Travel Insurance medical claim denied by AXA

Annemos

That last bit  (this is only my impression of it as a non-expert) 

If it had said   "that has required treatment, including surgery, tests or investigation?"   (Note the comma after treatment)     Then I think your son would have had to answer yes as that would imply any treatment at all. 


But they way they have it here, it says     "that has required treatment including surgery, tests or investigation?"

So, the treatment has to have included:    surgery, tests or investigation. 


Is the fact that the GP took a look at it and had a prod at it, an investigation??  (Or is an investigation X-rays?)



Maybe that ambiguity might at least tip your scenario into more of a misunderstanding re that last sentence, rather than a deliberate refusal to answer properly.    


I wonder what the others will think!! 

user1977

I would interpret "investigation" as being something beyond the initial consultation with a GP.

sheramber

Annemos said:

That last bit  (this is only my impression of it as a non-expert) 

If it had said   "that has required treatment, including surgery, tests or investigation?"   (Note the comma after treatment)     Then I think your son would have had to answer yes as that would imply any treatment at all. 


But they way they have it here, it says     "that has required treatment including surgery, tests or investigation?"

So, the treatment has to have included:    surgery, tests or investigation. 


Is the fact that the GP took a look at it and had a prod at it, an investigation??  (Or is an investigation X-rays?)



Maybe that ambiguity might at least tip your scenario into more of a misunderstanding re that last sentence, rather than a deliberate refusal to answer properly.    


I wonder what the others will think!! 

It does not sat treatment that involved surgery, tests or investigations.

It states treatment that includes them. 

That is not an exclusion to any other treatment such as advice or medication

 Did the son get any medication prescribed ?

The condition was bad enough for him to consult his GP.


Unfortunately, when it comes to insurance we need to be very careful what we state, and should ask, if necessary.


Son has the option to  follow the complaints procedure which will be explained in the policy document/booklet.

DullGreyGuy

SiliconChip said:

DullGreyGuy said:

Annemos said:

It all goes to show.

Policyholders often have a gut feeling for what they feel should be the correct/sensible way to handle a claim. 

But sometimes this is not borne out by the actual Insurance legislation. And Policyholders often have no idea of what is involved behind the scenes. 

It should be taught at school! 

I noticed on the BBC today, the famous storm issue of when is a storm not a storm... when gusts are less than 55mph. 

https://www.bbc.co.uk/news/articles/clyj6y10y15o

In this day and age I can see every NHS appointment I've had in the last few years in the app so dont need to rely on my memory.

Maybe your medical professionals are more assiduous at updating records that feed into the app but it is definitely not the case that I can see all of my appointments. Recently I have been able to see appointments at my own GP surgery, and the app seems to be increasing the history that is retained, but it doesn't show all appointments that took place at other medical centres or at hospitals (generally but not always referrals from my own practice). It's why I have been keeping my own records for at least the past 7 years, so that I can refer to them should I need to.

No, our medical professionals are absolutely useless and the majority are now physician associates who dont know their !!!!!! from their elbow but whatever software they use is hooked into NHS Spine so any visits to any of their surgeries automatically are logged without them doing anything else most would be missing. 

Slightly annoyingly our hospital trust uses a different system, MyChart, which in many ways is better as you can see all blood tests (inc overtime charts), letters etc but would be better if the two were together... that said when Falcon took out a load of the global IT systems it was useful that the two were on separate systems as Spine went down but MyChart didnt and so was able to convince the GPs to do something for me based on the letters I could see on my phone but they couldn't get into my records.