Insurance claim from NATS meltdown

Hi

First time on the forum, so apologies in advance if I have missed anything. I can't find any other threads that specifically relate to this, but happy if anyone can point me towards them,

My family was on holiday in Italy in August, and got hit by the NATS meltdown. We were stuck at a crappy airport hotel outside of Milan for 3 days. All of that was covered by British Airways, who did an OK job in a !!!!!! situation. 

My insurer, Yellow Jersey, confirmed that they would pay out under their 'Delayed Departure' clause: 

"Delayed departure - Up to £250 benefit in total after a major delay to outbound or return transport at the departure point. Alternatively up to £5,000 in total if you abandon your journey on the outbound leg only."

They outsource their claims to CSA Ltd, whose only purpose in life appears to be to stretch out the claims process over as long as possible before denying it. In this instance they took months to deal with the claim, then, hallelujah, they accepted it, before changing their mind 2 days later.

Their denial hinges on the clause where it says the delay needs to be due to: 

"mechanical breakdown of or a technical fault occurring in the public transport on which you are booked to travel."

They say that since the plane itself didn't breakdown then they aren't going to pay out.

Since there are 3 of us on the policy, we stand to get £750, so I'm reluctant to let this go. But wondering if there's any real prospect of getting the claim accepted. My next step is to go to the Financial Ombudsman.

thanks

S

Comments

  • DullGreyGuy
    DullGreyGuy Posts: 9,168
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    Your next step has to be a complaint, only after their final response (or 8 weeks have passed, whichever is sooner) can you go to the Ombudsman.

    That exclusion is for Section D1 - missed departure, ie where you fail to get to the airport in time but presumably you did get to the airport on time and therefore your claim is under Section D not D1? 
  • twopenny
    twopenny Posts: 5,314
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    Wonderful answer!
    My experience is with holiday companies and possibily insurance is that they try to delay and hope you will go away.

    You can try email (but get it in writing) then you may want to make this formal and go the complaint via post. Having worked in similar situations and done one myself paper has to be answered in a time frame. The fatter the file on their desk the more annoying it's going to be for pressure to answer.
    Emails are quick to answer and easy to ignore.

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  • Your next step has to be a complaint, only after their final response (or 8 weeks have passed, whichever is sooner) can you go to the Ombudsman.

    That exclusion is for Section D1 - missed departure, ie where you fail to get to the airport in time but presumably you did get to the airport on time and therefore your claim is under Section D not D1? 

    Thanks. It's for Section D:


  • twopenny said:
    Wonderful answer!
    My experience is with holiday companies and possibily insurance is that they try to delay and hope you will go away.

    You can try email (but get it in writing) then you may want to make this formal and go the complaint via post. Having worked in similar situations and done one myself paper has to be answered in a time frame. The fatter the file on their desk the more annoying it's going to be for pressure to answer.
    Emails are quick to answer and easy to ignore.

    Cheers. 

    Given they outsource claims to a third party would you suggest complaining to my insurer, the claims company or just go straight to the Financial Ombudsman?
  • DullGreyGuy
    DullGreyGuy Posts: 9,168
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    SpiderJ said:
    Your next step has to be a complaint, only after their final response (or 8 weeks have passed, whichever is sooner) can you go to the Ombudsman.

    That exclusion is for Section D1 - missed departure, ie where you fail to get to the airport in time but presumably you did get to the airport on time and therefore your claim is under Section D not D1? 

    Thanks. It's for Section D

    Ok, there goes my claim to being reasonable at scan reading!

    Comment on complaint still stands however having read the clause properly this time I am not sure what grounds you have to complain about... delayed departure is only for a finite set of reasons. Had Public Transport not have been a defined term then you could have tried to argue the NATS system is part of the public transport system as a whole and it was a technical fault with the software that caused the problem. It is however a defined term and appears to make it more tightly defined as the vessel/vehicle itself and not the wider system. 

    At the end of the day you've nothing to lose but I wouldnt be planning what to do with the money. 
  • eskbanker
    eskbanker Posts: 29,908
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    SpiderJ said:
    Given they outsource claims to a third party would you suggest complaining to my insurer, the claims company or just go straight to the Financial Ombudsman?
    Complain to the company with whom you have a contract, i.e. the insurer.

    However, on what grounds are you arguing that they should settle the claim?
  • eskbanker said:
    SpiderJ said:
    Given they outsource claims to a third party would you suggest complaining to my insurer, the claims company or just go straight to the Financial Ombudsman?
    Complain to the company with whom you have a contract, i.e. the insurer.

    However, on what grounds are you arguing that they should settle the claim?
    I guess it will hinge on whether NATS is part of the 'public transport' definition. 

    TBH, if the insurer had simply said at the start of the whole thing "sorry, but you aren't covered", I would have just shrugged and moved on. But they initially said I was covered, and then asked for reams of evidence, then for the same evidence again, then accepted the claim and only then denied it.
  • Ok, there goes my claim to being reasonable at scan reading!

    Comment on complaint still stands however having read the clause properly this time I am not sure what grounds you have to complain about... delayed departure is only for a finite set of reasons. Had Public Transport not have been a defined term then you could have tried to argue the NATS system is part of the public transport system as a whole and it was a technical fault with the software that caused the problem. It is however a defined term and appears to make it more tightly defined as the vessel/vehicle itself and not the wider system. 

    At the end of the day you've nothing to lose but I wouldnt be planning what to do with the money. 

    Oddly enough, your comment may be more apt than you intended. D1 says a claim can be made for the 

    "the failure of other public transport"

    In which case then maybe that will include NATS?
  • eskbanker
    eskbanker Posts: 29,908
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    SpiderJ said:
    D1 says a claim can be made for the 

    "the failure of other public transport"

    In which case then maybe that will include NATS?
    That interpretation isn't supported by the policy wording, in that the context of that reference in D1 is missed departure, i.e. "if you fail to arrive at the departure point in time to board the public transport on which you are booked to travel on for the international outbound and return legs of the trip as a result of: 1 the failure of other public transport..." and the definition of 'public transport' is clearly "Any publicly licensed aircraft, sea vessel, train, coach or bus on which you are booked or had planned to travel", so I'd see that clause as relating to, say, your bus to the airport breaking down.
  • eskbanker said:
    SpiderJ said:
    D1 says a claim can be made for the 

    "the failure of other public transport"

    In which case then maybe that will include NATS?
    That interpretation isn't supported by the policy wording, in that the context of that reference in D1 is missed departure, i.e. "if you fail to arrive at the departure point in time to board the public transport on which you are booked to travel on for the international outbound and return legs of the trip as a result of: 1 the failure of other public transport..." and the definition of 'public transport' is clearly "Any publicly licensed aircraft, sea vessel, train, coach or bus on which you are booked or had planned to travel", so I'd see that clause as relating to, say, your bus to the airport breaking down.
    Yeah, I realise I'm clutching at straws. Sunk cost fallacy. If they had just said "no" when asked if my insurance covered the circumstances at the start I would have moved on. But I've invested enough time to want to see it through.

    I guess we'll find out.
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