Travel Insurance decline to pay out....advice please

mallissaann

I wonder if anyone can advise me on this one, my mum booked us a holiday with Thomson online and had to take out travel insurance which turned out to be with Axa before she could confirm the booking. Running up to our holiday my mum was a bit poorly but kept being prescribed antibiotics over the phone by her doctor saying it was a viral infection....no problem there.
Anyway the week we were due to fly she made an appointment as she was still having problems with her chest and saw a different doctor who sent her for a chest xray immediately which resulted in her being rushed to hospital with a spontaneous pneumothorax.......her consultant at the hospital admitted her straight away and told her to forget the holiday. In her words 'if you had got on that plane you'd be dead' quite simple as that. She had to remain in hospital for just over 2 weeks being treated hence I immediately contact Thomson who told me not to panic it's covered under the insurance and advised me to cancel and claim...this I did.
After sending the medical certificate signed by her doctor and all the paperwork they required AXA have now declined (claim went in mid August they declined the claim in November) to make any refund as her doctor had said that 'Chronic Asthmsa' (which she has never been diagnosed with and 'possible COPD' again never diagnosed or even investigated could have contributed to her spontaneous pneumothorax and she had not declared any 'pre existing medical conditions'.
Obviously my first question is how can she declare conditions she's never been diagnosed with?????
Her doctor has clearly stated that this was a New Problem and that the date of onset was just 10 days before we were due to fly. Incidently I should mention this doctor had been the one prescribing her drugs over the phone and completely misdiagnosed her in the first place, thank god she did get a second opinion. The consultant at the hospital is an expert in her field of respiratory problems and she had clearly stated that they don't know what causes this particular problem and that it could of happened to anyone.
Following the conversation that Axa had with my mum today obviously we are at a loss as to what to do, they won't accept anything from the consultant and keep banging on about pre existing medical conditions that my mother has never had diagnosed. I am going to investigate myself when these conditions were apparently diagnosed, but after reading several reviews see that any appeal or complaint we put in is going to be ignored. Here's the good bit the advisor on the phone said 'of course if you had at least gone to the airport or got on the plane it would be different'!!!!! Oh so if my mother had got on the plane and died after being explicitly told it would kill her they'd pay out would they???
Yes I'm stunned at that but Thomson also said something very similar to me on the phone.
What should I do? Should I bother complaining directly to AXA or the Financial Ombudsman or even just go to watchdog with it?
Any advice would be really welcome, if this was just a couple of hundred pounds I'd leave it but this cost myself and mum £1500 each, and that's without the excursions.
Help Please!

Poppie68

Your mum needs to go back to her GP, her usual one if the one who completed the form isnt and take the letter from AXA with her. Get the GP to write out a detailed report from paperwork recieved from the hospital and a explanation of why he had put the wrong information on the original form.Also ask for copies of hospital letters and discharges to enclose.
They will maybe try and charge her, flatly refuse. If the GP isnt playing ball go through the practice manager.

luci

Once you have done the above, if Axa are still declining the claim, read the Complaints Procedure on the policy and carry it out to the letter.

Once you have exhausted all avenues with Axa you can take it to the Insurance Ombudsman.

Good luck. Axa do not have a great reputation for paying out claims.

Pollycat

Sorry to hear about your lost holiday and I hope your Mum is recovering.

I picked up on the first part of your post:

mallissaann wrote: »

I wonder if anyone can advise me on this one, my mum booked us a holiday with Thomson online and had to take out travel insurance which turned out to be with Axa before she could confirm the booking.

Is this actually true?

Whenever I've done a booking with Thomson you are given the option of taking out insurance with them, rather than 'having to' before being able to confirm the booking.

I've done a dummy booking and after choosing flights and accommodation, you get to the 'extras' page which includes optional insurance.


You have 3 option buttons:

• no insurance
• individual insurance
• individual insurance with excess waiver

If you select 'no insurance', it just takes you to the next screen (which is passenger details).

I can see how your Mum may have thought that she had no option but actually you can opt out of Thomson's insurance.

Not relevant to your situation (and probably a good job your Mum did go for it as she may have forgotten or not got round to organising seperate insurance and you'd be in a much worse situation then) but it may be worth remembering for another time.

