Pre-existing nightmare

dunstonh

We are currently awaiting the decision of the Ombudsman but to be honest I dont think we will get a favourable result.

The guidelines to which the FOS work on with non disclosure are published so you should be able to more or less work out for yourself what the outcome will be.

pedro123456

• claims arising directly or indirectly as a result of a pre-existing medical condition relating to you, your travelling companion, a relative or close business associateof yours, or the person with whom you have arranged to stay whilst on the trip, relating to
No mention of the cat, rabbit, hamster or budgie?

It's about time this travel policy was reviewed.

It's cases like this (and thousands more) when it is obviouse that T&C are unbalanced in favour of the IC's, its ironic that they can just stick a T&C in the small print and that T&c is accepted.and then individuals will say "well didn't you read your policy, well more fool you" or "well if you haven't read the T&C it your fault".........hows that work, most T&C shouldn't even be allowed in there in the first place!!!!

I undestand that T&C are ,to a degree needed, but they should be drawn up, agreed and accepted by all parties not just implimented to protect the financial interest of the IC's.

They should be challenged in a court of law, and IC should be informed that they cant just please themselves. or write extra in the small print to aid loopholes for their own ends.

Pete

cogito

I have every sympathy with nco41 whose claim should be paid in these circumstances. This is the sort of scenario that gives insurers a bad name.

On the other hand, if the insurers had been provided with information they consider to be material, the chances are that they would have issued cover but excluding anything relating to the mother's heart condition. Would nco41 have accepted the policy on these terms? Who knows but the chances are that (s)he would have regarded the risk as negligible and accepted the policy. Looked at in that light, (s)he's no worse off.

nco41

Mikeyorks wrote: »

Increasingly you do. You have to tell them about the health of anyone upon whom your trip relies. If you dont know then you either find out ... or they can't be 'close' enough that you would cancel because of them? I got very close to a similar issue with the death of my Mother last year. Some policies also exclude cancellation if you take out the insurance after the holiday confirmation is issued!

If you booked the insurance by phone ..... they must have sent the policy to you. This is an extract from my current Travel policy ... and covers the aspect you're concerned about :


What you are not covered for (Cancellation & Curtailment) :
The insurer will not pay for the following
• claims arising directly or indirectly as a result of a pre-existing medical condition relating to you, your travelling companion, a relative or close business associateof yours, or the person with whom you have arranged to stay whilst on the trip, relating to:
a) any pre-existing medical condition which would require you to answer yes to the Medical ScreeningQuestions, unless declared to and accepted by us



The Ombudsman may be sympathetic in the light of the 20 elapsed years .... but I'm afraid it's far from clear cut.

Thanks all of you for your kind words and advise.they have been a great help. just to answer your questions.
I was 11 when mum had her heart attack
I never received a written copy of the T+C of the policy
They never asked me or advised me about the health of non travelling family members.If they had i would of told them about my 84 year old father as well as mum.
To all of you who have suffered in the same way my heart goes out to you.
I will keep you posted.
Thanks once again
Nco Xx

nco41

dacouch wrote: »

I agree with Dunstonh, I have been reading the Ombudsmans rulings on these types of cases and he seems to deal with each case indivually. It seems to hinge on how clearly the Insurer pointed out the importance of declaring the PEMC. How aware the OP would have been of the PEMC and how relevant the PEMC was to the actual claim.

So the simple answer is to go through the executive complaint route with the IC and then going to the Ombudsman. Bear in mind the ombudsman can take a long time to deal with claims.

The other option would be to go to one of the newspaper financial problem solving columns such as Jessica at the Telegraph, they can be very successful as when the media are involved companies often back down (Note these tend not to get involved if the case is being looked into by the Ombudsman)

What may help your case is doing a test quote with the IC for a similar holiday and then declare the heart attack 20 years ago to find out if the IC would offer cover and under what terms. Keep records of this as it might be helpful to the ombudsman.

Thanks for the advise,
I have made a dummy insurance application over the phone with the IC they accepted my application and once again they did not say anything about pemc of non travelling family members. I informed the IC of this and they pratically accused me of lying.Telling me that all their staff are fully trained and follow a set guideline when processing telephone applications.
I have not had any contact with IC since then.In case they think im some bitter bunny boiler.
I think i will have to go down the ombudsman route.
Thanks for your help

nco41

pedro123456 wrote: »

• claims arising directly or indirectly as a result of a pre-existing medical condition relating to you, your travelling companion, a relative or close business associateof yours, or the person with whom you have arranged to stay whilst on the trip, relating to
No mention of the cat, rabbit, hamster or budgie?

It's about time this travel policy was reviewed.

It's cases like this (and thousands more) when it is obviouse that T&C are unbalanced in favour of the IC's, its ironic that they can just stick a T&C in the small print and that T&c is accepted.and then individuals will say "well didn't you read your policy, well more fool you" or "well if you haven't read the T&C it your fault".........hows that work, most T&C shouldn't even be allowed in there in the first place!!!!

I undestand that T&C are ,to a degree needed, but they should be drawn up, agreed and accepted by all parties not just implimented to protect the financial interest of the IC's.

