Business Profile

Insurance Claims Processing

Crawford & Company

Headquarters

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Complaints

This profile includes complaints for Crawford & Company's headquarters and its corporate-owned locations. To view all corporate locations, see

Customer Complaints Summary

119 total complaints in the last 3 years.
27 complaints closed in the last 12 months.

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The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

Initial Complaint
Date:09/09/2023
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Trip canceled due to wife's pregnancy and return date overlapping with the expected delivery date. Filed a claim but the insurance company hasn't reviewed my claim in 4 months.The travel insurance company I had a policy with was Broadspire(Crawford & Company). Insurance claim (claim #*******) was filed in May 2023. After the initial review of the documents, additional proof was requested and was provided within a week. 4 Months have passed since then and even after numerous phone calls and voice mails, no action was taken.The customer service line always picks up the phone and asks me to talk to the adjuster. The adjuster never picks up his/her phone and is unreachable. Left a voice mail numerous times and never got a call back.Can I get some help, please?
Business Response
Date: 09/25/2023

CHUBB
P.O. Box 4700
**********, ** 23327
O ************
E ****************************************

September 25, 2023

Better Business Bureau of Metro Atlanta, ****** & NE *******
***********************************************
*******, ** 30303

RE: Case ID:

20579886

Complainant:

******************;

Claim Number:

4191525

Policy No.:

9907-44-34

Date of Loss:

05/17/2023
Type of Claim:

Credit Card Benefits - Trip Cancellation

Writing Company:

Federal Insurance Company

To Whom It May ****************** received the consumers complaint submitted to the Better Business Bureau of Metro Atlanta,
Athens & NE ******* (hereinafter BBB). This claim was handled by our third-party claim
administrator, Broadspire Services, Inc., a subsidiary of Crawford & Company (hereinafter
Broadspire), the third-party administrator assigned to process claims on behalf of Federal Insurance
Company. In the complaint, it is indicated that the claimant has not had documents reviewed in four
(4) months and is unable to contact the adjuster who handled the claim.

The complainant is covered under policy number 9907-44-35 (hereinafter the Policy) which
provides *************************** through use of their **** of ************ Signature credit card
to secure the common carrier transaction. Therein, it outlines the terms and conditions of the benefit.
Please note, the Policy outlines that the following loss(es) are not covered:

This benefit does not apply to loss caused by or resulting from:
5) the Insured or an Immediate Family Member:

a) traveling against the advice of a Physician; or

b) traveling while on a waiting list for specified medical treatment; or

c) traveling for the purpose of obtaining medical treatment; or

d) traveling in the third trimester (seventh month or after) of pregnancy.

Additionally, the Policy contains the following exclusion:

Disease or ************************* does not apply to any Accident, Accidental Bodily Injury or Loss caused by or
resulting from, directly or indirectly, the Insured Person's emotional trauma, mental or physical
illness, disease, pregnancy, childbirth or miscarriage, bacterial or viral infection, bodily
malfunctions or medical or surgical treatment or diagnosis thereof.

We have reviewed the claim file thoroughly. Our records confirm the trip was cancelled as a result of
pregnancy as travel was scheduled one (1) month prior to the due date. The claim was submitted to
Broadspire on May 17, 2023, and an acknowledgement letter and claim form were sent via email the
following day. On June 08, 2023, documentation was uploaded for review, assigned to an adjuster,
and reviewed June 14, 2023. It was determined additional documentation was required in order to
make a coverage decision and an email was sent the same date advising of the required documents.
On June 23, 2023, additional documentation was uploaded for review, reviewed on July 03, 2023, and
confirmed that the loss was not eligible for coverage. Management authorized the denial on July 06,
2023, and the complainant was notified of the determination via email the following day.

Upon receipt of the above-referenced BBB complaint, a member of the Broadspire management team
reviewed the file and determined that the original denial was accurate per the terms and conditions of
the policy. Our review confirms the same. Broadspire placed a call to ************* and the final decision
was discussed. A follow up email containing a copy of the original denial letter was sent on September
19, 2023.

It is confirmed that the assigned adjuster did miss four (4) calls from the complainant between August
21, 2023 August 23, 2023. We sincerely apologize for any inconvenience this may have caused as
this is not the level of customer service we expect our members to receive and will work with
Broadspire in regard to this.

