Insrnce won't pay partner's half of hol cancelled cuz my Dad died: Ombudsman?

chog24

Last September, my partner and I booked a last minute-ish holiday (we booked 3 weeks before we were due to travel). I already had travel insurance, but we realised a week or so before we were due to leave that my partner's had expired and so we had to buy some for her after we booked but before we travelled. We'd been trying to get away for a holiday for the whole of the summer, but things kept getting in the way and we weren't able to go until late in the Summer. It had been a busy, stressful year and we both needed the break.

Shortly before we booked the holiday, my Dad told me he had prostate cancer, but he went to great lengths to explain that he was in remission and that the therapy he was on was effective and there was nothing to worry about. Of course we did our research on the web into the prognosis for prostate cancer and we were reassured when we found that the prognosis for hormone therapies for this type of cancer were good and that most patients lived for five years or more. We'd had such a stressful year and were so in need of a holiday that we didn't see Dad's news as a reason not to book a week away. However, the night before we were due to fly, we found out that he had died.

My travel insurance payed out pretty swiftly (although they felt that the death certificate wasn't enough and insisted on my getting Dad's GP to fill out a form which revealed that his diagnosis had been terminal and the care he was receiving was palliative, which was pretty painful to find out).

My partner's insurance, however, has refused to pay out, stating that her insurance didn't cover our cancellation because we knew my Dad had cancer. We have pointed out several times that, to our knowledge at the time, he was in remission and his prognosis was good, but they've still refused to pay out.

There are several things affecting this which make me think that perhaps they're not treating us fairly:

1. Our travel insurances were with the same company (TopDog Insurance) although the policies, it turns out, were slightly different, having been bought at different times.

2. We are a co-habiting same-sex couple, although we are not civil partnered. I feel this is relevant because the clause which the company kept pointing out said that the policy would pay out if a close relative dies or "if cancellation was unavoidable". Although we accept that my Dad is not my partner's close relative, we both think it's pretty unthinkable that my partner would continue with her holiday leaving me at home to deal with the death, funeral and grieving process on my own, and that this itself made cancellation unavoidable. It makes me wonder - if we were husband and wife - whether this process might have been smoother.

3. They have repeatedly pointed out the clause that talks about the insurance not being valid if the cancellation results "directly or indirectly from any medical condition you knew about before the policy was started that affects [...] a close relative who is not traveling". So they seem to be ignoring the fact that we were unaware of the extent of Dad's illness.

4. The company are making an assumption that I knew my Dad would have had treatment in the 90 days prior to my purchasing the policy. This is an unfair assumption as we cannot know whether he needed treatment in that 90 day period unless he had told us (he had told us that he was in remission and received the hormone treatment in April/May which is more than 90 days before the purchase of the policy.

I'm aware that even though it's ten months ago, my judgement is still coloured by my grief and I'm probably not thinking as clearly as I might be under other circumstances. I feel as though we're being victimised and that the insurance company are being unreasonable, but I know that might be my anger and grief at my Dad's death talking.

We have received the insurance company's final written judgement (after their appeals process). Should we now take this to the Ombudsman or is that process just likely to bring us more hassle and stress?

Thanks in advance.

InsideInsurance

First of all, sorry for your loss.

At the end of the day, other than filling in a form and then having to wait for up to a year, there is little to lose by going to the ombudsman given it doesnt cost you anything.

That said, in all honesty I wouldn't rate your prospects particularly highly because there is a clear term about pre-existing and no matter what the prognosis the condition was pre-existing.

Looking at the last prior and current policies on their website I see they have both switched underwriter for the policy and also who the claims administrators are which probably would explain the difference in approach taken. This is perfectly legitimate and just because they have given you a goodwill payment they are under no obligation to do the same to your partner.