Travel Insurance claim advice needed

panavia

Hi..
Could anyone please offer me any advice, on a matter of Travel Insurance company refusing to pay out for cancellation.

Unfortunately my dad passed away 3rd Oct(suddenly ..heart attack)....My sister had a holiday booked, which started 7th Oct. Obviously she cancelled the holiday, due to my dad passing away.

She informed the Insurance company, who sent out a form requesting all my dads medical details, etc, they wanted to know things like.."was she with him when he died!!"...
When she spoke to them asking why they needed all his details, they asked if he had any health problems previously...well he had done, but had been fine for 5 years, and as far as we knew..was not at risk of dying!

Basically the company are refusing to pay her holiday costs back to her, as he had had a stroke 5 years previously...surely this can't be correct!!!

If this is the case, what is the point of anybody having cancellation insurance!!! I am sure there are many people who have someone in the family,, that has been ill at some time...so basically if they die..and you have to cancel...its tough luck!!

Personally I think it's totally wrong... she has cancelled because she lost her dad, and had to stay home to attend the funeral...and all the other obvious reasons...How dare they use my dads health as a get out clause..
I am furious..a.nd would also like to make others aware of this...as basically it could be you it happens to..and you will get fobbed off too.

Sorry to rant.. but I can't see how they can get away with this... and would love any feedback, on what she can possibly do to take the matter further.

Thanks in advance.

clear_blu

Obvious question...............has she got the refusal and the grounds for same in writing.
If not then ask for that...........then ask the company to reconsider her claim.
If still no joy then write to the chief executive laying out the facts and asking they he/she can help.
I dont think that the reason for refusal is valid but there may be more than meets the eye.

paulboy83

Without wanting to pry into any past medical history I can say if your father passed away because of the previous condition or something related to that it will be in the policy wording stating its not covered. If its unrelated you certainly have case to take it further.

That said I would certainly reccomend following the insurers complaints procedure as that is the first step once a claim has been declined to dispute it. There should be full details on the policy wording supplied with the insurance, if that does not get you anywhere and you are still not happy with the conclusion you can take it to the ombudsman who will look independently at the case and the insurer will have to abide by their decision.

courtjester

It does sound like so far you have only had a verbal indication of declining the claim....? It is essential that any repudiation is provided in writing by the insurers giving full details of the terms that the insurance company is relying upon to turn the claim down.

Most travel insurances have conditions which say you must declare any material facts about your health before travelling - this is generally so that if you have a condition which could give rise to a claim whilst on holiday, the insurers have the right to refuse to offer cover or (normally) cover the condition subject to medical advice or extra premium.

Although these terms essentially apply to the person travelling, most policies would have similar (but less onerous) terms saying that you need to declare any material fact about the health of persons upon whom the commencement of the holiday is dependent.

But this can't be interpreted to mean that you have to provide a list of all your family members with detailed medical information and history. Common sense tells you that it should relate to obvious problems such as someone who has been hospitalised with a potentially life threatening condition which may worsen during or before the holiday. You can't be expected to have a crystal ball knowledge of any illness or sudden condition which may befall any member of the failiy - that would give the insurers unlimited rights to turn down any claim for cancellation.

Generally, if you have a family member with a terminal prognosis prior to the holiday, this would be something that would have to be declared if the cancellation cover were to be granted based on their death.

To be effective, the insurers would have to demonstrate that the reason for declining the claim was material to the policy - in this case, an unforeseen heart attack is hardly something you could have anticipated and I fail to see how the insurers could justify not paying on this alone. They must have reasonable grounds to allege that the person's health was such that a cancellation might be necessary or likely and hence warrants a notification to them at the time of taking out the policy (which is the key date of your knowledge).