The contents of this letter should not be construed as a waiver of any rights and defenses that we may
have under the policy and law. Neither this communication nor further communications that we may
have regarding this claim should be construed to wave any of these rights and defenses. We are willing
to review any additional information that you may provide. We further reserve all of our rights to assert
defenses based upon other policy provisions whether or not specifically mentioned herein.

Should you have any additional questions or concerns, please do not hesitate to contact the undersigned.

Sincerely,

************************;

*************************
Senior Claim Specialist, Accident & Health
Chubb *********************
Initial Complaint
Date:08/23/2023
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Truck was parked in walkway blocking half the street without any lights on. As I carefully went around it another car came out and forced me to move closer to truck and damage my car This has been going on 3 months and numerous calls. No response
Business Response
Date: 09/11/2023
Dear Sir or Madam,

Please see attached the analysts response regarding the above-referenced BBB matter. Thank you.

Best regards,

*****************************
Senior Analyst

Customer Answer
Date: 09/13/2023

Complaint: 20510982

I am rejecting this response because:
I have not received any communication regarding this complaint
Sincerely,

*************************
Business Response
Date: 09/20/2023
Dear Sir or Madam,

Please see attached the analysts response regarding the above-referenced BBB matter. Thank you.

Best regards,

*****************************
Senior Analyst
Customer Answer
Date: 09/24/2023

Complaint: 20510982

I am rejecting this response because:
After numerous calls and being given to another and another agent, no one really asked for any details. Just a short detail. The photo and other information was never asked for and they clearly had no intention to review the mater. The last correspondence made reference of still being reviewed
i am under medical care and even through Im on medication- this does not make since.
Sincerely,

*************************
Initial Complaint
Date:07/12/2023
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Submitted a paid family leave claim, and was told they received everything they needed to process my claim. Its been over 3 weeks, and I have not received my paycheck. I called and was told my claim was still under review. Review with who? No one can answer my question, and *** called 5 times requesting to speak to my claim specialist or a supervisor only to be told theyre out of the office. According to the call center representatives, notes have not been entered in my account since June 20th!
Business Response
Date: 07/27/2023
Our office has communicated directly with consumer to resolve her inquiry.
Please let us know there are any additional concerns on this matter.
Initial Complaint
Date:07/08/2023
Type:Product Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
This complaint is about your Broadspire company in ********, *********, that handles your Airbnb claims. you need to contact his department and you need to get them to release what theyre supposed to the payment to my account. The paperwork has been filled out, but they cant seem to manage to deliver it.I have called them and I have emailed them every day and they do not answer and its becoming ridiculous to the point where I have to try to contact your company and other means like this because this matter needs to be settled and it needs to be paid. An agreement has already been made and the payment is due so we need to make that happen within this week and I have emailed your company with no avail so Im gonna have to file a complaint against you until you guys actually do what youre supposed to do It would be nice if they could just answer their email and answer the phone but they cant do that.So Im asking that they send the payment within the 10 days with the account information that they already have you think either a partner bank or wise transfer or transfer wise or some method to transfer the money and get this over with.Due to the sensitive nature of the issue, I will not upload the document, you can contact me directly for that or you can just contact the Airbnb claims department and tell them to get a move on it
Business Response
Date: 07/14/2023
Our office communicated directly with the consumer and this matter has resolved.
Customer Answer
Date: 07/14/2023

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

Sincerely,

******************************************
Initial Complaint
Date:06/18/2023
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
While on duty as a Professional Commercial driver on the date of November 1, ********************************************************* which left ram was fractured. That following month of October of that same year claim was denied. So I immediately field a ********* comp. claim against my employer insurance company Broadspire. As time pass on I am forced to seek legal assistance which i did. Eventually insurance company accepted claim in the month of February 2023.I have tried multiple times to connect company through email's txt's and fax. No feedback at all. I am due compensation due to my unfortunate situation . All im asking is what is due to me. Im in a very tough situation at this point no income:!
Business Response
Date: 06/29/2023
Better Business Bureau
*****************************************************************

RE: Complaint ID: 20202048

Dear Sir/Madam:

We are in receipt of your correspondence dated June 18, 2023 in reference to the above captioned matter.

The complainant, ********************* alleges Broadspire failed to issue indemnity payments for a ********** Worker Compensation claim for the date of loss referenced above. We have reviewed our file materials on this matter. Please accept this correspondence as our formal response to the complaint.

