Help!!! Need to know if I can make a claim on my Travel Insurance!!

dacouch

What is not covered:
Exclusions Applying To Section A, B & C
1.
2.
(i)
(ii)
3.
4.
5.
6.




No compensation will be payable:
under more than one of items 1,2 or 3 and on payment of a
claim under any one of these items all liability under this
Section will cease in so far as YOU are concerned
Claims arising from:
All pre-existing medical conditions or if YOU are awaiting or
undergoing treatment or YOU are undergoing or awaiting any
medical investigations or consultation with a specialist or
awaiting diagnosis or test results or (please refer to the Pre-
Existing Medical Conditions) Any condition that could
reasonably require Medical Treatment during the Period of
Insurance.
Travel arrangements made or undertaken:
against the advice of any Registered Medical Practitioner
for the purpose of obtaining medical treatment abroad
YOUR intentional self-injury or suicide or attempted suicide or
wilful exposure to needless risk (except in the attempt to save
a human life)
the influence of intoxicating liquor or of a drug or drugs (unless
prescribed by a Registered Medical Practitioner), or
substance or solvent abuse or venereal disease
emotional, psychological or psychiatric disorder, or whilst
suffering from any condition of anxiety, stress or depression
unless same results in admission to a hospital as an in-patient
and is not a pre-existing condition (please refer to the Pre-
Existing Medical Conditions)

http://www.insurewithease.com/travel-insurance/Downloads/IWEBronzePolicyWording2009.pdf (Page 6)

The above exclusions are not very clear but appear to relate to the travellers on the policy not the non travellers. It's not worded very clearly, where a policy wording is not worded clearly if it goes to the Ombudsman he tends to use an interpretation that is best for the policyholder.

There is an overall exclusion about the miss use of drugs HOWEVER that applies to the travellers not the close relatives not travelling.

There is (As do all Travel Policies) have an exclusion for any existing medical conditions for people travelling or non travelling close family on whom the trip depends eg your brother. Assuming your brothers problem is not deemed an existing condition (Prior to you booking / taking cover) then this exclusion should not apply

Put a claim in and see how it goes, there is a chance they may initially refuse the claim, however it would appear you would have a good arguement for having it paid. If it went to the Ombudsman (This takes a long time) then there is a reasonable chance he will rule in your favour

nicki2626

Incapuppy wrote: »

You wouldn't be able to obtain insurance for something that has already happened, never mind getting as far as a fraudulent claim.

Incapuppy - I know that I can't put in a claim for something that has already happened - I acknowledged that. I just wanted to know if there was an insurer who did cover mental illness or solvent abuse - that's all

dacouch wrote: »

What is not covered:
Exclusions Applying To Section A, B & C
1.
2.
(i)
(ii)
3.
4.
5.
6.




No compensation will be payable:
under more than one of items 1,2 or 3 and on payment of a
claim under any one of these items all liability under this
Section will cease in so far as YOU are concerned
Claims arising from...................................

Dacouch - thank you so much for doing that - makes it so more easier for me to read - your efforts have been truly appreciated with this matter, and I'm extremely grateful for your time.

I will let you know how it develops as and when.

But sincere thanks for all the advice.

Nicki

dacouch

You could always give the Ombudsman a quick call before you put your claim in, they answer telephone queries pretty quckly (Formal complaints take many months). They are very approachable and will be more than happy to give you some guidance which you may find helpful etc http://www.financial-ombudsman.org.uk/contact/index.html

The Ombudsman tends to err on the customers side especially if the wording in a policy is ambiguous or if he feels its unfair.

Here are guidance notes from the Ombudsman on Cancellation / Existing Medical Conditions for non travelling family

[FONT=Verdana, Arial, Helvetica, sans-serif]cancellation
There are many reasons for cancelling a holiday. All policies cover cancellation due to the accidental injury, illness or death of the policyholder or other closely connected person, but there are many exclusions. One of the main causes of dispute is the exclusion for any existing medical condition or for a condition about which the consumer has seen a doctor before buying the insurance. We frequently receive complaints from policyholders who have interpreted this as meaning that only illnesses that have been diagnosed are excluded. However, the standard exclusion applies to all medical conditions, regardless of whether the policyholder’s doctor has identified the cause of the problem. The only exception would be illnesses where an incorrect diagnosis has been made and the true cause is only determined after the claimant has bought both holiday and insurance. [/FONT]

