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Holiday cut short due to bereavement - claiming from insurance proving tricky! Help.
Brammeldi
Posts: 41 Forumite
UPDATE: RESOLVED
I'm just posting this update to let you know that we finally "won" our case and we had the due money back in full, plus a bit extra that we weren't entitled to have.
To cut a long story short, we went and wrote to the ombudsman who in turn told us that we were to write to the head office in Ireland, explain the case point-by-point and request a "final letter". They informed us that we had to hear back from them within 25 days of them receiving the letter, I think it was. We sent it international signed for so we knew which day they had it. I started counting the days and low and behold, on the 25th day my mum phoned me at work in tears...she said she'd received a letter from White Horse and my heart went into my mouth because I thought it was a final letter of refusal.
It turned out the tears were tears of joy as they refunded every penny owed. They said in the letter that although their T&C's were in such a way where we weren't covered, that it was only fair they take it on a case-by-case basis. They refunded the holiday not taken and refunded the emergency return flights "as a good will gesture". I think maybe they paid up in the end as they didn't want it to go to an Ombudsman because it would expose their unfair T&C's.
The terms of the refund, was of course "without prejudice", but we were pleased that with perseverance we got there in the end and that if you are having similar difficulties, never give up!
Thanks to people who posted, made suggestion or just comments of support. I appreciate it.
________________________
Hi All,
I joined this forum having read many threads as a guest before now. I've always been one to be a warrior consumer. Getting free items from complaining even as a teenager, getting my dad out of an undeserved parking ticket and right now I'm trying to help my mum claim unused holiday from her travel insurance and it's proving very difficult. It seems they are interpreting their own terms in a way that suites them. I'll try to give you the full story as brief as possible. Apologies in advance if it seems all over the place and if there are a few gramatical errors - I am usually quite thorough.
My parents booked a holiday to celebrate their 25th wedding anniversary. They booked through Going Places but the holiday was set-up by Cosmos (the tour operator) and the insurance that came with it was White Horse Insurance Ireland LTD.
They went about Sept 12th. Before this, my grandfather (my mum's dad) was ill, but certainly not to the point of being able to predict his death. He just had a dry mouth problem that the doctors were beginning to treat him for. There didn't seem to be any cause for concern so my mother and father went on holiday.
On the 17th Sept, my sister went to visit my grandfather and he was suddenly really ill and she got him into hospital. My 8pm that evening, he had been resuscitated. My sister called my mum to tell her to get home ASAP. My mother called the 24 hour Cosmos helpline and they give her the go-ahead to return home.
Obviously by this point, my mum was highly stressed, anxious, sick and shaking. No one at the airport helped her. For four hours they were waiting for someone to help. Eventually, they got a 1pm flight on the 18th Sept. They landed at about 3pm and arrived at the hospital at 6pm when my grandad was unconscious, and barely breathing. My mum said goodbye to him and he died shortly after. Bare in mind now that he died 22 hours after Cosmos gave my mum the go-ahead to return.
Turns out from the autopsy that my granddad died from a brain tumour and secondary cancer in the liver and kidney. He was never diagnosed with this, just the dry mouth condition as mentioned earlier. Also, I saw him the Saturday before he died (just 4 days prior) and I could have a normal conversation with him.
This is where the claiming comes in. My parents had about 8 days unused holiday, and unused return flight as well as the return flights they paid for out of their own pocket. Mum called White horse, explained the situation and they sent out claim forms and a form for my grandfathers doctor to fill in to declare he had not been diagnosed with cancer prior to departure. Forms sent off detailing all this with the doctor confirming their was no prior knowledge of my grandfather's condition.
Mum received a letter some weeks later dated October 28th saying that the claim is refused because the terms and conditions state that prior to curtailment of the holiday permission must be sought from the emergency advice line to agree it is necessary to return home.
Mum phoned the FSA for advice and they sent a book with information of how to complain and ways to take it further if unsuccessful. At this point, mum didn't want to bother because she was just glad to get home and the money doesn't matter, which is fair enough but I felt she was been robbed and treated unfairly and I felt the company might have used her this to play off.
So, I read the whole booklet and couldn't find this statement. Instead I told them I couldn't find it and then threw some other T's & C's at them that my mother followed to the letter; calling the tour operator (Cosmos) which she did and also noted that according to the FSA a firm is obligated to point out the most strict of conditions. My parents were never warned of this condition. I also was probably a bit naughty in pointing out spelling mistakes and gramatical error in the T&C's quotes I used by writing "[sic]" after the error.