Our records reflect that the claim was initially denied, once the new examiner took over the file and reviewed it with defense counsel the denial was overturned pending ******************************** state disability information and medical reporting.

The injured worker has been receiving ********************************, and we are currently pending the full amount and dates of payments since they started in March 2023.

In addition, our office just recently approved a new designated primary treating physician and updated work status is pending.

Payment issued on pending.

Thank you again for the opportunity to address the issues between ******************* and TForce Freight Inc. We trust that the provided information satisfies your inquiry. Should you have any further questions, please do not hesitate to contact the undersigned.

Please be assured that Broadspire Services is committed to establishing and maintaining a professional and cooperative relationship with all affected parties. Our policy is to provide prompt and appropriate responses to all claim issues.

Sincerely,

*********************
Senior Claims Examiner
Crawford &Company - 2G81746
Customer Answer
Date: 07/03/2023

Complaint: 20202048

I am rejecting this response because:

Sincerely,

*********************
Initial Complaint
Date:06/16/2023
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
My 2019 Tacoma was stolen from a delearship 2/11/23. I have had a open claim with this insurance since then. ****** should have been 100% liable for this theft! However, I was sent an evaluation of ****** that was not going to cover my loan. I owed ****** on it. I was then told to send in all of my reciepts ($5,788.60) proving that my truck was worth more than what they were wanting to pay. ******************* then went ahead and settled with my lienholder for ****** & forced me to use my Gap to pay off the rest of my loan. I was outraged, and ***** then informed me she would be processing my receipts under a different policy. I had to come up with 9 different documents for Gap to get my loan paid off. I then lost $6000 in unused warranty refunds to cover the rest of my loan. I have done the work on my part, but now it has been 2 ************* is not responding to my last 3 e-mails. I need my claim finished so that I can move on & get into a new vehicle. Putting someone through 4 months of unnecessary stress after a tragic event is outrageous! ***************************** ************* Claim# *********-001
Business Response
Date: 06/28/2023
June 28, 2023

Better Business Bureau
***********************************************************************

COMPLAINT ID:                                   20197731
INSURED'S NAME:                               ******* Investment Company, LP
CARRIER:                                             CNA
CLAIM #:                                              189995055-001
DATE OF LOSS:                                    2/11/2023
CLAIMANT:                                          *****************************

To Whom It May ********************* you for the opportunity to respond to the above-referenced complaint matter involving ***************************** and ******* Investment Company, LP.   Broadspire is the third-party administrator handling claims on behalf of CNA and their insured, ******* Investment Company,LP. Broadspire is not an insurance company. In a good-faith effort to resolve this complaint, Broadspire provides the following information for your records.

This loss involves an auto theft which occurred on February 11, 2023. ********************** 2019 ****** Tacoma was parked inside the repair shop for service. During the night someone broke in, stole the truck, and drove it through a window. The truck was later recovered. An appraiser was assigned to inspect the truck. ******** arranged a rental vehicle for *********************

On February 21, 2023 adjuster ******************* contacted ***************************** to advise the truck was a total loss. ******************** advised that she has a lien on the truck through EECU along with GAP insurance through ***********. She was advised to give them our information and that we would work with them to resolve the claim.

The value of the ****** was determined to be $28,414.63. This amount was paid to the lien holder,EECU, on April 19, 2023.

As noted, ******************** owed more on her vehicle than it was worth and had GAP insurance through ***********. Adjuster Saks provided all requested documents to *********** on May 1, 2023. *********** dealt directly with ******************** and EECU to resolve the balance on the lien.

******************* did provide adjuster Saks with some receipts for items added to her truck. These were reviewed by an Auto Appraiser who advised the items did not increase the value of the truck. ******************** was advised that we are unable to issue an additional payment for these items.

In summary, we have paid the value of Ms. ********* 2019 ******. ******************** has separate GAP insurance to cover what wasnt covered by the underlying insurance.   An appraiser reviewed the items added to the truck and determined they did not increase the value of the truck.

Should you have any questions, please contact me. Thank you.

