Am I Being Robbed Again ?
My Insurance Company Is Trying To Find a Way To Avoid Paying Claims !
Today insurance, and more specifically insurance companies, could possibly be the bane of my existence. The irony is - I used to sell insurance. The type of insurance I dealt in however was related to both health, and death. Yes the age old joke, life insurance is in fact death insurance. Most of these products had outcomes that were generally black and white. Take life insurance for example. There is no half dead, or half alive designation (although I could argue with some people there should be). To the insurer you are either alive or dead. That is about as black and white as you can get. The insurer may argue that the insured lied about a pre-existing condition on the application, and therefore may try to deny the claim upon one's passing, but there is no arguing the status of dead or alive. One could argue that critical illness insurance also has definitive outcomes. If an insured is diagnosed with a covered illness, and if that illness fell under the contractual terms of being deemed critical, a payout would occur. The only insurance product that I dealt with which had any ambiguity whatsoever was disability insurance. This is the one coverage where the possibility of being able to game the system was present. What is an ailment that would prevent someone from performing the daily activities of their job, and therefore being eligible to collect an income without working? Back pain, stress, depression? Indeed all of these could very well be situations that would impede a person's ability to perform their job, but how does one prove they are truly suffering from any of these conditions? Your doctor may tell you that you are unable to work, but the insurance company may disagree. There are businesses that exist to challenge the insurance companies on their disability decisions. I hear commercials for this being advertised on the radio almost daily.
Of course there are the other insurances which are not related to health, but related to covering assets, and protecting against liabilities. Take car insurance as an example. There is no option in Ontario but to carry liability coverage of a minimum of $200K. Maybe you don't care about the car, or its replacement value, but you better protect yourself from potentially hurting others. There is home insurance to protect against fire, theft, flooding etc. Travel insurance to protect against an unforeseen medical emergency, an unexpected trip interruption. There is even pet insurance to cover unforeseen vet costs associated with sick animals.There is practically no limit to what can be insured.
When we shop around for insurance, we either employ the help of a broker, or for the do-it-yourselfers, there are enough on-line portals allowing one to complete their own application. If you are anything like me, we rely on the broker to source the insurance provider, and assume that broker has shopped around for the best rate, found the best company for our needs, and uses only suppliers that are easy to deal with, and have a good, and fair, history of claims payouts.
When my bag was stolen, and for a finite period of time, our trip was interrupted, I assumed that I would be able to claim our stolen goods, and unexpected expenses on any of the various insurance contracts we owned. Contracts that, for the record, we faithfully paid in full, and on time. Afterall like life insurance, my situation was about as black and white as one can get. Either I had my bag, or I didn’t, and If I didn’t, either it was stolen, or it was lost. I suppose there was a third possibility. That was one in which I made up an elaborate hoax that my bag was stolen, so that I could make a false report to the airport police, spend a whole day (and $500+CDN) at the Canadian consulate in Miami obtaining a new passport, and spend over 40 days in both Colombia and Mexico without my laptop and Ipad. Possible, yes, probable, no.
So, after finally arriving in Cartagena, I began the unenviable task of pivoting away from the two major editing projects I had so diligently prepared for, to embark on the role of insurance claimant.
I began by listing out the various coverages we had, and identified what I assumed each company could help with:
1) Travel Insurance - they would be able to help us with purchasing items needed immediately i.e. sunglasses, medications, extra costs incurred for trip interruption, and hopefully some, if not all, of the contents of the stolen bag
2) Credit Card Insurance - We were not really sure how to coordinate all of the coverages together, but took the approach of opening claims with them to see where that took us. We had two cards, a VISA and an AMEX
3) Home Insurance - They would cover the items that were not covered by the insurance listed above, and only if necessary
4) Oddly I had put hull insurance on my drone. This was a separate stand alone policy, which I originally purchased for liability purposes when completing drone jobs. Adding hull insurance was about $100 for the year, and I thought that would be a nice safeguard from a crash. Never in my wildest imagination did I think I would be using the coverage for a theft related event.