So, I sent this letter to them, recorded with all supporting documents including copied pages of the T&C's I used and highlighted them. Two weeks on (yesterday) mum received another letter. The letter pointed out the location of the T&C they quoted in the 28th October letter and I realised that in the first letter, they only quoted half of the condition.
The full condition stated that before leaving, a medical certificate proving the urgency to return home AND contacting the 24 hour emergency hot line was needed in order to return. So basically, according this T&C, even if she'd have called the White Horse emergency number (which I haven't yet found in the T&C book...something so important should really be easy to find!), it still wouldn't have counted because she wouldn't have had a medical certificate. Now if the T&C said, "medical certificate OR 24 hour hot line" I'd understand but it isn't so.
How then, may I ask, when my grandfather was literally on his death bed, was my mother going to be able to obtain a medical certificate from the UK and then send it to White Horse Insurance LTD to gain the necessary permission to return, all in less than 22 hours!? This T&C seems to be an impossible fulfillment. Would you agree?
Anyway, in the same letter that gave the T&C in full, they say that they will re-look at the claim only upon the receipt of my grandfather's medical history for a full two years prior to them booking the holiday so they can check he had no history of cancer. I mean, they already received a form filled in by the doctor stating he had no prior history of cancer on his records before his autopsy.
Can these people really do this? Can they really draw this out like this? And if my mother has to pay for these records, can she bill this to White Horse Insurance LTD on top of her claim? After all, she's already paid the doctor to fill out a form in the first instance that states my grandfather has never been diagnosed with cancer.
Any help or advice before I send the next letter (with possibly the medical records) would be really great.
Many thanks in advance.
I'm just posting this update to let you know that we finally "won" our case and we had the due money back in full, plus a bit extra that we weren't entitled to have.
To cut a long story short, we went and wrote to the ombudsman who in turn told us that we were to write to the head office in Ireland, explain the case point-by-point and request a "final letter". They informed us that we had to hear back from them within 25 days of them receiving the letter, I think it was. We sent it international signed for so we knew which day they had it. I started counting the days and low and behold, on the 25th day my mum phoned me at work in tears...she said she'd received a letter from White Horse and my heart went into my mouth because I thought it was a final letter of refusal.
It turned out the tears were tears of joy as they refunded every penny owed. They said in the letter that although their T&C's were in such a way where we weren't covered, that it was only fair they take it on a case-by-case basis. They refunded the holiday not taken and refunded the emergency return flights "as a good will gesture". I think maybe they paid up in the end as they didn't want it to go to an Ombudsman because it would expose their unfair T&C's.
The terms of the refund, was of course "without prejudice", but we were pleased that with perseverance we got there in the end and that if you are having similar difficulties, never give up!
Thanks to people who posted, made suggestion or just comments of support. I appreciate it.
________________________
Hi All,
I joined this forum having read many threads as a guest before now. I've always been one to be a warrior consumer. Getting free items from complaining even as a teenager, getting my dad out of an undeserved parking ticket and right now I'm trying to help my mum claim unused holiday from her travel insurance and it's proving very difficult. It seems they are interpreting their own terms in a way that suites them. I'll try to give you the full story as brief as possible. Apologies in advance if it seems all over the place and if there are a few gramatical errors - I am usually quite thorough.
My parents booked a holiday to celebrate their 25th wedding anniversary. They booked through Going Places but the holiday was set-up by Cosmos (the tour operator) and the insurance that came with it was White Horse Insurance Ireland LTD.
They went about Sept 12th. Before this, my grandfather (my mum's dad) was ill, but certainly not to the point of being able to predict his death. He just had a dry mouth problem that the doctors were beginning to treat him for. There didn't seem to be any cause for concern so my mother and father went on holiday.
On the 17th Sept, my sister went to visit my grandfather and he was suddenly really ill and she got him into hospital. My 8pm that evening, he had been resuscitated. My sister called my mum to tell her to get home ASAP. My mother called the 24 hour Cosmos helpline and they give her the go-ahead to return home.
