Seven Corners Insurance Failure to Pay Out of Pocket Travel Medical Expense Carmel Indiana

My daughter and participated in an educational tours (EF Tours) trip to Peru in June 2017 for which paying for Travel Insurance provided by Seven Corners, Inc  (which included medical coverage) was a prerequisite for traveling on the tour.  My daughter and 12 other students became ill with food poisoning during the trip which required services of a hotel-call physician. The hotel-call medical service had no means for payment other than cash, which was paid directly by me.  I was assured by a Seven Corners representative over the phone that we would be reimbursed under their travel coverage for which we paid.

When I originally submitted the claim in July 2017, Seven Corners refused reimbursement of the claim for $172 of medical expenses paid, citing that we needed to make the claim with our primary insurance carrier. Nowhere in Seven Corners Travel Insurance Description of Coverage do they provide relief for themselves with regard to a covered's primary insurance, nor would it have been relevant in this case, since the treating medical facility in Peru had no way to bill directly to a US Insurance Carrier.  Seven Corners has subsequently requested that I provide them with a copy of my primary insurance carrier’s Summary Plan Description, which is a 400+ page document. I have subsequently provided them with relevant sections of my SPD, but it has been over 8 months that Seven Corners has been countering our claim reimbursement requests with requests for “additional documentation.”  It has become apparent that Seven Corners has no intention of paying this claim and is only in the business of collecting premiums and denying coverage.  I have subsequently filed formal complaints with the State of Indiana and State of Californai Insurance Commissions. I will also be submitting a complaint to EF Tours for partnering with this fraud of an insurance company. Suggest more people do the same.