Holiday Cancellation

thomson122

Could someone please help. I had to cancel my holiday because my mother in law was admitted to hospital on the 31st july with pneumonia and ten days later died.The holiday insurance will not pay out because she had been in hospital with a stroke and heart attack in April but was home and well for 8 weeks before she took sick again. She was not due to travel with us. Can they do this? Thanks

Tubby_Hubby

Sorry for your loss.

Unfotunately insurance companies will often try to enfore their t&c just to get out of paying.

Some years ago I had a dispute with an insurance company over holiday curtailment, they refused to pay for my partners holiday curtailment, ski pass etc when I had to be flown home early due to injury. I formally complained and when this failed then lodged a formal complaint with the ombudsman (AIB - Association of Insurance Brokers I think), as soon as the Ombudsman got involved the insurance company paid the full claim without any further issue.

Don't let them get away with it, would they be saying the same if she had been run over and killed?

Go through their formal complaints procedure then ask them for details of the ombudsman and refer the complaint to them, you've got nothing to lose. Who was the insurance company? name and shame.

thomson122

Travel plan online: They are so rude to deal with.Thanks for the reply I will contact the ombudsman. They prob would say the same if she had of been knocked down..lol

dacouch

What date did you book the holiday?

What date did you take the Insurance Policy out?

Did your MIL have any circulation eg blood pressure problems or heart problems before you took the Insurance Policy out?

Did the Stroke / Heart contribute to her death?

thomson122

Booked holiday on 21st July and took insurance out same day, she had a heart attack and stroke in April but was home for weeks and doctor put on claim form we had no reason not to travel.She was admitted again on July 31st with pneumonia not a heart attack or stroke.

dacouch

I assume you did not advise the Insurers about the heart attack / stroke.

A travel Insurer will normally exclude any claims that are connected to an existing medical condition or any of the travellers or any other person on whom the trip depends eg your MIL unless you declare the conditions to them and pay any extra premium / terms they apply. However the policy you have does not specify that you have to declare existing medical conditions for non travellers on whom the trip depends eg your MIL. (See the medical screening flow chart / declaration on page 2 of the polict wording http://www.travelplandirectinsurance.com/policydocuments/TPDPolicyDoc060709.pdf NOTE IT REFERS TO YOU AND YOUR TRAVELLING COMPANIONS, IT DOES NOT SPECIFY NON TRAVELLING PERSONS ON WHOM YOUR TRIP DEPENDS eg YOUR MIL)


They do however have an overall exclusion as follows.

GENERAL EXCLUSIONS APPLICABLE TO ALL SECTIONS OF THIS INSURANCE
This insurance does not cover:
1. claims (for You or anyone else upon whom Your Trip depends) arising directly or indirectly from:
a) travelling or acting against medical advice
b) awaiting results of tests or medical investigations
c) being on a hospital waiting list for treatment
d) having received a terminal prognosis
e) pregnancy, where the pregnancy will exceed 26 weeks by the return date of the Trip
f) anxiety, stress or depression (unless admitted as an in-patient)

So providing you MIL was not await results of tests of medical investigations or on a hospital waiting list or had received a terminal prognosis then they cannot decline the claim.

If you point the aboev out to them they will probably try and say they are declining the claim due to the heart attack / stroke being a material fact that you should have declared or that it does not cover events that could reasonably expected. These are general exclusions in most policies. However the Ombudsman is very very very likely to rule in your favour in this matter as the policy wording does not spell out that you should declare medical conditions for non travelling persons on whom the trip depends (Except the general exclusion I copied and pasted earlier).

The Insurer is Fortis who are a very good company on claims.

I would suggest you bring these points up with the Insurer and advise them you expect the claim to be paid. If they still refuse you can make an official complaint that they have to investigate properly and respond to you within a set period. Once this has been done you can then go to the ombudsman.

If you need any other advice let us know, it would be easier if you post on the Insurance Forum on MSE as other people will be able to help and other people in the future who may have a similar problem as you will find it easier to find your post and may find it helpful

thomson122

I would like to thank you so much for your time on this matter.

dacouch

No problem.

