Travel Insurance

May 5, 2008

We thought we'd be returning from Portugal about now, and indeed we are home, but unfortunately that's because we never left.

I guess that's what we get for planning ahead, at least by our standards. Receiving a Seabourn Cruise Line email in late December, we noticed a repositioning cruise, this time in the opposite direction from the one we took last fall. Departing from Ft. Lauderdale Sunday, April 6, the Seabourn Legend would cruise the Atlantic, arriving in Lisbon April 19 after a stop at Madeira. Seabourn is another top-end small-ship cruise line, which many think is superior to Silversea. And the discount was even bigger – fifty percent this time. I guess the idle rich are more interested in shore excursions than in cruising the seas, providing opportunities for those of us not quite at that level who do enjoy the seagoing experience.

So we checked Condé Nast Traveler's annual list of top travel agents and chose one recommended for "Cruises on Luxury Small Ships Worldwide," as well as several other interesting specialties, e.g., "Culinary Trips." A member of Seabourn's board, he had first-hand knowledge of which of the available suites were preferable to others, as well as being able to get us a very good price. In fact, when we received our final cruise documents, we saw that we had received a two-category upgrade to a forty-percent-more-expensive balcony suite.

The timing was particularly attractive, arriving in southern Europe towards the end of April, when the weather is usually pleasant, the tourists have not yet arrived, and prices are still low. Of course, that's just relative, thanks to our weak dollar. Since we had been to Portugal during a wine tour after 9/11, our first thought was to go back to Cannes after the cruise. However, TAP, Portugal's national airline, having no competition, charges $300 for that flight, while EasyJet flies to Paris or London for about one-quarter of that price

But after studying the guidebooks, we realized that although we had seen Lisbon, Porto, and the Douro valley, where most Port wine grapes are grown, we could easily spend several more weeks visiting historical, cultural, scenic, and yes, even beach areas. And SilverJet, one of the remaining business class airlines, had flights from London to Newark for about $800

Although we didn't need to decide on those details yet, we did need to determine whether to purchase travel insurance. Our travel agent recommended it – even at half price, the cruise wasn't cheap – but to choose an independent provider. After all, if the cruise line went bankrupt, we'd be doubly unfortunate. We had previously purchased annual policies for medical evacuation, which can approach $100,000, but not ones relating to trip cancellation. However, our current policy would run out in the middle of the cruise, and policies for trip cancellation include medical evacuation.

So we consulted http://insuremytrip.com and eventually selected AIG Travel Guard. To waive the pre-existing condition clause, they require purchase within two weeks of the initial deposit, which was made January 8, although further coverage can be added until nearly the day of departure. The cost was less than five percent of the insured amount. We later added USAir flights to Ft. Lauderdale and an overnight stay at a boutique hotel – as some on our previous repositioning cruise found, it doesn't have to be winter for flight delays to cause you to "miss the boat." While those unfortunates did miss the first four days, the first stop this time would be eleven days after departure – and there are no helicopter transfers.

In the meantime, we went to St. Maarten. Soon after our return, I got a cold, the type with bouts of frequent coughing. However, when early one morning, a coughing spell resulted in ear pain severe enough to wake me up, I realized this was a little more serious. The doctor looked in my ear and said I had a middle ear infection. When I asked how she knew, she said she could see red behind the eardrum. She prescribed an antibiotic, but said it may take several weeks – even several months! – to return to normal. Having never suffered an ear infection, I researched it on the Internet. No doubt those of you with children already are familiar with what I learned, since most of the sources assume that it's not afflicting a geezer, it being discussed under such headings as Baby's Health or Kid's Health.

The middle ear begins at the eardrum, and includes the hammer, anvil, and stirrups that we learned about in school, (or actually, the malleus, incus, and stapes) that transmit vibrations to the inner ear, where the cochlea converts them to electrical signals that our brain recognizes as sound, and which also includes the semicircular canals that inform us which way is up.