Obviously by this point, my mum was highly stressed, anxious, sick and shaking. No one at the airport helped her. For four hours they were waiting for someone to help. Eventually, they got a 1pm flight on the 18th Sept. They landed at about 3pm and arrived at the hospital at 6pm when my grandad was unconscious, and barely breathing. My mum said goodbye to him and he died shortly after. Bare in mind now that he died 22 hours after Cosmos gave my mum the go-ahead to return.
Turns out from the autopsy that my granddad died from a brain tumour and secondary cancer in the liver and kidney. He was never diagnosed with this, just the dry mouth condition as mentioned earlier. Also, I saw him the Saturday before he died (just 4 days prior) and I could have a normal conversation with him.
This is where the claiming comes in. My parents had about 8 days unused holiday, and unused return flight as well as the return flights they paid for out of their own pocket. Mum called White horse, explained the situation and they sent out claim forms and a form for my grandfathers doctor to fill in to declare he had not been diagnosed with cancer prior to departure. Forms sent off detailing all this with the doctor confirming their was no prior knowledge of my grandfather's condition.
Mum received a letter some weeks later dated October 28th saying that the claim is refused because the terms and conditions state that prior to curtailment of the holiday permission must be sought from the emergency advice line to agree it is necessary to return home.
Mum phoned the FSA for advice and they sent a book with information of how to complain and ways to take it further if unsuccessful. At this point, mum didn't want to bother because she was just glad to get home and the money doesn't matter, which is fair enough but I felt she was been robbed and treated unfairly and I felt the company might have used her this to play off.
So, I read the whole booklet and couldn't find this statement. Instead I told them I couldn't find it and then threw some other T's & C's at them that my mother followed to the letter; calling the tour operator (Cosmos) which she did and also noted that according to the FSA a firm is obligated to point out the most strict of conditions. My parents were never warned of this condition. I also was probably a bit naughty in pointing out spelling mistakes and gramatical error in the T&C's quotes I used by writing "[sic]" after the error.
So, I sent this letter to them, recorded with all supporting documents including copied pages of the T&C's I used and highlighted them. Two weeks on (yesterday) mum received another letter. The letter pointed out the location of the T&C they quoted in the 28th October letter and I realised that in the first letter, they only quoted half of the condition.
The full condition stated that before leaving, a medical certificate proving the urgency to return home AND contacting the 24 hour emergency hot line was needed in order to return. So basically, according this T&C, even if she'd have called the White Horse emergency number (which I haven't yet found in the T&C book...something so important should really be easy to find!), it still wouldn't have counted because she wouldn't have had a medical certificate. Now if the T&C said, "medical certificate OR 24 hour hot line" I'd understand but it isn't so.
How then, may I ask, when my grandfather was literally on his death bed, was my mother going to be able to obtain a medical certificate from the UK and then send it to White Horse Insurance LTD to gain the necessary permission to return, all in less than 22 hours!? This T&C seems to be an impossible fulfillment. Would you agree?
Anyway, in the same letter that gave the T&C in full, they say that they will re-look at the claim only upon the receipt of my grandfather's medical history for a full two years prior to them booking the holiday so they can check he had no history of cancer. I mean, they already received a form filled in by the doctor stating he had no prior history of cancer on his records before his autopsy.
Can these people really do this? Can they really draw this out like this? And if my mother has to pay for these records, can she bill this to White Horse Insurance LTD on top of her claim? After all, she's already paid the doctor to fill out a form in the first instance that states my grandfather has never been diagnosed with cancer.
Any help or advice before I send the next letter (with possibly the medical records) would be really great.
Many thanks in advance.
2010 wins
22" LCD TV, Cadbury's Creme Egg Keyring
22" LCD TV, Cadbury's Creme Egg Keyring
0
Comments
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My thread has been viewed 51 times and not one person has any help or advice?
Thanks for taking the time to read anyway - I know it was a very long post. Guess I'll be fighting this one alone.
Kind regards.2010 wins
22" LCD TV, Cadbury's Creme Egg Keyring0 -
Sorry I have no advice, but condolences on the loss of your grandfather.
I hope someone who does have advice will be along soon.0 -
Hi - my sympathy for all aspects of your situation. I have just browsed in.
I can only think of generic advice - if you have complained to the company and this has been rejected, then your next stop should be the Financial Ombudsman Service (FOS). It may be worth telling the company this and giving them a last chance to settle before you call FOS in.
