Insurance claim took two years to be approved

Q:

Two years ago, I was scheduled to travel to Omaha to stay with my mother and provide postoperative care for a week. My return flight was scheduled for a week later.

My mother had complications after surgery that not only lengthened her hospital stay but also required me to lengthen my trip to take care of her at home when she returned from the hospital.

I changed my return date to fly back a week later than scheduled so I could give my mother two weeks of care at home instead of one. The cost to change my return flight was $360 - a $200 change fee, plus $130 fare difference and $30 processing fee.

I filed a claim with Allianz pursuant to "Trip Interruption due to Nonmedical Reasons." The cause for filing the claim is stated in Section 2 of the travel insurance policy. Per a letter submitted by my mother's physician, my mother required extended hospitalization and she required my care upon release due to her complications.

I have submitted this letter and other information to Allianz. But they just continue to ask for more information. Now they want a form completed that requires information from the hospital about my mother's surgery and complications, despite having the letter from her physician.

This situation has taken a lot of my time and my mother is still having health problems, so I don't want to continue asking her to chase down more information.

Two Allianz agents, before I changed my flight, told me I would simply need a letter from the physician explaining the situation to file a claim. I hope you can help get Allianz to honor what I believe is a valid claim. - Tami Miller, Malvern

A: Allianz should have paid this claim long ago. So why didn't it?

Section 2 of your insurance policy says you're covered when a family member who isn't traveling with you is seriously ill or injured.

"Specific requirement," it adds. "The injury, illness, or medical condition must be considered life-threatening, require hospitalization, or he or she must require your care."

That looks like a covered reason to you - and to me. So what's the hold-up? You say two representatives told you a doctor's letter would be enough to process the claim, but then another representative asked for additional details. Insurance companies are well within their rights to request this documentation, although they should also make every effort to resolve a claim in a timely manner. Two years is too long.

I list the Allianz customer service contacts on my consumer advocacy site: http://elliott.org/company-contacts/allianz/. Reaching out to one of them in writing might have helped move your claim along. But you can't waive a paperwork requirement in the way you want. A company like Allianz must show its underwriters that it processed a valid claim.

I contacted Allianz on your behalf.

"We have been waiting for her to send us the required documentation we need to finalize her claim," a representative told me. "The number one reason that claims are delayed is lack of proper documentation. In this case, we have decided to approve Ms. Miller's claim based on the documentation we have."