The Denial Letter

The denial letter was short and not-so-sweet (jpg of the letter shown below).

"Thank you for your recent claim submission.  We regret to advise you that we found your claim to be ineligible for the following reason(s):

* Under the Exclusions section of the policy it excempts (sic) from coverage, "...the loss for which coverage is sought was directly or indirectly, wholly or partially, contributed to or caused by: (6) ...abuse..." Our records indicate your loss is a result of abuse."

HUH?

Doesn't abuse imply some type of intentional act?

I think a reasonable person would say this was an accident, pure and simple.

Our main concern over their logic is that any type of accident could be construed as "abuse."  It's like saying, yeah, you're insured, but we can deny any claim we want to...

So here's the policy:  https://www.onlineclaim.americanexpress.com/pdf/PP-DOC-CCSG1-02-07.pdf

Specifically, there are two parts of the policy that pertain to this claim:  The definition of a Covered Incident and then the Exclusion they cite:

Covered Incident  means the theft of, or damage, whether by accident or vandalism, to any one item of property purchased worldwide as a gift or for personal or business use and charged to Your Account.

Exclusion:  (6) fraud or abuse or illegal activity of any kind by the Cardmember.

Well, later in the policy, there's this verbiage that pertains to residents of Oregon:


In the Exclusions section the following are removed:
4. violation of a criminal law, offense or infraction;
6. fraud or abuse or illegal activity of any kind by the Cardmember;

We wrote American Express a couple page letter and pointed out that the exclusion they cited was not valid for residents of the State of Oregon (where we live). Here's our letter to them: http://americanexpresspurchaseprotectionfail.blogspot.com/2011/06/our-response-to-amex-appealing-their.html

We figured that would put an end to this nonsense and they'd pay for our accidental loss ("Covered Incident").