It tells you where to right an official complaint about Travel Plans here (Mark it "Official Complaint)

COMPLAINTS PROCEDURE
It is the intention to give You the best possible service but if You do have any questions or concerns about this
insurance or the handling of a claim You should in the first instance contact the Managing Director of Travellers
Protection Services Limited. The contact details are:
The Managing Director, TPS (Insurance Admin Services), PO Box 132, Leeds, LS10 9BT
Tel: 0844 412 2723 Fax: 0844 412 2723 Email: info@tpsltd.com
Please ensure Your policy number is quoted in all correspondence to assist a quick and efficient response.
In the event You remain dissatisfied and wish to make a complaint, You can do so by contacting the following:
The Head of Claims, UK Underwriting Ltd, 2 Gibraltar House, Bowcliffe Road, Leeds, LS10 1HB.
If it is not possible to reach an agreement, You have the right to make an appeal to the Financial Ombudsman
Service. This also applies if You are insured in a business capacity but have a group annual turnover of less
than £1 million, or are a charity with an annual income of less than £1 million, or are a trustee of a trust with a
net asset value of less than £1 million. You may contact the Financial Ombudsman Service at:
Financial Ombudsman Service, South Quay Plaza, 183 Marsh Wall, Docklands, London, E14 9SR. T e l :
0845 080 1800
This does not affect Your statutory rights.

Here is a link to the Ombudsman's site http://www.financial-ombudsman.org.uk/

You might find this guidance note from the ombudsman helpful if the Insurer say there must have been symptons of pneumonia when you took cover out or before you travelled

http://www.financial-ombudsman.org.uk/publications/ombudsman-news/13/jan-conditions.htm

The case at the bottom of this link may also be helpful to your case

http://www.financial-ombudsman.org.uk/publications/ombudsman-news/56/56-travel-insurance.htm

viktory

thomson122 wrote: »

Could someone please help. I had to cancel my holiday because my mother in law was admitted to hospital on the 31st july with pneumonia and ten days later died.The holiday insurance will not pay out because she had been in hospital with a stroke and heart attack in April but was home and well for 8 weeks before she took sick again. She was not due to travel with us. Can they do this? Thanks

Would an insurance company really cover you if you cancel because a relative has died? Even though they are not travelling?

dacouch

viktory wrote: »

Would an insurance company really cover you if you cancel because a relative has died? Even though they are not travelling?

Yes its a standard part of most Travel Policies.

Here is the relevant part of the Policy the OP has

SECTION 4 – LOSS OF DEPOSIT, CANCELLATION OR CURTAILMENT
We will pay up to the appropriate amount stated in the Schedule of Cover in the event that You shall sustain pecuniary loss in
respect of:
i. irrecoverable deposits, payments and contractual obligations including those for pre-paid excursions and unused travel and
accommodation, for which You contracted prior to the commencement of the Holiday, and
ii. additional accommodation and additional costs of returning to Home
where the Holiday is necessarily and unavoidably cancelled or Curtailed due to:
a. the death, injury or illness as certified by a registered medical practitioner of:
i. You, the Insured Person, or
ii. the person with whom You are travelling or had arranged to travel, or
iii. Your Close Relative or Close Business Colleague or that of the person with whom You are travelling or had arranged to
travel,

Here is there definition of a "Close Relative"

Close Relative – Means Your spouse, partner, fianc!(e), parent, parent-in-law, step-parent, son, son-in-law, step-son, daughter, daughterin-
law, step-daughter, grandparent, grandson, granddaughter, brother, brother-in-law, step-brother, sister, sister-in-law or step-sister

P.S Its an awful policy to read, its very poorly laid out, I can easily understand policies but this one is truely awful. The surprising thing is the normal Fortis policy is really easy to read and understand

thomson122

dacouch I wish you lived next door to me then I could get you to deal with this all for me.