I then emailed our broker who represents our home coverage, and Manulife's travel insurance claims department. When I didn't hear back from either for a couple of days, I tried calling. As it turns out we didn't have a calling plan on our Colombian SIM cards. Upon arriving in Colombia we had our driver stop to help us purchase SIM cards. Our primary thoughts were data and texting limits. We just assumed that a calling plan would be included with these, and further assumed that a calling plan was the base of all SIM cards. Apparently not. There was a simple fix to that I thought, pop in my Bell SIM card, and begrudgingly pay the $16/day Roam Better fee. There was only one problem, our SIM cards were in the stolen bag.
Two days, and multiple hours on the chat option with Zoom’s tech support, we were finally able to get a calling plan in place. And so began the calls.
Manulife’s travel insurance.
After explaining to the claims support person with Manulife what had happened, I was advised that theft coverage only applied to a bag that was not in our possession. When would the bags not have been in our possession? Only between the time the bags were checked, and before they arrived on the luggage carousel. If bags disappeared during that time, what would trigger the thinking the bags were stolen, and not lost. I feel confident in saying that if I contacted the insurer hours after the bags didn’t arrive they would tell me to report it to the airline, and deal with them. This would fall under the criteria of being a very grey area. Bags lost, not our problem, bags stolen, but in your possession, not our problem.
I had some prescription medication that was stolen, and the only way that I could replace the prescriptions was to make an appointment with a doctor. I made a telehealth appointment and submitted the $75 USD invoice to Manulife. That cost was declined because, as the claims adjuster put it, “we are not able to cover the doctor’s note, because it was not considered a stolen item”. WHAT? If I were in an accident, and needed emergency surgery, would the TRAVEL and MEDICAL insurance deny my claim because there was no theft involved? Simply ludicrous.
We were stranded in Miami for one extra day as we waited on pins and needles to see if my passport would be expedited that day. If it were, it would mean that we would only be delayed by one day. If that didn’t happen, it would mean being in Miami for an extra 5-6 days. As it turned out, we were stranded there for just the one 24 hour period. We did however have to burden the costs of an extra night in a hotel, meals, and transportation. For anyone that has been to Miami, they know that prices there are not for the faint of pocket-book. When I submitted the costs incurred for the one extra day, and under the category of trip interruption, we were declined. The reason - a stolen bag is not deemed trip interruption. While that may be true, a stolen passport is, in my opinion, the very definition of trip interruption. If I can’t legally continue on with my trip, how is that not considered trip interruption??
Finally Manulife was very kind to reimburse me for the cost of the passport replacement. A whopping $100 of the $500 of the real costs. Perhaps Manulife needs to get a better understanding of what the true costs of replacing a passport are.
I have appealed these decisions well over a month ago, and am still awaiting a response to these.
AMEX and VISA
When I got on a call with both of those companies, the first question that was asked was whether the bags were in our possession. Oh- Oh this was sounding eerily familiar. When I mentioned yes, I was told that there was no theft coverage for bags that were in our possession. Seems like all the insurance companies are all singing off the same song sheet. There was however one caveat. For items purchased in the last 90 days, on the respective credit cards, and were items lost due to the theft, those could be claimed.
AMEX, to their credit, reimbursed me for the couple of items that fell under this criteria, and with little effort. I only needed to show them a copy of the police report, and a redacted copy of credit card statements proving those items were purchased using an AMEX card. With Visa however, I had to provide a police report, a redacted copy of the credit card statements, a copy of our home insurance policy, and original receipts for the items being claimed. All this for $170 worth of items. Even after providing those items to Visa, they requested them again for a second time. I am not sure if the claims adjuster lost the first batch of items, but the cynic in me thinks that perhaps they were trying to make the whole process frustrating enough I would eventually just give up. I didn’t and have since been paid out on both of those claims.
Home Insurance
By far this process was the most egregious display of a hawkish adjuster trying to deny claims before they were even submitted. If I ever had any doubt that adjusters were bonused based upon the claims they decline, those doubts have been put to rest.
In my initial conversation with the adjuster, one of the first questions I was asked was what I did for a living. I advised her that I was mostly retired, but I have a couple of side projects. I do pension benefit consulting, a little bit of real estate photography, and do some content creation. I was then asked if any of the stolen items were used in the process of earning income. I acknowledged that the possibility was there, but I would have to go back and look at what was stolen, and of those items, confirm what was used in what capacity. It was only after this conversation I was advised our policy only covers business equipment stolen off our premises, and up to a maximum of $5,000 in total. My laptop alone was worth over $5,000, and none of the items stolen were off our property.
