We never actually had to use Sky Med but I was very impressed with them the only time we attempted to. After having to argue and almost beg for answers to my questions with Allianz after hurricane Irma, I made one phone call to Sky Med and had my full refund within four day of first calling them. I finally gave up with Allianz since in the end I was able to get the answers I needed and receive full refunds all around from American Airlines along with full restitution of all our air miles.