AXA improperly rejecting travel insurance claim - draft complaint letter

Tirian

Following a protracted dispute with "AXA Claims Assistance" regarding a recent claim on our Co-op bank packaged Worldwide Travel Insurance policy, I appear to have reached an impasse. They maintain that travel delay is only covered for international journeys. I maintain that their policy wording specifically includes UK domestic sea-crossings and flights. Here is my draft letter to their complaints department ... any comments/tips before I hit send?

To whom it may concern:

I am writing to express my extreme dissatisfaction with the handling of our claim (ref: XXXXXXX) in respect of travel delay on our recent holiday in Colonsay, under our Co-operative Bank provided “Worldwide Travel Insurance” policy.

We have repeatedly been told that the claim is being rejected on the basis that we did not travel internationally, and that as such the journey is not covered under the travel delay section of our policy.

I would like to point out in the first instance that the Key Facts section of the policy refers throughout to “worldwide” travel and makes no reference to any exclusion for non-international travel other than that there must be two days accommodation pre-booked – which was in fact the case in this instance (we had seven days accommodation booked on the Colonsay estate).
Moreover, the wording of the policy in Section Delayed departure, which has been quoted to us as the grounds for rejecting our claim, in fact clearly indicates the opposite - that our journey is indeed covered under the policy. I quote this section below for reference:

What IS Covered

If you have arrived at the terminal and have checked-in, or attempted to check in for your pre-booked flight, sea crossing, international coach or international train journey from or to the United Kingdom, and it is delayed for more than 12 hours beyond the intended departure time as a direct result of:

1 strike or industrial action, or
2 adverse weather conditions, or
3 mechanical breakdown of or a technical fault occurring in the scheduled public transport on which you are booked to travel.

We arrived and attempted to check in at the Colonsay ferry terminal. We had a pre-booked sea crossing. Colonsay is in the United Kingdom, and as such the journey was from the United Kingdom. Oban is also in the United Kingdom, and as such the journey was also to the United Kingdom. The sea crossing was delayed by approximately 24 hours as a result of adverse weather conditions.
There is therefore no part of these conditions which our journey does not fulfil. In fact, while it is specified that only international coach or international train journeys qualify, no such qualification is applied to flights or sea-crossings. Furthermore, nowhere in this section is it specified that it is necessary to leave the United Kingdom – only that the origin (“from”) or destination (“to”) of the journey must be in the United Kingdom.

The only rational interpretation of this wording, especially in the light of the policy as a whole which sets out clear conditions for qualifying travel within the UK (minimum two nights pre-booked accommodation - which our journey also met) is that delay to UK domestic flights and sea crossings are indeed covered. What would not be covered under this wording, would be a flight or sea crossing that does not include the United Kingdom as the departure or destination point (for example, a flight from Paris to Frankfurt).

If you do not wish to cover journeys such as ours in future, then I can only suggest that you update the wording of your policy to reflect that. However it is abundantly clear under the terms of the policy which you have provided to us, that our claim is valid.

I would also like to take this opportunity to express my disappointment with the way in which our claim has been handled throughout. After first attempting to reject the claim on this basis, we were next informed, without further contact from AXA, that our claim was now to be rejected on the grounds we did not have two nights pre-booked accommodation – without anyone even enquiring whether or not this was the case.

If there was any doubt over this matter, a simple query could have cleared the matter up – and any additional documentation needed could have been asked for. Instead, an approach was taken that appears very much to suggest that far from providing assistance, “AXA Claims Assistance” are simply looking for grounds on which to reject claims without making any effort to establish whether or not they have any basis. I find this a very troubling attitude, and certainly not one that I would view as consistent with Treating Customers Fairly.

I am sorry to say that when Co-Op ask me again about the value of the various elements of my packaged bank account, I will have to rate AXA’s travel insurance offer as extremely poor value.

I look forward to your swift reply, and trust that you will resolve this quickly and spare us both the trouble of arbitration by the Financial Ombudsman Service.

Yours sincerely,

XXXXXX

InsideInsurance

Before writing the formal complaint I would have asked them to explicitly highlight which text they are stating means it only covers international journeys/ excludes UK only journeys

Tirian wrote: »

If you have arrived at the terminal and have checked-in, or attempted to check in for your pre-booked flight, sea crossing, international coach or international train journey from or to the United Kingdom, and it is delayed for more than 12 hours beyond the intended departure time as a direct result of:

My guess would be that they are possibly relying on the word "or" where as in your case, as you have highlighted, the correct word would be "and". If this is the case then I would remove the whole part that your arrival port was also in the UK and rely on the fact you have met the first condition that the departure was from a UK port.

Evidently if they are relying on another part of the wording it would be necessary to see that before commenting.

Tirian

If you define something as "A or B" then it may be A, or it may be B, or it may A and B. The only thing that is definitively excluded is "not A and not B". (I studied logic in both maths and philosophy, and this is the foundation of all logic!!)

I have repeatedly asked them which part of the wording excludes our journey, and they have so far just quoted this entire section (highlighting the words "from or to the United Kingdom), and said that because I haven't travelled outside the United Kingdom, it isn't covered.

I have replied that it doesn't say anywhere in the section that it is required to travel outside the United Kingdom.

Tirian

For further illustration ... if there was delay caused by both strike action and adverse weather, would that be reasonable grounds to reject a claim?

They also specify "or" for these conditions - but it's obvious that if they all apply, then that doesn't suddenly disqualify the claim.

Recalling the conversations I've had with them, they may be relying more on the words "to" and "from" meaning that you must be coming from or going to somewhere that is not the United Kingdom. But given that they don't actually specify that, and that they do specifically qualify the rail and coach journeys as having to be "international" then I don't think they can realistically argue this - especially given the context of the general terms of the policy, which set out criteria for qualifying domestic travel.

If they don't want any domestic travel to qualify for travel delay, it would be a very simple matter to express that clearly - by saying exactly that. You would also expect it to be noted as an exclusion under Section D exclusions in the Key Facts. It is not - the only exclusion noted here is "Strike, industrial action or air traffic control delay publicly declared."

Quentin

Even if they do want to argue that, once you have received their final reply to your complaint you can then escalate it (free of charge to you, but at great expense to Axa) to the FOS for their ruling.

If you read up on axa here and on the net you will see they are not the quickest to agree to pay out on claims!

InsideInsurance

I am somewhat clutching at straws as to their possible interpretation having not read the whole policy book but certainly concede to your point

Tirian

Well, I kind of assumed that most people wouldn't really want to read the whole policy document .. but it's here if you want to!

Tirian

Quentin wrote: »

Even if they do want to argue that, once you have received their final reply to your complaint you can then escalate it (free of charge to you, but at great expense to Axa) to the FOS for their ruling.

You'll note that I do appeal to them to avoid my having to escalate to FOS in my final para ....

Quentin

The trouble with axa is that they don't seem bothered about making their customers go "all the way"

_Andy_

I would amend then letter - it needs to end with a clear, specific instruction as to what you want done to resolve the matter. At the moment it's rather vague.

Tirian

Uh ... I want them to pay the claim? What else would I want?

But no harm in spelling it out I suppose .. last para amended to :

I look forward to your swift reply, and trust that you will resolve this quickly by meeting your liability under this policy by paying our claim, and spare us both the trouble of arbitration by the Financial Ombudsman Service.