Sincerely,

*********************
Team Manager
Broadspire
**********************************************************************; 60047
************
******************************************************
Customer Answer
Date: 06/28/2023

Complaint: 20197731

I am rejecting this response because:
************ sent me an estimate of ******. I did not agree with this evaluation. I was then told to send in all of my receipts. After waiting a month for them to be reviewed, *********** starts pressing me for my lienholders information. She then settles with my lienholder & does not review my receipts! I was forced to use my Gap, losing out on $6000 in refunds because ************ did not properly handle my claim! ************ did not assist in providing documents to Gap. I provided all 8 of them because ************ was taking weeks to get this done. ************ then informs me that I will be issued a check for my reciepts under a different policy. I was then asked to send her my reciepts again because she had never reviewed them before. After sending them again, I wait another 3 weeks. Finally, I am now being told I will not be compensated & all of this was done under false pretenses! My truck was stolen from a delearship that left the keys in the vehicle & had no working cameras. I should be compensated for everything I have lost due to their negligence!

Sincerely,

*****************************
Initial Complaint
Date:06/11/2023
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I filed a claim for trip insurance benefit on 12/20/2022 for a capitol one transaction in the amount of $107.10. My claim number is *********. I called several times regarding updates on the claim but each time I called, I was told that the represenative assigned to my case will get back to me within 5 business days and each time nobody did. I called customer service on 06/11/23 and ********** informed me that the claims team mismanaging a high volume of claims and as a result my claim fell through as well. I am deeply disappointed how this company handled my claim. They are unethical and lazy and failed to handle my claim properly. I will also file a claim with capitol one regarding this issue. I want my refund of $107.10 and apology from the business for mishandling my claim and delay it for so long. Thanks
Business Response
Date: 06/23/2023
Please see attached response to complaint.
Initial Complaint
Date:05/31/2023
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I bought insurance for my flight through this company and I have asked them may times to contact me. Which they have not. I am in disability and they for me for ******. I want my money returned.
Business Response
Date: 07/12/2023
July 11, 2023

BBB Serving Metro Atlanta
************************************************************************

RE:                          BBB Case ID Number:                    20121495
                                Claim Number:                                 *******
                                Insured:                                               *****************************
                                Policy Number:                                 CUDFQ-KVGAC-INS
                                Date of Loss:                                      August 16, 2022
                                Type of Loss:                                     Trip Cancellation
                                Insurance Company:                      ******************

We are in receipt of the above referenced complaint that was received on May 31, 2023, and in reference to the above captioned claim, adjudicated by Broadspire. Broadspire Services, Inc., a subsidiary of Crawford & Company, is a third party administrator assigned to act on behalf of ******************, to process claims for plans sold by ********************** Services, LLC.

In this BBB complaint,****************** has expressed her frustration with the lack of communication received from her assigned adjuster. We have reviewed our claim file and offer the following in response.

On September 14,2022, notice of this loss was received in the Broadspire office. The acknowledgement letter and claim form was sent to ****************** via email on October 17, 2022. On December 14, 2022, ****************** submitted a claim form via **** mail and the claim was assigned to an adjuster for review.

Upon review of the submitted documentation, the assigned adjuster reviewed the documentation and determined that the following items were still pending to resolve the claim:

Confirmation of the reason for the Trip Cancellation, Interruption or Delay (Physician Statement indicated the onset date of injury/illness and the last date of re-occurrence to eliminate pre-existing condition)
Complete Travel Itinerary (i.e., flight schedule, hotel confirmation or tour/cruise itinerary)
Proof of payment(s) for the trip
Cancellation letter from tour operator/agency (with cancellation policies)
Penalty letter or penalty terms from the affected travel company, carrier, lodging or other provider
Documentation showing any refunds (if applicable)
Medical Records from treating Physician and/or signed HIPAA medical records release form,

An email was sent to ****************** on the same day advising her of the pending documentation. Several requests and submissions were received and reviewed over the span of several weeks. After exceeding ninety (90) days of requesting the required documentation, the claim was placed in an inactive status on February 3, 2023.

Upon receipt of the above-referenced complaint, members of the management team review the file in its entirety. Our review of the file indicates that ******************** file is still pending all the above referenced documentation to determine if her loss is eligible for coverage under this policy. A call was placed to ******************, and this was explained to her.

Upon receipt of the required documentation, we will re-open and review the claim in its entirety against the policy language to determine if the loss is eligible for coverage. We will ****************** with an update at that time.

