Travel insurance claim denied? Here's how to turn a "no" into a "yes"

When Deborah Koduru's flight from Albuquerque to Dallas was delayed under unusual circumstances, it set off a cascade of events that sunk her long-awaited river cruise in Europe. And that wasn't the worst of it. Her travel insurance company denied her claim on a technicality, meaning she would also lose $22,000.

Is there a way to turn her insurance company's "no" into a "yes"?

I get questions about travel insurance denials almost every day on our consumer advocacy site . Many are not fixable because insurance companies have rigid rules about what is -- and isn't -- covered.

But Koduru's case was different, and I thought our advocacy team might have a chance to overturn this denial.

I'll also reveal some of my strategies for appealing a travel insurance denial. And I'll answer a few burning questions about travel insurance, including:

• How does travel insurance work?
• What to do when your travel insurance claim is denied?
• What kind of strategies can I use to reverse a travel insurance denial?

And, of course, my advocacy team and I will do everything we can to help Koduru.

Are you ready?

A flight delay under unusual circumstances

The unusual problem: President Biden visited Albuquerque on the day Koduru and her husband were supposed to leave for their vacation. When Air Force one lands at a civilian airport, there's an automatic ground stop on all flights. Her flight to Dallas was delayed, which made her late for her connecting flight to Amsterdam.

"When we got to Dallas, our international flight had already left," she says.

Koduru immediately contacted Viking, her cruise line, and her travel agent. (The couple had booked an air-inclusive cruise.) The cruise line quickly rebooked them on another flight.

"But when we went to the counter, a representative told us that the flight was full and to come back for standby," she recalls. "There were no seats to accommodate us. We called Viking at that time, but they didn't give us any alternative."

That meant they would miss their cruise. Disappointed, the couple flew back home to Albuquerque and decided to file a claim with Trip Mate. They were confident that their policy would cover them.?

But they were wrong.

"No benefit" for this claim

Koduru filed a claim and waited. She checked the status of her claim online regularly, expecting that it would sail through.

It did not. After several months of delays and two letters apologizing for the delay, Koduru logged on to the Trip Mate site and saw the news.

"I looked at the claim status online and saw 'no benefit' listed under our claim," she says. "There was no date, and nothing has come in the mail."

No benefit? But that didn't align with Trip Mate's promise .

If your flight is delayed or canceled for 3 or more hours, you will be reimbursed up to a maximum of $750 for additional transportation expenses needed for You to join the departed Trip and non-refundable trip payments for the unused portion of your Trip. See Plan Documents for full details.?

You will also be reimbursed up to $150 per day to a maximum of $750 for any additional accommodation, meal and local transportation expenses if you incur a delay of 12 hours or more for a covered reason during your trip.?

They should have at least received something, right? Why was the claim denied?

I reviewed her policy . It looks like the peril for which she was trying to file a claim was not named -- in other words, her claim fell into a gray area.

The Trip Mate policy would have covered her if there had been a complete or partial closure of the air traffic control tower or the airport from which she was scheduled to depart. But the closure "must be caused by a power outage or electronic or systems failure," the policy notes -- not by the presence of a presidential aircraft.?

But does that mean she is out of luck? Not necessarily.

How does travel insurance work?

Koduru and her husband had paid $1,600 to protect their river cruise and they believed they were entitled to some protection. I agree with them. But that's not how travel insurance works.

A "named perils" policy like the one they had through Trip Mate covers only what is written in the policy. This is one of the most common misperceptions about travel insurance, as I explain in my complete guide to travel insurance .

But even when a peril isn't named, there's still some wiggle room. An adjuster should have seen that Koduru and her husband made an effort to make their cruise but ultimately couldn't and found a way to pay the claim.

Koduru could have filed an appeal. That would have meant sending a brief, polite email to Trip Mate, offering any new information relevant to her case. In other words, there was a full stop on air traffic in and out of Albuquerque because of Air Force One.

Travel insurance companies like Trip Mate usually assign appeals to a senior adjuster. That person will carefully review the claim to ensure the initial adjuster didn't overlook anything. An appeal can take at least as long as the initial claim, and sometimes longer , and since Koduru's had taken more than two months, she faced another two months of waiting to hear back from Trip Mate.

What to do when your travel insurance claim is denied?

If you receive a denial from your travel insurance company, you'll want to go back to your policy to find out if it made a mistake. Read the policy carefully. Then read it again.?

Travel insurance policies can be slippery. You can interpret it one way, a travel insurance adjuster can interpret it another way. But you need to review the policy with great care to make sure you didn't overlook anything.?