I knew for the real estate photography, I had separate, professional grade equipment which I still had in my possession. None of the items I had were used in pension benefits consulting. That left only the items that were used for content creation. I looked back, and realized only three devices were used for content creation - my phone, a drone, and a microphone. None of these items were stolen. Yes another drone was taken, but not the one that was used to make any of the posted YouTube videos.
I explained this in a follow-up note, and sent time stamped pictures of the equipment still with me, along with purchase receipts. She confirmed again that none of the items stolen were used in business, and I acknowledged such.
I then received a notification that I was now being investigated. It would appear that noting that I had to confirm if what was taken was used in the process of earning business income was an admission that I had confirmed that some of the items were used for business purposes. Clearly a scare tactic on their part. The letter sounded ominous, and for the first time during this whole process I was beginning to feel like I was being made out as the criminal, not the victim. I vowed that when we settled the claim, we would leave and find a new insurer. I still stand by that assertion.
When I submitted my claim form, my laptop was declined. I was told by the adjuster that the computer had been used for business purposes. I had no idea why, or how she would know that. I refuted that suggestion, advising that I still had a laptop in my possession that I had owned since 2020, and this was used exclusively for business purposes. I sent her a copy of the receipt, along with a time stamped photo of that laptop’s serial number, which corresponded with the serial number on the receipt that I sent. I explained that I had purchased my new laptop in early 2023, and when the projects I was working on got very busy, I had no time to set-up and use the new laptop. Later in 2023, when things slowed down, I finally sat down and became acquainted with the new software I had purchased. I explained it was my intent to get further acquainted with the laptop, and more specifically a new editing suite, while we were traveling in early 2024. If I were happy with everything, then it was my intention to sell the old laptop, and bring my new, personal laptop into the business. I even went in so far as to confirm the laptop was purchased in my name, and not with corporate dollars. Surely this explanation would suffice. It did not. I was then told that if even the intention to use the laptop for business purposes was a possibility, then it was considered a business item. I was incensed! Using that same theory, if I were to buy a car with the intention of becoming an Uber driver, and I decided in the end not to move forward with that, will I be deemed a rideshare driver, and have to pay higher insurance rates? Not only was I still experiencing PTSD from the feeling of being violated that my personal possessions were floating around somewhere in Miami, or that I was being made to feel like a criminal by our insurance company, but now my intelligence is being insulted by a claims adjuster who is telling me what my intentions were. In a rage I reached out to our broker explaining the situation, and asking him to talk some sense into these people. The next call would be to our lawyer. I don’t think that the adjuster telling me what my intentions were would ever stand up in court. I know this may seem like an overreaction, but this was no longer about the replacement cost of the material items, this was now about a computer that was stolen and an adjuster trying to find some loophole to get out of having to pay that claim. If you hadn’t guessed this was the big ticket item in the claim, and we were both digging our heels in. In my opinion this was as black and white as it can get. My personal computer was stolen, and I was trying to make a claim to have it replaced, The insurer was trying to deny that claim by using shades of grey to explain why they wouldn’t accept the claim. The call from the broker must have worked, because shortly thereafter I received a note from the adjuster advising they would allow my personal computer to be made part of the settlement.
Hull Insurance
This one turned out to be frustratingly long, taking from March 1 until May 2 for the claim to be settled. It eventually did get settled and without any pushback, and very little paperwork.
In summary, I question the motives of insurance companies outside of their objective of making profits. Don’t believe for a second they are here to help. I had a bag stolen. That is a fact. I had goods in that bag that I could provide receipts for. That is a fact. I had a witness to the crime, a police report, and a detective in Miami on the case. Those are facts. Despite the facts, the black and white shall we call it, the insurance companies are purposely working in shades of grey. They make navigating the system, and the claims process difficult. They decline items that should be covered, and make victims feel like the criminals. No doubt many people throw their hands in the air in frustration and give up pursuing what is rightfully theirs. I am sure the insurers are banking on a certain percentage of people doing that in the hopes of adding to their bottom line. I wasn’t going to be one of those to add to their profitability, and neither should you.
Yikes and double yikes!