For faster service, please upload the completed and signed claim form and all required documents
to:
**************************************

Fax:**************
(Attn: *******)
Or mail the required documents to:

Claim Benefit Services
P.O. Box 459084
****************
(Attn: *******)

Should you have any questions or concerns, please do not hesitate to contact the undersigned.

Respectfully,

***********************
Director of Claim Operations
Broadspire Services
Phone: ************
Initial Complaint
Date:05/30/2023
Type:Customer Service Issues
Status:
UnansweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I contacted the insurance company. I was told to upload the required documents through their site or send it by mail or fax it. Initially, I uploaded all the required documentation. I received an automated email stating that Adjuster 1 (*******************************) needed more documentation. This time I sent all the required documentation (Attachments **** with narrative) by mail. Later I received another automated email stating that Adjuster 2 (****************************) requested another document. I inquired about what happened to my review with Adjuster 1. I was told by the customer service rep that Adjuster 1 no longer works with the company. I faxed my credit card statement (Attachment 12) to Adjuster 2. The company acknowledged all the documents I sent (uploaded, mail, fax).Later I received another automated email from Adjusted 3 (*******************************) requesting the same documentation. I talked to Adjuster 3 and explained that I already submitted all the documents. She then asked me to contact the airline company to verify if I received a voucher. I told her that I booked the flight through a travel agency. Nevertheless, I contacted All ************** and received an email to direct my inquiry to the travel agency since I did not book from them (Attachment 13). It only proves that I did not get a voucher!Later I learned that Adjuster 3 no longer works with the company, and my case was being reviewed by Adjusted 4 (*************************). I was frustrated at this point and emailed *************************** (supervisor) to expedite my case. After a few weeks, I called a customer service rep and later learned that my case was being reviewed and a recommendation to reimburse my airfare but not the medical expenses (Attachment 14). I told the customer service rep I was okay with the airfare reimbursement. At this point, I don't care anymore about the medical expenses. Later I received another automated email from Adjuster 5 (************************) to send the same documentation. SAME CYCLE AGAIN!
Initial Complaint
Date:05/28/2023
Type:Product Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
We had put in a claim for a vacation interruption due to the *** NOTAM system crash on 1/11/23. We had a flight from *** to *** with layover in *** for 6am that morning. We checked in with ******** Airlines and then learned of the *** NOTAM system crash which affected every flight in ****** and Globally. All flights were delayed. After sitting in the airport for 6 hours our flight was released, but we wouldve missed our connecting flight in ***, as our layover window had shrunk. AA could not get us a flight out of *** or *** until 1/13/23. We had a choice to stay in ** or go to ********* and stay at our own expense. We opted to stay & AA rebooked ** for 1/13/23. We lost two nights at the condo we rented, and our claim was for those two nights for $1163. I sent all the required documents, but they only reimbursed us $400 for the delay, rather than the $1163 for trip interruption. I have been repeatedly calling, but no one has responded as to why I did not receive the full amount. My Claim number: *******
Business Response
Date: 06/07/2023
BBB of Metro Atlanta

************************************

Suite # ***

*******, ** 30303

RE:                        BBB Case ID Number:                    20114638

                              Claim Number:                               4119054

                              Insured:                                             *****************************

                              Policy Number:                               FH6F4-4Y8BM-INS

                              Date of Loss:                                   January 11, 2023

                              Type of Loss:                                   Trip Interruption/Delay

                              Insurance Company:                      ******************



We are in receipt of the above referenced complaint that was received on May 28, 2023, and in reference to the above captioned claim, adjudicated by Broadspire. Broadspire Services, Inc., a subsidiary of Crawford & Company, is a third party administrator assigned to act on behalf of ******************, to process claims for plans sold by ********************** Services, LLC.

In this BBB complaint, ********************* has expressed her dissatisfaction with the check that was issued and the lack of communication recevied from his assigned adjuster or their team manager. We have reviewed our claim file and offer the following in response.

On January 23, 2023, notice of this loss was received in the Broadspire office. The acknowledgement letter and claim form was sent to ********************* via email on the same day. On February 2, 2023, ********************* began submitting documentation to her file via mail, and the claim was assigned to an adjuster for review.