They should be challenged in a court of law, and IC should be informed that they cant just please themselves. or write extra in the small print to aid loopholes for their own ends.

Pete

Thanks Pedro,
My problem also with the IC is they never sent me a written copy of their terms and conditions! So they are quoting me their policy that i have never seen or been informed about.
I agree with you something needs to be done about insurers small print. I bet if you opened a thread on her and asked members to post bad iinsurance experiences they system would crash!!
Maybe it could be Martins new challenge when he finally wins against the banks?
Go Martin!!

nco41

Thanks for you reply and advise.
I have done all i can with the IC so now its on to the next step.
I am more miffed at the fact that i had my claim turned down for non disclosure. I could not fail to disclose something i was not asked about or knew about.If they had asked me about family health and i had failed to disclose then fair enough. But im not a mind reader so how am i susposed to know!!
I just want this whole situation sorted its very stressfull and up setting to have to keep on going on about it.
The holiday to Egypt was susposed to be to mark my 40th.I had booked a balloon flight over the Nile for the children and I for the morning of my birthday.Instead i was about to bury my mum. In fact she was burried the next day. Sometimes life can be so cruel.:mad:

:AMum

nco41

:beer: For your reply.
Where will i find out the Ombudsmans criteria for non-disclosure of pre existing medical conditions?
I might be worth me seeing what my chances are before i go to them.I dont want to waste their time if i have no chance and its alot more worry for nothing.
Thanks for the idea and advise

nco41

scouselad1974 wrote: »

Hi

First of all I am so sorry for the loss of your Mum and I understand exactley what you are going through.
18 months ago my Dad suffered a brain haemmorage while on holiday in Spain and I had to travel out to be with him as it was touch and go, anyway he pulled through and I brought him home two weeks later.
After 2 weeks of admission to a private hospital my Dads insurance company decided to not validate the policy, due to him ticking the wrong box on an online application, he ticked a box to say he was a non smoker when he should of ticked the box that said he was a non smoker who had given up over 20 years ago, he also did not declare another pre exsisting condition as there was confusion at the time as his GP had told him he no longer had the condition and had stopped all treatment for it, my Dad didn't realise he still had to declare it.
We are currently awaiting the decision of the Ombudsman but to be honest I dont think we will get a favourable result.
I would deffinatley advise you to go down the Ombudsman route even If you don't think you can win the case, otherwise the isurance companies can get away with murder.
People who make genuine mistakes should not be treated like criminals, especially if they have been a regular customer in the past.

Thank you for your message.:think::think:
I hope your father has made a good recovery and is back to full health now?
I do hope that the omdudsman finds in your favour.A mistake is a mistake.We are all human and these things happen.Are the insurance company saying that they are imortal and never make mistakes?
We are treated as crimals for attempting to make what we think are ligitimate claims,but Insurance companies are allowed to take our hard earned money with the intension of never paying out.
Its like they say AT LEAST !!!!!! TURPIN WORE A MASK WHEN HE ROBBED YOU.!!!
Good luck with every thing.:hello:
Please keep me posted as to how you get on.
Nco.Xx

scouselad1974

nco41 wrote: »

Thank you for your message.:think::think:
I hope your father has made a good recovery and is back to full health now?
I do hope that the omdudsman finds in your favour.A mistake is a mistake.We are all human and these things happen.Are the insurance company saying that they are imortal and never make mistakes?
We are treated as crimals for attempting to make what we think are ligitimate claims,but Insurance companies are allowed to take our hard earned money with the intension of never paying out.
Its like they say AT LEAST !!!!!! TURPIN WORE A MASK WHEN HE ROBBED YOU.!!!
Good luck with every thing.:hello:
Please keep me posted as to how you get on.
Nco.Xx

Hi

Thanks for your comment, my Dad recovered quite well but has since suffered from a heart attack, luckily he is making good progress.
I won't go into to much detail but his insurance company treated him terribly, fair enough he made a simple mistake, I should never of let him fill the application form in online as he was new to the whole web thing, but he did travel with this company previously and he had declared the condition that he missed off many times before, so it wasn't as if the insurance company didn't know about the condition.
Anyway some people will say it was his own fault and it's a lesson learnt, but the fact of the matter is the way in which the insurance company dealt with the whole matter, for example my dad had just recovered form a haemmorage and they called him in hospital on the phone next to his bed to say that the claim was denied, even though they had been told to contact a member of the family as Dad still really wasn't with it.
You can only imagine what the shock of the call could of done to him and I seen it with my own eyes.
They have admitted to errors on their side of things and offered us compensation, we replied to say that we were willing to consider it and how much would they be offering, we where then told we can't tell you until you have accepted it as a full and final offer, now come on who in their right mind would accept an offer like that.
It's no longer about the cost involved, we have taken out a loan and we are slowly paying everything back, the hospital bill was over 10k and that is without all of the costs involved, ie flights, accomadation etc, it's now about not letting them think they can treat elderly people like scum, even if we get nothing at least we put up a fight.