Sometimes, a travel insurance company will list the reason for the denial. For example, you may need to provide more documentation for your claim. Those types of claim rejections are relatively easy to deal with as long as you have the right documentation.?

The harder claim denials are when the policy doesn't address your claim or when you and the adjuster have an honest disagreement about what the policy says.

With Koduru's Trip Mate claim, she seemed to be having a difference of opinion over what the policy said. And worse, the adjuster wasn't even giving Koduru a reason for the denial, which was frustrating.

"No" doesn't always mean no

In the travel insurance world, "no" doesn't necessarily mean no. You can take your appeal to the next level.

Your agent

Koduru could have enlisted the help of the insurance agent or travel agent who sold her the policy. Agents can often act as intermediaries when something goes wrong with a policy. And don't forget that agents take a commission on your policy -- and they want your repeat business. They'll fight for you.

Your state insurance commissioner

Your insurance commissioner may be able to help if your insurance company rejected your claim for no good reason. You can find your state insurance commissioner through the National Association of Insurance Commissioners site. I've heard of claims being honored simply by copying your state insurance commissioner on their appeal.

Small claims court

You don't need to hire an attorney to go to small claims court, but there's a limit on the claim amount. So be sure to do your research before filing a complaint. This is often your last resort. If your agent or insurance company prevails in small claims court, that's it.

A consumer advocate

A third party may be able to help you get a claim honored, depending on the type of claim and the advocate. Ultimately, this is the option Koduru chose by asking me to help her. And when she told me about her case, I agreed that she should have been covered -- even if her policy doesn't explicitly address her type of delay.

Would I be able to get her $22,000 back?

What kind of strategies can I use to reverse a travel insurance denial?

This is one of the most common questions from travelers with an insurance problem. Here are some strategies that I've seen work.

Know who to ask

It's fine to appeal your claim through normal channels. But if you aren't getting anywhere, you might try copying an executive on your appeal. I list the names, numbers and emails of all the travel insurance executives on this site .

Mind your manners

I have seen lots of appeals fail, and they tend to have one thing in common. They use UPPERCASE letters to yell or deploy F-bombs when they don't get their way. People! Mind your manners. These insurance adjusters are human, too.

Be patient

Insurance claims take time. But after this summer's air travel debacles, they're really taking their time. A few years ago, the average claim might have taken just a few weeks, a month tops. Now, it's more like two months. When you get impatient, you become pushy and impolite -- and that can affect the outcome of your case. Take a deep breath and let the process work.

Will Trip Mate reverse its denial?

I reached out to Trip Mate and asked it to review Koduru's claim one more time. Only a few days later, Koduru reported back.

"We received a letter from Trip Mate denying our claim," she said. "But no specific reasoning. The date on the letter was October 25th, although the postmark was late November."

That didn't seem right. I had contacted Trip Mate after it wrote the letter but before it mailed it.

"That's not their final answer," I said. "I heard back from them November 9 and they are looking into this."

Koduru had spent the last few weeks reviewing her policy and she was sure Trip Mate had overlooked something. So was I.

Finally, earlier this week, she got some good news.

"To our total shock, we received two checks," she says. "I do not know what transpired. There was no explanation of any kind, just the checks. This all must be due to your efforts. We thank you very much."

The checks covered the value of almost her entire claim, and she says she is happy with that outcome.

Maybe my involvement led to a faster resolution. But I also think the appeal steps I outlined earlier in this story would have yielded the same result. (Here's five tips to change a 'no' into a 'yes' .)

As to the reason Trip Mate denied Koduru's initial claim but then decided to honor it -- it isn't saying. Maybe someone overlooked something. Maybe an adjuster found a clause that allowed Trip Mate to ultimately honor the claim. (Related: Travel insurance claims can hinge on the tiniest details .)

Then again, maybe someone at Trip Mate saw that Koduru ?and her husband were about to lose $22,000 through no fault of their own — and decided to do the right thing.

Christopher Elliott is the founder of Elliott Advocacy , a 501(c)(3) nonprofit organization that empowers consumers to solve their problems and helps those who can't. He's the author of numerous books on consumer advocacy and writes three nationally syndicated columns. He also publishes the Elliott Report , a news site for consumers, and Elliott Confidential , a critically acclaimed newsletter about customer service. If you have a consumer problem you can't solve, contact him directly through his advocacy website . You can also follow him on Twitter , Facebook , and LinkedIn , or sign up for his daily newsletter . He is based in Santiago, Chile.