Here is the reason why – If you need them in an emergency and time is of the essence, THEY NEED MORE THAN 48 HOURS TO AUTHORIZE OTHERWISE THEY REFUSE TO PAY YOU. Plus THEY WILL SAY THEY NEVER GOT YOUR CLAIM EVEN WHEN THEY HAVE CALLED YOU IN THE PAST. So, even though they may sound “reputable” – I would consider RUNNING AWAY FROM THEM. Here’s my story – make your own judgement.
Always used TATA-AIG, TILL WE NEEDED THEM
Whenever my family travels to USA from India, they always take travel insurance. Of course, like any other insurance, the hope is you never need it, but if you do, you want to have one which would be useful. So, we have always chosen a highly reputed alliance – Tata AIG – two of the biggest names in India and USA respectively, and certainly not the cheapest. However, I guess reputation means nothing to even these companies. They play their tricks just like any other shady insurance firm when it comes the time they have to pay a claim.
Leg fracture on the plane
Here is the complete story. My brother and her wife came to the US and were on their way back home on Virgin Atlantic from SFO to Mumbai, via London. On the airplane, during disembarkation at London to switch planes, there was a piece of food in the cramped aisle on the plane and the wife slipped on this food. She fell in these cramped quarters and hurt her right foot real bad and was in extreme pain. London airport authorities had to call an ambulance and take her to the nearest hospital in London. The debacle of support provided by Virgin Atlantic during this entire process, in spite of clear negligence on their part, is a writeup for another post. Concentrating on the insurance company here.
The Hospital visit
The ambulance took the wife to the closest national hospital. My brother was juggling with the efforts of trying to calm his wife, handle the three pieces of carry-on luggage which was just handed to him, and talk to the medics. Reaching the hospital, after almost 3 hours, finally an emergency room doctor saw the wife and declared that she had a broken bone fracture. The doctor advised that she would be given a “boot” to support her leg, and she should go to her home country (India) as soon as possible so the doctors in India can do further treatment, which could be either surgery or a foot cast. They did not recommend doing that in London as it would have a major mental strain (given they did not have any family support in London), logistical challenge (travel, lodging etc.) and of course very expensive for a visitor treatment in London. Also, if a surgery was required, it would mean multiple days in the country. These were all the reasons the doctors recommended going back to India as soon as possible. They also cautioned that with the leg cast, and given the patient was not very thin, there was a very high concern for VTE, which would be life threatening. They recommended upgrading the seats for the 10 hour flight, and periodic motion when possible on the flight.
The Insurance contact
While my brother and his wife were on their way to the hospital, they contacted me in US and provided me with their insurance details and asked that I contact the insurance company. I did so, and the insurance agent said they will reach out to my brother. And indeed, they reached out before the doctor had seen the patient. My brother gave them the details and asked if there was a need to do any preauthorization. They indicated once the doctor has seen the patient, to contact the insurance company for the next step. After the doctor had seen the patient, and given their recommendation to travel back to India as soon as possible, my brother again reached out to the insurance company. The agent claimed there was no record of the incident (no record of the previous call). Once again my brother gave all the details, and asked if there was a need for a preauthorization. The agent indicated she would get back to him. A little later, my brother reached out to the insurance company again, as he wanted to make the flight bookings for the following day. For the second time, the insurance agent claimed there was no record of the incident. This is where things started to look a bit worrisome. How can a multinational company lose the incident report twice? Once again, my brother gave the details and asked if any preauthorization was requested. This time, he specifically asked for the issue record number. The agent indicated that he would need preauthorization, but given it was a Saturday, it would be 48 hours before he could provide the same to him. This was obviously unacceptable as per doctor’s recommendations, the pain the patient was in and the lack of any local support. This was communicated to the agent upon which they indicated they can provide the claim form and this can be handled as part of the claims process. Additionally, they recommended that my brother approach the airline for the upgrade, given it was obviously their mistake that caused the entire issue to begin with. The airlines provided no support at all – again, details in the other post. So, right up until the flight the next day, my brother kept in touch with the insurance company to check if they had managed to get the authorization for this emergency. They could not. Given the life threatening possibility and recommendation from the doctors, my brother went ahead and paid for the ticket from his pocket and returned home, with the hope (which was also unofficially told by the insurance agents he spoke with) that the claims officer would see the situation and approve the expenses.
The Insurance Claims nightmare
As soon as my brother arrived in India, he contacted the insurance company at the earliest opportunity. As instructed, he filled all the claim forms and provided all the documentation requested. This is where the nightmare stared. First off, the insurance company said – you are in India, so any expense for this accident, even though it clearly happened on travel, is not admissible. I wonder if we had opted to get treated in London, if their claim would have been – you should have come back to India. Next, and this is the biggest issue, they say “Because you decided to leave London without waiting for the authorization, so it cannot be an emergency claim. It will be treated as just a break in journey.” What a sham. In fact, because it was an emergency, that was exactly why we could not afford to WAIT FOR 48 HOURS FOR THEIR EMERGENCY RESPONSE TIME TO PROVIDE AUTHORIZATION. This is clearly a tactic so they have to pay just a small percentage of the actual payment due. We are still in discussions with the Insurance company, and if they do provide a better response – I will be sure to update it here. But for now, I WOULD ADVISE NOT TO USE TATA-AIG AS A TRAVEL INSURANCE COMPANY AT ALL COSTS.
Some tactics they use to not pay the proper amount
1. It was clearly a fracture, not a sprain and they had medical proof of the same in their hands. Yet, their communication was “a twisted ankle”.
2. If you followed doctor’s orders and took the action in light of an emergency to bring the patient back to India for further treatment without waiting for their ridiculous 48 hour turn around time, then they claim “the very fact you have evacuated by yourself indicates that it was not an emergency”.
3. They throw “clauses in their fine print” at you, but if you send one relevant one back to them, they just ignore it.
4. They use delay tactics by requiring you to register the same complaint multiple times, which adds to the already stress of the emergency.