Is it just me, or does anyone else find it shocking that a GP prescribes medication without seeing a patient?

jtr2803

Pollycat wrote: »

Is it just me, or does anyone else find it shocking that a GP prescribes medication without seeing a patient?

Not really...I know it differs depending on your location but if I fell ill today and needed to see a doctor I would be lucky if I could even get an Emergency appointment, let alone a regular one. It's a standing joke at the surgery that you need a crystal ball to figure out when you need an appointment because they book over a week in advance. Because of this, our surgery quite often does telephone consultations. If it was something serious then no, they wouldn't prescribe based on a telephone call but I have had quite a few bouts on antibiotics prescribed over the phone.

OP - Pollycat is right, you don't have to take out the providers recommended insurance, I don't as I have an annual policy.

I think your mum needs to go to the surgery and speak to the doctor.

dickydonkin

It seems this is a trait with Axa - particularly related to travel insurance.

http://www.reviewcentre.com/reviews75639.html

http://www.thisismoney.co.uk/money/experts/article-2094481/ASK-TONY-I-got-pneumonia-Axa-refused-holiday-claim.html

http://www.guardian.co.uk/money/2011/nov/25/axa-holiday-insurance-claim

http://www.telegraph.co.uk/finance/personalfinance/consumertips/jessicainvestigates/9466298/Axa-takes-a-hard-line-approach-to-the-case-of-a-stolen-laptop.html

There are many more examples and I always check all of my policies prior to purchase to ensure that AXA are not the underwriters as luci pointed out above, they have a bad reputation in respect of trying to wriggle out of paying genuine claims.

miamoo

I am really shocked by this, I thought AXA were one of the better underwriters, I need to do better research!
Which underwriters have a better reputation?

dickydonkin

miamoo wrote: »

I am really shocked by this, I thought AXA were one of the better underwriters, I need to do better research!
Which underwriters have a better reputation?

Fortis apparently have a good reputation.

tooldle

Before contacting Axa, you need to know what has been diagnosed and when.
It is not necessarily the current health problem that is the issue. Does your mum have any other health conditions that she did not mention on the application for insurance? The premium is based on their assessment of risk. I have come across similar problems with car insurance, where the claim has been refused as the customer declared only part of their previous accident history. The customer was more risky than he had lead the company to belive. Had he been truthful, he still could have otained insurance but for a far higher price.
Pre-existing health conditions can make insurance very expensive or even impossible to find.

meer53

Was the OP's mum being treated for chest problems before the insurance was taken out though ? If she was then i can sort of see why the insurers won't pay out if she didn't tell them about her treatment.

Pollycat

meer53 wrote: »

Was the OP's mum being treated for chest problems before the insurance was taken out though ? If she was then i can sort of see why the insurers won't pay out if she didn't tell them about her treatment.

I agree that the timeline is important.

From the OP's post, it does sound like the holiday was booked and then her Mum started having these specific health problems.

mallissaann wrote: »

I wonder if anyone can advise me on this one, my mum booked us a holiday with Thomson online and had to take out travel insurance which turned out to be with Axa before she could confirm the booking. Running up to our holiday my mum was a bit poorly but kept being prescribed antibiotics over the phone by her doctor saying it was a viral infection....no problem there.

Whether she had been treated for that previously and AXA are treating it as a pre-existing condition reamins to be confirmed.

I think (one of) the OP's Mum's doctor may have caused some of this:

mallissaann wrote: »

After sending the medical certificate signed by her doctor and all the paperwork they required AXA have now declined (claim went in mid August they declined the claim in November) to make any refund as her doctor had said that 'Chronic Asthmsa' (which she has never been diagnosed with and 'possible COPD' again never diagnosed or even investigated could have contributed to her spontaneous pneumothorax and she had not declared any 'pre existing medical conditions'.
Obviously my first question is how can she declare conditions she's never been diagnosed with?????
Her doctor has clearly stated that this was a New Problem and that the date of onset was just 10 days before we were due to fly. Incidently I should mention this doctor had been the one prescribing her drugs over the phone and completely misdiagnosed her in the first place, thank god she did get a second opinion. The consultant at the hospital is an expert in her field of respiratory problems and she had clearly stated that they don't know what causes this particular problem and that it could of happened to anyone.

Why would a GP filling in an insurance report say that a patient had an illness that had never been diagnosed?

It's quite confusing as the OP refers to a number of medical people.