Each middle ear continually secretes mucus, which drains through its own Eustachian tube into the throat behind the nose. The Eustachian tubes also allow pressure to equalize during altitude changes – under normal conditions, that is. However, when a cold or allergy affects the nasal passages, the Eustachian tube may become blocked by congestion in its lining or by mucus within the tube. This blockage allows fluid to build up within the normally air-filled middle ear. Bacteria or viruses that have entered the middle ear through the Eustachian tube can also get trapped, eventually leading to an ear infection.

Most articles I found referred to children, no doubt because, according to the Mayo Clinic, three out of four have had at least one ear infection by age three! One reason children are more susceptible to ear infections is that their Eustachian tubes are shorter and more horizontal than those of adults, which allows bacteria and viruses to find their way into the middle ear more easily. Also, children's immune systems aren't yet fully developed so they have more trouble fighting infections.

The fact that most ear infections occur in children and that viruses are unaffected by antibiotics, whose indiscriminate use can lead to resistant strains, has resulted in a recent reconsideration of treatment methods. It is possible to determine the cause of an infection, but it requires withdrawing a sample of fluid via a needle through the eardrum!

So I'm fortunate that even without a test, the next visit to the doctor – we were now approaching two weeks before departure – indicated that the infection had been quelled. However, there was still only about thirty-percent hearing in my left ear, and "popping" it had no effect.

Fortunately, I was able to make an appointment with my ENT with about a week left. Focusing his microscope on my eardrum, he was able to see bubbles in fluid on the other side, and recommended that unless this was the trip of a lifetime, I should cancel, since flying would pose substantial risk of a ruptured eardrum. I assured him that this trip was anything but, referring him to my website for corroboration.

Of course, we are up for adventure, so I looked into alternate modes of transportation, this time on the surface. Amtrak's overnight Silver Meteor travels from Washington to Ft. Lauderdale in about 22 hours. However, the scheduling is not very convenient, the train arriving after 6 PM. In Portugal, a sleeper train goes from Lisbon through Spain to the French border, where the high-speed TGV train leaves for Paris. One has to change stations from its arrival at the south of Paris to the north, where the high-speed Eurostar leaves for London, with a total trip time of about 25 hours. We are familiar with the London to Southampton train to meet Cunard's transatlantic liner – now the QM2, which sails for New York every twelve days – and the Metroliner from there to Washington. However, in addition to the complexity and added time of this itinerary, the price would about double – so much for adventure.

So now it was time to learn how easy it would be to claim the insurance. The first step was certainly simple enough – they emailed me all the forms. However, some of the instructions seemed extreme, asking for a record of all doctor visits, and permission to contact the doctors, beginning from six months before the policy was purchased. It turned out not to pertain to us, since we had enrolled soon enought to waive pre-existing condition scrutiny. The ENT filled out his form with the requisite medical terminology ("otitis media with effusion"), which I faxed along with proof of payments, copies of the cancellation policies, permissions to contact the various doctors, and the signed statement that I wasn't lying about all this.

The instructions also recommended writing down the date that was four weeks in the future, which would be the earliest time to contact them with any questions about the status of the claim. So it was a real surprise to receive payment in full sixteen days later! An even more pleasant surprise was that, because Travel Guard rounded up our claimed cost to a higher level of hundreds, or perhaps thousands, of dollars, the unexpected cancellation fee levied by our travel agent, $100 each, was also covered!

Some have asked if we've rescheduled, but such a cruise is a once-a-year opportunity. And the cost may have been once in a lifetime – not just the fifty-percent off, but also that Seabourn's latest offerings are priced in euros.

A month later, I returned to the ENT, who verified that the fluid was gone. Although the Eustachian tube still is blocked, he said that at some point it probably opened momentarily and the fluid drained out. But my hearing is still impaired and I won't be able to do any air travel until I'm back to normal – certainly any future similar insurance claim would be scrutinized very carefully!

Later update: In October we were once again invited to join Betty Lou's sister and brother-in-law in their time-share condo in Playa del Carmen. The ENT pronounced me able to fly, and indeed there were no problems. So we'll be trying again for this year's Seabourn repositioning cruise. And you can be sure we'll get travel insurance!

Still later update: The next spring the crossing was once again available, and at an even bigger discount, and this time the trip went off without a hitch .

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