事情是这样子的，我在今年5月的时候花$10800买了两张乌斯怀亚号去南极的船票，今年11月3号出发，这个船在距离南极还有五个小时的地方因为一位乘客洗澡摔倒返回了，我买了保险认为符合旅行中断，但是提交后被保险公司拒了，我不懂这方面的法律，请各位帮我看看他们是否符合拒绝条款，我还有机会上诉吗？附件图片附上了船方对此次事故的说明，非常感谢了。（我确认我买的保险包含最高$10000的interruption和cancelation)
We are in receipt of your claim submission and supporting documentation in regards to the above indicated claim, filed as a result of an unrelated passenger being injured causing the ship to return to port.
After careful consideration, we have determined the reason provided for your claim is not covered under the post departure benefits (i.e. trip interruption, travel delay or missed connection) underwritten by Nationwide Mutual Insurance Company.
Please note, this is a named peril plan which covers specified losses and only reimburses covered expenses as indicated in the plan documents. To view the plan provisions and a complete list of covered events and covered expenses, please visit www.tripmate.com, plan # N300E.
We are sorry that our response could not be more favorable. Nationwide Mutual Insurance Company and Trip Mate, Inc. understand that things happen outside of your control; however, we must adjudicate claims in accordance with the plan provisions and the documentation submitted.
After you review your plan provisions and if you feel this information is incorrect, please submit any additional documentation that may have a bearing on this claim decision to [email protected]. Please include your claim ID and name in the subject line.
filed as a result of an unrelated passenger being injured causing the ship to return to port. After careful consideration, we have determined the reason provided for your claim is not covered under the post departure benefits。我也对这句话很疑惑，这难道都不算旅行被迫中止吗？
并没有限制，我觉得我符合第三条，非家庭成员受伤，The Company will reimburse You, up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if You interrupt Your Trip after Your departure or if You join Your Trip after Your Scheduled Departure Date due to any of the following Unforeseen reasons that occur while this coverage is in effect for You:
Your Sickness, Accidental Injury or death, that results in medically imposed restrictions as certified by a Physician at the time of Loss preventing Your continued participation in the Trip. A Physician must advise to cancel the Trip on or before the Scheduled Return Date.
NSIITC 2000
-5-
SCOPE OF COVERAGE
COVERAGES
Sickness, Accidental Injury or death of a Family Member or Traveling Companion booked to travel with You that a.) occurs while You are on Your Trip; b.) requires Necessary Treatment at the time of interruption; and c.) as certified by a Physician, results in medically imposed restrictions so disabling as to prevent that person’s continued participation on the Trip.
Sickness, Accidental Injury or death of a non-traveling Family Member.
Your or Your Traveling Companion’s company being made unsuitable for business by fire, flood, burglary, vandalism or other Natural Disaster and You or Your Traveling Companion are responsible for policy and decision making with the company and is directly involved as a member of the disaster recovery team.
You or Your Traveling Companion being required to work during the Trip. Proof of requirement to work, such as a notarized statement signed by an officer of Your or Your Traveling Companion’s employer must be presented.
Your or Your Traveling Companion’s company being directly involved in a merger, acquisition, government required product recall or Bankruptcy or Default proceedings. You or Your Traveling Companion must be an active employee of the company and must be directly involved in said event.
You or Your Traveling Companion have a previously approved military leave revoked or experience a military re-assignment.
You, Your Traveling Companion or Family Member, who are military personnel, and are called to emergency duty to provide aid or relief in the event of a Natural Disaster (this does not include war).
Weather that causes complete cessation of services for at least twenty-four (24) consecutive hours of the Common Carrier on which You are scheduled to travel and prevents You from reaching Your destination. This benefit will not apply if the Natural Disaster has been forecasted or a storm has been named prior to purchase of this coverage.
Natural Disaster at the site of Your destination that renders Your destination accommodations Uninhabitable.
A Terrorist Incident that occurs in Your departure city or in a city listed on Your Trip itinerary during Your Trip.
You or Your Traveling Companion are a victim of a felonious assault.
You or Your Traveling Companion being hijacked, Quarantined, required to serve on a jury or subpoenaed during the Trip; having Your Home made Uninhabitable by Natural Disaster; or burglary of Your principal place of residence during the Trip.
Bankruptcy or Default of a Travel Supplier causing a complete cessation of travel services provided the Bankruptcy or Default occurs during Your Trip. Benefits will be paid due to Bankruptcy or Default of an airline only if no alternate transportation is available. If alternate transportation is available, benefits will be limited to the change fee charged to allow You to transfer to another airline in order to get to Your intended destination. This benefit only applies if Your Scheduled Departure Date is no more than fifteen (15) months beyond Your Effective Date.
Strike that causes complete cessation of services of the Common Carrier with whom You are scheduled to travel for at least twenty-four (24) consecutive hours.
The Company will reimburse You up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for the following:
a) pre-paid unused, non-refundable land or sea expenses to the Travel Suppliers;
b) the airfare paid less the value of applied credit from an unused travel ticket, to return home, join or rejoin the original Travel Arrangements limited to the cost of one-way economy airfare or similar quality as originally issued ticket by scheduled carrier, from the point of destination to the point of origin shown on the original travel tickets.
The Company will pay for Reasonable Expenses incurred by You if Your Traveling Companion must remain Hospitalized or if You must extend the Trip with additional hotel nights due to a Physician certifying You or Your Traveling Companion cannot fly home due to an Accident or a Sickness but do not require Hospitalization.
In no event shall the amount reimbursed exceed the amount You pre-paid for the Trip.
SPECIAL CONDITIONS: You must advise the Company or its authorized representative no later than seven (7) days in the event of a claim. The Company will not pay benefits for any additional charges incurred that would not have been charged had You notified the Company, its authorized representative and Your Travel Supplier as soon as reasonable possible.
