be assertive and professional throughout. . . . I did not lose my temper.”

But maybe at some point she should have.

Meanwhile, what about the insurance company? (The Maurices had paid $98 for that coverage).

Travel Guard International, the parent company of Insure America, headquartered in Stevens Point, Wis., at first referred the matter to its New York PR firm, but later thought better of it. On Tuesday, Dan McGinnity, Travel Guard’s vice president for communications, called from South Africa, where he was on a business trip, to confess to “a mistake on our part.”

“My feeling is, we should have done a better job up front,” he said. “She wasn’t totally clear that 80% of the claim was going to be paid by New Frontiers. . . . That was a miscommunication on our part.”

McGinnity asserted that, in general, “We take great pains to create a system that pays claims. We put in a new system four months ago and are doing a lot more over the phone, aimed at paying 90% of the claims within 10 days.”

Ten percent to 12% of all those who buy a comprehensive travel policy make “some kind of claim,” he said. “We pay 90% to 95%. Cancellation is about 70% of the total, but there are also medical claims, baggage, trip delay or trip interruption.”

Sounds good. But the Maurice case should induce both these companies to work on smoother performance in the future.

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Ken Reich can be contacted with your accounts of true consumer adventure at (213) 237-7060 or by e-mail at ken.reich@latimes.com.