Travel insurance claim rejected

drod

Hi

I am a first time poster here and hope that someone can help me. I was on holiday in the States in June of this year with my husband and daughter, when we received a call on the 3rd day that my father had died unexpectedly at home in Scotland. Obviously our priority was to get ASAP. My husband contacted our insurer, Travel Insurance Web.com, and explained the situation. They said that the only way they could authorise getting us home was to phone my mother, speak to my dad's GP and also to see a death certificate. My husband told them that he was not prepared to upset my mother further and also that a death certificate would not be available until after a post mortem. They told us to contact our airline. I called Virgin Atlantic to ask them to change our return date and they said that they could get us home that day at a cost of £3000 - double the amount we had paid for our round trip. They would not change our return date even although they were fully aware of our circumstances. With another airline we got flights for £1200 and submitted a claim to the insurance company upon our return. They accessed my dad's medical records and refused to pay anything because he had died of a heart attack and had been diagnosed with angina just 2 days within the six month period prior to our policy starting. Although I knew nothing about this , they state that these are the terms of their policy. I have looked over it, and this is included but surely this is nonsense.

Is there anything I can do? I have since put a claim into Virgin, and they have said that will consider refunding airport tax only, but this is still under review.

Thanks

Dawn

Travel_Insurance_Expert

The problem with travel insurance is that people are not aware/not told that it is not just their health that they have to declare but anyone upon whose helath the trip depends e.g. close relatives.

Of course they cannot expect you to declare something that you were not aware of and if, like some parents, especially when you have booked a trip away or have a big function coming up they did not tell you, you need to make the insurance company aware of this.

It is always worth writing again and asking for it to be passed higher up the chain

drod

Thanks for that - I'll write again and failing that, contact the Insurance Ombudsman.

suzy.johnston

Hi Dawn,
I completely sympathise with you. I have had a similar experience. We were due to go to Portugal on the 5th July (family of 4 plus my father) and my father died suddenly on 3rd July. We had taken out a family policy for the 4 of us and daddy had taken his own insurance and declared his illnesses and medication (his insurance company paid out for his flights within a week incidentally) He was only 64 and had had a heart attack 20 years ago and surgery 12 years ago so it's not as if we were expecting this in any way. He hadn't even consulted his GP in the months before his death. Our insurance company turned us down for 'non-disclosure' of his medical condition and we just found out yesterday that they have also rejected our appeal (all this has taken over 3 months to get to this stage)
How can these companies get away with this ludicrous clause? In this day of patient confidentiality and data protection, how can anybody be expected to disclose such personal information about the health of 'close family members' (in our case that would amount to 11 people)
This is causing great distress whilst we are still grieving but I am determined to take this as far as I can. Can anyone suggest where we should go next? We have been thinking of taking legal advice.
Hope to hear some suggestions. It is really eating me up.
Thanks,
Suzanne

Altarf

Exhaust the insurance company complaints procedure and request a 'deadlock letter' from them if they refuse to pay the claim. Then make a complaint to the Financial Ombudsman Service.

They don't stand for any of this nonsense as article 56/5 here shows - http://www.financial-ombudsman.org.uk/publications/ombudsman-news/56/56-travel-insurance.htm

and other examples http://www.financial-ombudsman.org.uk/publications/ombudsman-news/64/64-travel-insurance_cases.html

drod

Suzie

Sorry to hear about your situation. I have now written a formal complaint to the company, as advised, and will refer my case to the Financial Ombudsman if I don't get any success from that.

Altarf, can I ask what a deadlock letter is?

Dawn

suzy.johnston

Thanks Altarf. I think my husband has written to them today requesting what you call a 'deadlock letter' I am quite encouraged by the number of complaints upheld in the examples you provided. Thanks for that.

And Dawn I hope you get somewhere with your claim too. Keep me posted if there are any further developments and I will do the same.

Suzanne

Altarf

drod wrote: »

can I ask what a deadlock letter is?

The final response you get from the business when you have been through every layer of their complaints procedure.

The Financial Ombudsman Service will not investigate until you have exhausted their complaints procedure. When you have and you still do not agree, i.e. you are still at 'deadlock', the the company will send you a letter saying 'tough' and if you want to take it any further then you need to complain to the Financial Ombudsman Service.

Have a look at the FSO page for more details -
http://www.financial-ombudsman.org.uk/consumer/complaints.htm

drod

I received a letter on Friday from the underwriter to inform me that although they agreed that the company were correct to reject my claim due to their definition of a pre-existing condition, they were prepared to offer 50% of my outlay as I was unaware of my dad's condition. My dilemma now is do I accept this or take it to the ombudsman. Any advise much appreciated.

Thanks

Dawn

suzy.johnston

Just to let you all know that I have had a result! To cut a long story short, we eventually managed to prise a letter declining the claim out of EuropAssistance at the end of December, which we duly forwarded to the Ombudsman (we had already completed a complaint form prior to that) Then last week we had a phonecall from EuropAssistance to say that they were going to settle our claim in full! A letter followed a few days later - no apology mind you, but a full and final settlement figure which will be paid to us in the next few days. So I hope this will encourage others in a similar situation. These insurance companies are getting away with murder. Don't give up if you think your claim is valid, as I know ours was, take them to the Ombudsman and get back what you're entitled to - we would be £3000 out of pocket if we hadn't - it took seven months but it's worth it. Dawn, what did you decide to do about your offer in the end?:j
Good luck, Suzanne

mattymoo

Good result Suzy - glad it paid off.