[FONT=Verdana, Arial, Helvetica, sans-serif]Where the person who is ill is not the policyholder but a family member, or someone with whom the policyholder was planning to travel, the exclusion for pre-existing medical conditions may be more onerous. Most of us do not have full details of other people’s medical history. When investigating complaints of this type, a detailed enquiry may be required to establish both the precise state of health of the person concerned and also what the policyholder should reasonably be taken to have known. [/FONT]

[FONT=Verdana, Arial, Helvetica, sans-serif]Policies normally also include cover for cancellation due to missed departures, although the cover provided is strictly limited. Cancellation due to a disinclination to travel because of a change in personal circumstances – such as the end of a romance – will not normally give rise to a valid claim. Only a truly unforeseen cause will fall within the policy cover.[/FONT]

http://www.financial-ombudsman.org.uk/publications/ombudsman-news/7/july-travel.htm

nicki2626

dacouch wrote: »

You could always give the Ombudsman a quick call before you put your claim in, they answer telephone queries pretty quickly (Formal complaints take many months). They are very approachable and will be more than happy to give you some guidance which you may find helpful etc ..............................

dacouch - thank you again.

I cannot express how much this information is helping and your efforts are sincerely appreciated.

I have passed everything over to my dad who is sorting it out - as it is his policy that needs to be checked.

But a massive thank you, sincerely, for all the information you have provided!

It makes forums like this worthwhile visiting! (Martin would be proud!)

Many Thanks!

Nicki :T

stephb34

nicki2626 wrote: »

dacouch - thank you again.

I cannot express how much this information is helping and your efforts are sincerely appreciated.

I have passed everything over to my dad who is sorting it out - as it is his policy that needs to be checked.

But a massive thank you, sincerely, for all the information you have provided!

It makes forums like this worthwhile visiting! (Martin would be proud!)

Many Thanks!

Nicki :T

I too think its great that so many people are willing to be so helpful for no financial gain just the satisfaction of being able to help and hopefully what goes round comes round.
ps can anyone tell me how to insert an icon in the text only everytime i try it goes in the title box!!!

nicki2626

dacouch wrote: »

You could always give the Ombudsman a quick call before you put your claim in, they answer telephone queries pretty quickly (Formal complaints take many months). They are very approachable and will be more than happy to give you some guidance which you may find helpful etc .................

dacouch - just a quick update.

My dad has just phoned the ombudsman and they have said that they cannot advise him nor guide him with our situation until he has made a claim.

Is there a specific number we have to call? As it appears they couldn't or wouldn't help us.

He's literally been on the phone for 5 mins, explaining everything, and then told he can't be helped by them.

Many thanks!

dacouch

They normally give you some friendly pointers on the claim.

If they cannot help just put the claim in and let things take the course, please make sure you photocopy all the documents you submit and preferably send them by recorded post. Make sure you keep a diary of all calls and what was said along with a note of the persons name and date / time.

If they do refuse the claim then the next course of action is an official complaint (It explains how to do this in your policy), they have to deal with this with a certain amount of time and investigate it properly. If they still deny the claim then you can then ask the Ombudsman to make a ruling.

I would not worry to much at the moment as their policy wording is not that precise so there is a good chance they will pay it.

nicki2626

dacouch wrote: »

They normally give you some friendly pointers on the claim.

If they cannot help just put the claim in and let things take the course, please make sure you photocopy all the documents you submit and preferably send them by recorded post.............................QUOTE]

dacouch - yet again I really appreciate your advice.

Will again pass this onto my dad and hopefully he will have a positive response from either party.

Truly appreciate advice!! :T :T :T :T

Thanks!

Nicki

richardw

What a complicated situation, but perhaps the chances of a payout relating to the cannabis user are nil, consider doing a claim where all the boxes are likely to be ticked by the assessor.

nicki2626

richardw wrote: »

What a complicated situation, but perhaps the chances of a payout relating to the cannabis user are nil, consider doing a claim where all the boxes are likely to be ticked by the assessor.

richardw - I think it all depends on the doctors and what they declare as being the catalyst for his breakdown.

At the moment, from testing etc. it looks like the drugs only part affected his behaviour and that it was stress/emotional induced breakdown.

But we shall wait and see.

They have sent the claim forms through anyway.

Thanks for all the advice - all round!

:T :T :T :T :T :T

Nicki