Travel Insurance - Cancellation claim denied

adders1974

A very annoying situation I believe I am probably snookered on but want some advice.


I have annual travel insurance for the family that we automatically renew every year. Last year it renewed in October (14th). When it renewed we had a holiday booked for February 2017. Late Janauary my father passed away and we cancelled the holiday and made a claim. 7 months on the claim was denied because on the 9th Oct 2016 my father was diagnosed with cancer and was planned to start chemo straight away. We had no knowledge of this until early November. The policy term states we are not covered if a close relative has knowledge of treatment when the policy is taken out.


THe ombudsman has ipheld the decision due to the term and the fact my fathers medical records (which we did not see) show the diagnosis dates for treatment to be just before the policy.


Anywhere else to go or do we just wave goodbye to 3K and learn to read T&C?

Browntoa

if the dates are correct then he had his diagnosis before the renewal and despite you not knowing it should have been disclosed as they say in the t&c


its wave goodbye to 3K I'm afraid

adders1974

Yep they have. It stinks and its seems to allow them to sell insurance that is against the whole premiss of insurance.

katejo

adders1974 wrote: »

A very annoying situation I believe I am probably snookered on but want some advice.


I have annual travel insurance for the family that we automatically renew every year. Last year it renewed in October (14th). When it renewed we had a holiday booked for February 2017. Late Janauary my father passed away and we cancelled the holiday and made a claim. 7 months on the claim was denied because on the 9th Oct 2016 my father was diagnosed with cancer and was planned to start chemo straight away. We had no knowledge of this until early November. The policy term states we are not covered if a close relative has knowledge of treatment when the policy is taken out.


THe ombudsman has ipheld the decision due to the term and the fact my fathers medical records (which we did not see) show the diagnosis dates for treatment to be just before the policy.


Anywhere else to go or do we just wave goodbye to 3K and learn to read T&C?

When did you first know about the diagnosis? Perhaps they would have paid out in January if you had known and declared the diagnosis to the insurer in November (before you knew that you definitely need to cancel)? I agree that it is wrong to expect us to know of all conditions diagnosed. We aren't flies on the wall when a relative visits the doctor.

adders1974

My father told me early November, just before he started Chemo. Hindsight around the dates and informing insurance company looks easy now. At the time the holiday hadnt crossed our mind and in truth its one of the reasons we go with annual insurance as we holiday quite a bit so we would always be covered. Not a cheap policy either as we have 2 boys that enjoy their sports so we have all th eactive stuff added on. If my Dad was on our policy as a traveller then maybe it would of occurred to us.


We were still planning on going anyway as he was healthy and responding well up until the morning of the day he died, it was that sudden.

daveyjp

Other travel insurance policy wording will refuse payout if YOU KNEW of the illness before taking out the policy and failed to declare it.

This a subtle difference from a close relative knowing, but it demonstrates why policy documents need to be understood and compared.

If the same company does single trip cover check the wording and see if it is different.

adders1974

The terms are the same for single and annual insurance. Listed in medical exclusions.

Affects cancellation only. All other claims relating to medical incidents has the exclusion listed as only the insured needs to have knowledge of.

rs65

adders1974 wrote: »

Anywhere else to go or do we just wave goodbye to 3K and learn to read T&C?

Did the ombudsman not explain the options?

Was the issue that you didn't tell them at renewal or didn't tell them when you found out

adders1974

Currently we are clarifying a couple of things with the ombudsman and the we have three options. 1, ask for second and final review, 2. Accept it and move on or 3. Take independent legal action.

The issue is with at the treatment being planned before we took out the policy. If he was diagnosed 6 days later and had the treatment planned we would of been covered.

I understand why the exclusion is there in T&c. It protects the insurance company against people finding out bad news and then insuring against it retrospectively, but for annual renewal it seems to be unreasonable.

rs65

adders1974 wrote: »

Currently we are clarifying a couple of things with the ombudsman and the we have three options. 1, ask for second and final review, 2. Accept it and move on or 3. Take independent legal action.

That answers your first question. The first two are free, the third isn't.

My issue on this is that you have answered to the best of your knowledge at the time. It is not unknown for people to keep medical issue to themselves.

What we don't know is how the insurers would have reacted had you known and disclosed this. Declined cover or charged more? If the latter, why not do that now. Others know more about travel insurance than I do though

adders1974

I suspect charge more, but that we will never know.

There is 3 parts to the term they have relied on to deny. The third being the one they cite as the reason to deny.

You, close relative or travelling campanion are on a waiting list, have knowledge of need or planned treatment at a hospital, clinic or home.

The first part is you, close relative or travelling companion have knowledge of disease or illness, but not yet diagnosed???

Reasonable on purchase?