Upon review of the submitted documentation, the assigned adjuster reviewed the documentation and determined that the following items were still pending to resolve the claim:

a)            Confirmation of the reason for the Trip Cancellation, Interruption, or Delay

An email was sent to ********************* on the same day advising her of the pending documentation. Several requests and submissions were received and reviewed over the span of several weeks. Upon review, payment was issued to ******************** in the amount of $400.00 under the Trip Delay Benefit. Our records indicate that the check was cashed on June 1, 2023.

Upon receipt of the above-referenced complaint, members of the management team review the filed in its entirety. Our review of the file indicates that per Mrs. ********* statement, the *** suffered a system crash which caused a delay with their flight. As a result, ******** Airlines rebooked Mrs. ********* flight for two days later. Mrs. ********* is requesting to be reimbursed for the unused pre-paid lodging accommodations that were missed, from January 11, 2023, through January 13, 2023.

Our review of the summary of benefits indicates that Mrs. ********* covered Trip Cost were in the amount of $999.88. Based on the submitted documentation the total expense for the lodging totaled to $6772.08, and the flight totaled to $1284.14. The full cost of the trip was not insured under this policy. In addition, the reason for the delay *** system crash is not a Covered Event under this policy for Trip Delay, or any other benefit. In addition, the expenses that ********************* is seeking is not a Covered Expense under the Trip Delay Benefit. Unfortunately, it appears that Mrs. ********* loss is not eligible for coverage and the $400.00 payment which was issued in May 2023, was issued in error. We sincerely apologize for the error. We attempted to reach ********************* via telephone to discuss our findings but each time the call was disconnected. A follow up email was sent to ********************* on June 7, 2023, requesting for her to return the call to discuss at her convenience.

Pertinent policy provisions follow:

Schedule of Benefits:

Trip Cancellation 100% of Trip Cost Insured

Trip Interruption 150% of Trip Cost Insured (Amount Insured - $999.88)

Travel Delay - $100 (per person daily limit applies) - $500.00 maximum limit per person - $5,000.00 maximum limit per plan.

TRAVEL DELAY COVERAGE

If you are delayed on your Trip for 12 hours or more, we will reimburse you, up to the amount shown in the Schedule for reasonable additional expenses incurred by you for lodging Accommodations, meals, telephone calls, local transportation, and additional vehicle parking charges and

additional pet kennel fees incurred due to the delay. We will not pay benefits for expenses incurred after travel becomes possible.

Travel Delay must be caused by or result from:

a. delay of a Common Carrier; or

b. loss or theft of your passport(s), travel documents or money; or

c. Quarantine; or

d. hijacking; or

e. natural disaster or adverse weather; or

f. being directly involved in a documented traffic accident while you are en route to departure; or

g. unannounced strike; or

h. a civil disorder.

TRIP INTERRUPTION BENEFIT

If your arrival on your Trip is delayed beyond your Scheduled Departure Date, or if you are unable to continue the Trip due to one of the unforeseeable Covered Events listed below that occur during your Trip dates to you or your Traveling Companion, we will reimburse you for

the unused, non-refundable land or water arrangements prepaid to the Travel Supplier prior to departing on your Trip, less any refunds paid or payable, plus one of the following:

a. Additional transportation expenses incurred to reach your scheduled destination if your departure is delayed and you leave after the Scheduled

Departure Date and time; or

b. Additional transportation expenses incurred for you to reach the final return destination of your Trip; or

c. Additional transportation expenses incurred to rejoin the Trip in progress from the point where you interrupted your Trip.

We will also provide reimbursement for unused air arrangements, less any refunds paid or payable, provided that these are not flights scheduled to travel to your Trip destination or flights scheduled to your origin of departure on your Trip, and provided that these are not flights within 24 hours of your Scheduled Departure Date or Scheduled Return Date.

