WARNING Staysure Holiday Insurance MUST register EVERY new condition since start!

vaio

To me the idea of a continuous requirement to disclose medical issues after the policy is taken out is alien to the concept of insurance as the policy holder never has any certainty about what is covered.

If I take out a policy then I expect it to cover me against the effects of medical things for the life of the policy based on my history correctly disclosed when the policy was taken out/renewed.

To my mind the FOS agrees

.....Mr K had an ongoing travel policy that his bank had provided, free of charge, as one of the benefits of his current account. Under the terms of the insurance, the cover remained in operation as long as he retained the account.

In October 2006, Mr K and his wife booked to go on a cruise, departing early in the New Year. A few weeks after making the booking, Mr K suffered a temporary loss of vision and was referred to a specialist. Mr K's vision had returned to normal by the time of his consultation with the specialist, but she suspected that he might have had a minor stroke.

She therefore made a small adjustment to the medication he had been taking since he had suffered a blocked artery and heart attack four years earlier.

Mr K had no further problems with his vision and appeared to be in good health when he and his wife set off on the cruise towards the end of January. However, several days before the end of their holiday, Mr K had a heart attack.

Once he had returned home and his condition had stabilised, his wife submitted a claim under their travel policy for the expenses they had incurred while away - as a result of his illness. To the couple's dismay, the insurer said it was unable to accept the claim. It pointed out that the policy contained a condition requiring policyholders to report any changes in their health. Mr K had not reported the loss of vision he had experienced after booking the cruise.

The couple disputed the insurer's decision. They considered that they had complied with the policy condition requiring them to declare health changes. This was because they had sent the insurer full details shortly after Mr K had suffered his first heart attack in 2001. They said that since Mr K had very quickly recovered from the temporary loss of vision, they had not thought it sufficiently significant to be worth mentioning.

complaint upheld

We looked closely at the policy condition cited by the insurer when it rejected the claim. We also examined the overall effect of the way in which the insurer applied this condition. The insurer told us it required policyholders to report all changes of health. Depending on the individual case, it would then consider whether or not to withdraw cover for any claims arising from that new medical condition.

The insurer said that because many apparently minor ailments or problems could be symptoms of a serious condition, it was impractical to provide policyholders with guidance about how significant a change in health needed to be before it should be reported.

In our view, this approach meant that the policy condition was a very onerous one. Requiring policyholders to contact their insurer every time they suffered any kind of ill-health placed a heavy responsibility on them. It also meant that policyholders could never be certain exactly what cover was available under the policy. If, each time a policyholder experienced any change in their health, the insurer could simply withdraw cover, it was difficult to see how a claim for ill-health could ever be made, unless the illness arose entirely without warning or as a result of an accident.

We noted that the insurer had agreed at the outset to offer cover against the risk of ill-health affecting a policyholder's travel plans. So Mr K was relying on the policy for the peace of mind of knowing he was covered for any financial loss he might incur if he was taken ill after booking a holiday.

We do not consider it fair for an insurer to use a policy condition to achieve an effect that would not be apparent to a reasonable policyholder, and that would place onerous demands on them.

If claims resulting from a change in health are not covered, then the benefit of the cancellation cover is severely limited. So we did not consider in this case that the insurer was entitled to rely on its policy condition to reject Mr K's medical expenses claim. We upheld the complaint.....

alexandr

I also found the following extract within the 70 page policy pdf.:

General conditions – applying to all sections
1. No cover will come into force, or continue in force, under sections 2, 3, 4, 5 and 6, unless each
insured person, who by reason of the Important Health Requirements must make a medical health
declaration in respect of the period for which insurance is required, has declared ALL pre-existing
medical conditions to us and they have been formally accepted by us in writing.
2. Any medical information supplied in a medical health declaration will be treated in the strictest
confidence, will be used solely for our own internal purposes for the assessment of the risk, and
will not be disclosed to any outside person or authority without the specific approval of the person
whose details are shown in the medical health declaration. We shall not refuse cover unless, in
our opinion, the risk associated with the particular person travelling is substantially greater than
that represented by the average healthy traveller. The cost of any medical evidence produced in
connection with a medical health declaration shall be borne by you.
3. During each period of insurance and before you depart on each trip you must declare to the
Medical Screening Helpline any change in your health or medical status. This change must be
accepted in writing by us before cover will be continued. If in doubt as to whether any change is
material, you should contact the Medical Screening Helpline.

I would imagine that if you have declared a heart attack or stroke that the risk is substantially greater than
that represented by the average healthy traveller??

I know which company not to use in the future!
I will forget about having another annual policy, it is a complete waste of money, despite appearing as good value. However, I will miss the re-assurance that if I hit a hole-in-one (with written proof of course!) I am entitled to claim £75.00 under this policy! I don't play golf.
alex

vaio

alexandr wrote: »

........3. During each period of insurance and before you depart on each trip you must declare to the Medical Screening Helpline any change in your health or medical status. This change must be accepted in writing by us before cover will be continued. If in doubt as to whether any change is material, you should contact the Medical Screening Helpline......

Pretty much guaranteed to be an unfair term which would be turned over by the FOS