Your line to FOS should be exactly what you've said on here - ie the policy conditions on which the claim is declined are unreasonable in principle, and/or unreasonable in your mum's particular situation, and/or so taxing that they ought to have been pointed out in the key facts, not just left in the small print.
Good luck!
Regards0 -
PS
Complaining to FOS is free for you ,but it costs the company £500 win or lose.0 -
I too am sorry for the loss of you grandfather, and for your parents loss and all the anxiety. I am aslo sorry that you had no posts prior to malaco. People are sympathetic but the posters who read are not sure they can help
so read, sympathise and move on.
I agree with Malaco. It is a good post, and good luck also.
Regards - Anniemake the most of it, we are only here for the weekend.
and we will never, ever return.0 -
Hi Brammeldi,
I'm sorry about your granddad. I was in a similar situation about a year ago when the funeral company made a complete mess of my granddads funeral. I just wanted to say to be careful to take your mum’s feelings into consideration. You are obviously doing this with the best of intentions but it really needs to be something that your mum is comfortable about otherwise it might be causing her unnecessary stress. Your post indicated that she may not be bothered?
I was very angry about my granddads funeral but I felt it was not my place to do anything or even to say that I wanted to complain – I left it to my mum to make the decision as it was her dad. In the end she did decide to complain and I helped as much as possible. The end result was successful but the journey was long and at times I wondered if it was the right decision as it detracted from what was important at times – if that makes sense.
If you want to pursue the complaint, I guess the next stage is to comply with their request and obtain the medical records. I am sure there is a maximum limit as to what can be charged for obtaining the records – maybe £50. The fact that they are asking to see them indicates that they are still willing to investigate the claim – or to appear to be doing so? If that is unsuccessful, you could always take them to small claims court.
Good luck.0 -
Hello Brammeldi
I am sorry for your loss and I do understand how critical illness/death of a parent whilst you are on holiday feels as it happened to us & we didn't get back in time to say good bye.
I have no advice to offer on the technical aspects of your claim, but I think you should continue your battle with the insurers by providing the information they have asked for as they appear to be willing to reconsider and they don't usually.
I think people wont have replied 'cos they haven't known what to say to help you. I've found posting on any forum can be a lottery until the right person passes by so don't give up using it.
Perhaps in due course you could let us know how you get on?0 -
Thank you for all your help.
We have thought about using the FOS if need be. Mum is quite happy to continue on and is willing to take it futher.
So far, at this stage (with the Christmas period) the Doctors surgery recieved the 2 year records (from the health authority) as requested and they have forwarded them to the insurance company. So far, the Doctors have not charged us a penny...so we'll see.
Now, we are just waiting for the insurance company to get back to us. I think we'll be on the phone regularly to keep a check on them.
Again, thanks to those who have responded - it's been really helpful!2010 wins
22" LCD TV, Cadbury's Creme Egg Keyring0 -
I have posted an update in the original post.2010 wins
22" LCD TV, Cadbury's Creme Egg Keyring0 -
Brammeldi.
Thank you for updating your post, it was interesting ,although to a degree sad. First and foremost sad because of the events you had to go through and from this point of view I hope time is helping you. Sadly there are no magic words to comfort you.
It is also sad, because this site has a wealth of knowledge that should have been more supportive at the time, you could have been guided a little better should we say.
I am not in the Insurance Industry, I have morals and principals.
As it happens I was not on this site at the time you first posted, I would though have tried to support you in whatever way I could have.
You state “I think maybe they paid up in the end as they didn't want it to go to an Ombudsman because it would expose their unfair T&C's” and I have to totally agree with you T&C IMO are used as tools to refute and deny valid claims day in and day out.
T&C are unbalanced and firmly in the hands of the IC’s, some are needed others T&C are just loopholes for the use of the Insurance Industry, they are immoral unethical, but not (apparently) illegal.
As indeed the whole Insurance Industry is unfair, that is why there little public confidence in Insurance products.
Well I want to finish by saying well done, it’s brilliant that you took them on your own and got a result, I wonder if you will stick around this forum now you have finished your mission?..................I hope so you no doubt have a lot to offer other people who day in day out find themselves in a similar position as you once were.
Anyway well done , and thanks, I hope all is well in the future.
ZCampaigning to recycle Insurance Policies into Toilet Paper :rotfl:
Z0
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