Covered Events:

1. The Sickness, Injury or death of you, your Family Member, your Service Animal or your Traveling Companion. The Sickness or Injury must first

commence while your Trip Interruption coverage is in effect under the Policy, must require the in person treatment by a Physician, and must be so

disabling in the written opinion of a Physician as to prevent you from taking your Trip (either because your condition prevents your travel, or because your Family Member, Traveling Companion or your Service Animal requires your care);

2. Common Carrier delays and/or cancellations resulting from adverse weather, mechanical breakdown of the aircraft, ship, boat or motor coach that you were scheduled to travel on, or organized labor strikes that affect public transportation;

3. Being directly involved in a documented traffic accident while en route to departure on your Trip;

4. Being hijacked or Quarantined;

5. Being required to serve on a jury, or required by a court order to appear as a witness in a legal action provided you, a Family Member or a Traveling Companion is not a party to the legal action or appearing as a law enforcement officer;

6. Your Home made Uninhabitable by fire, flood, volcano, earthquake, hurricane or other natural

disaster;

7. Your Accommodations at your destination made Uninhabitable due to fire, flood, volcano, earthquake, hurricane or other natural disaster. We will only pay benefits for losses occurring within 30 calendar days after the event renders

the destination Uninhabitable. For the purpose of this coverage, Uninhabitable means: (i) the building itself is unstable and there is a risk of collapse in whole or in part; (ii) there is exterior or structural damage allowing elemental intrusion,

safety hazards have yet to be cleared, such as debris on roofs or downed electrical lines. In order to receive benefits under this coverage to remain home or to return home when the destination is restored for use, you must have 4 days or 50% of your total Trip length or less remaining at the time the destination is restored for use. Benefits are not payable if the event occurs or if the hurricane is named prior to or on your Trip Cancellation Coverage Effective Date;

8. A documented theft of your passports or visas;

9. A mandatory evacuation (or public official evacuation advisement in geographic areas where no mandatory evacuation orders are issued by government authorities) at your destination due to adverse weather or natural disasters. We will only pay benefits for losses occurring within 30 calendar days after the evacuation order is issued.

In order to receive benefits under this coverage to remain home or to return home when the mandatory evacuation ends, you must have 4 days or 50% of your total Trip length or less remaining on your Trip at the time the mandatory evacuation ends;

10. Being called into active military service to provide aid or relief in the event of a natural disaster;

11. Your previously granted military leave being revoked. The leave must be approved prior to your coverage becoming effective, and official written revocation notice from your commanding officer will be required;

12. Your involuntary termination of employment or layoff (or the involuntary termination or layoff of your parent or guardian if you are a minor traveling alone), after continuous employment with the same employer for 2 years or more,

provided the termination or layoff occurs 14 days or more after your coverage has taken effect. This benefit is not available to temporary employees, independent contractors, or self-employed persons;

13. A Terrorist Act which occurs in your departure city or in a city to which you are scheduled to travel while on your Trip, and which occurs within 30 days of your Scheduled Departure Date, provided the city has not experienced a Terrorist Act in the 30 days prior to the effective date of your coverage;

14. Your Host being unable to provide Accommodations due to a life-threatening Sickness or Injury, or due to death. Official documentation of the event will be required;

15. The school where you attend must extend its operating session beyond its predefined school year due to unforeseeable events commencing during the Policy effective period. The school year extension dates must fall in your Trip dates in order for this coverage to be available. Extensions due to extracurricular or athletic events are not

covered;

16. Being required to take an academic examination on a date that has been fixed while on your Trip, and the examination date falls within your Trip dates;

17. Being unable to undergo a vaccination or inoculation, due to a medical reason, that is announced and published as required for entry into a country of destination while on your Trip. The vaccination or inoculation must be unannounced and unpublished to the public at the time your coverage is purchased;

18. Receiving official notification of an organ match available to you for immediate transplant, provided the transplant is considered medically necessary, the notification is received while you are on your Trip, and in the written opinion of the

Physician the transplant surgery and/or recovery is so disabling as to prevent you from continuing on your Trip;

19. Receiving a court-issued notice to attend an Adoption Proceeding, provided you are not attending as a condition of your employment and provided the person being adopted is not you, your Traveling Companion or your Family

Member. The date of the scheduled Adoption Proceeding must be during your Trip dates;

20. Receiving notice that your Adoption Proceeding or adoption arrangements have been cancelled or terminated, provided your Trip was for the purpose of executing the adoption.

Limitations

Benefits payable for additional transportation expenses will not exceed the cost of airfare (the same class airfare on

which you were originally booked) by the most direct route, less any refunds paid or payable.

This coverage is subject to the General Exclusions.

Should you have any questions or concerns, please do not hesitate to contact the undersigned.

Respectfully,

***********************

Director of Claim Operations

Broadspire Services

Phone: ************

Customer Answer
Date: 06/08/2023

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

Sincerely,

*****************************

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