Travel insurance claim rejected

agent69

I have recenty had to curtail my overseas holiday due to illness, but my claim for reimbursement of costs from my travel insurer has been decline. Can anyone advise if this is reasonable based on the following:

• I was on holiday in SE asia, and began to feel unwell almost immediately upon arrival.
• I felt progressively worse over the next 3 days and considered an early return to UK.
• The city I was in does not have good flight connections back to the UK, but I checked and found a flight on the evening of day 3
• I returned to UK without having seen a loacal doctor, mainly over concerns over flight availability and not liking the prospect of a10 hr journey the following day to my next destination.
• The day after return I saw my uk doctor, who has certified that my curtailment was justified.
• The insurance company will not pay out because they say it is a requirement of the policy to see a local doctor before curtailment occurs.

The policy requires certain actions to be undertaken before curtailment, but none of these are made a condition precedent to claiming. There is just a general disclaimer at the begining of the policy that says that if you fail to comply with the terms of the policy your claim may be reduced or rejected. I could understand this for example:

1. if you cannot provide a doctors cert there is no proof that you were ill (so claim rejected), or
2. if you cannot provide documents to cover all the costs being claimed then the claim value would be reduced.

In my case the rejection appears to be on a technicality, in that there is no dispute that curtailment was justified, it's just the timing of the certification which is an issue.


Am I wasting my time here, or are the insurers being unreasonble?

Caz3121

did you contact your insurer before arranging flights back?

tacpot12

Can you identify in your policy the condition that the insurer claims is there (that you must see a local doctor before curtailing your holiday due to illness)? If not, ask them to identify which clause of the policy they are relying on.

If the clause is a there, you will have to argue that it was unreasonable to see a local doctor or to call the insurance company's medical helpline for advice. It is normally a condition that if you need to curtail your holiday for medical reasons, you have to speak to the medical helpline.

I can't see how you were able to arrange flights back, but not speak to the insurance company's medical helpline, but you may be able to explain this to the Insurance Ombudsman.