Staysure wont pay my claim

killerkiwi

I have been with Staysure for several years. I have always updated as early as possible any change in medical issues. I am a 64 year old retired fire officer. Last year in the summer I booked after a lot of planning a holiday of a lifetime to the Galapagos islands. The trip which was due to start in mid February. Unfortunately just in early December I was rushed into hospital with extreme pain and nausea, vomiting etc.. After numerous test and hospital admissions through December including xmas day I was diagnosed with chronic pancreatitis.
My consultant advised me against any travel until I had finished with all test including a scan to check for possible cancer. This test was booked for the 27th of Feb so I had no choice but to cancel.
When the trip was booked this illness was not declared as I did not know it existed. When I submitted my claim they have refused for now to pay saying I should have notified them earlier.
As you can imagine this has been an incredibly stressful time, both Physically and now mentally.
I cant begin to explain the feelings I am having at the moment.
The total cost of this trip was £22750. With the cancellation excess i should be covered for up to 10,000 each.
I am not a wealthy man and this was Ment to be a celebration for both my wife and I of our life's hard work.
Might I add helping people. My wife was a nurse for over 30years,
Our lives have now been turned upside down. Please can somebody help me with how to go about taking this large company to court to claim my money. I cant afford to pay top solicitors and I believe that small claims only goes to £5000
Thanks in advance for any help or suggestions on how to proceed.

cw8825

removing the emotion.
early December you fell ill
by xmas day confirmed chronic pancreatitis
when were you told to avoid all travel?
when did you make the claim?

killerkiwi

Told early in early Febuary to cancel as the appointment was made for the 27th of Feb when I was due to be  away.
Entered the claim on day of cancellation
My main point is that when I booked and payed for the trip I did not or was not aware of this illness. As it was a new illness after the trip was booked ,well surely that is why you take insurance out for protection.
It was to close to departure date to cancel via the agents [Dial a Flight]

Aretnap

You don't need to take then to court. You start by making a formal complaint to the insurance company (how to do this should be explained in the policy documents) and if you are not happy with their response then you can escalate your complaint to the Financial Ombudsman Service. The FOS is free (to you), has a slight bias towards the consumer that the courts don't have, and is used to dealing with unrepresented complainants who don't always understand technical terms or the finer points of insurance law. 

What reason have they given for declining the chain? Hopefully something more specific than "I should have notified them earlier"? Are they saying that they think you knew about your illness before you took out the policy? Or that you should have notified them about the illness or cancelled the holiday dinner than you did? (For example if you'd cancelled the holiday sooner could you have got most or all of your money back?)

cw8825

Aretnap said:

You don't need to take then to court. You start by making a formal complaint to the insurance company (how to do this should be explained in the policy documents) and if you are not happy with their response then you can escalate your complaint to the Financial Ombudsman Service. The FOS is free (to you), has a slight bias towards the consumer that the courts don't have, and is used to dealing with unrepresented complainants who don't always understand technical terms or the finer points of insurance law. 

What reason have they given for declining the chain? Hopefully something more specific than "I should have notified them earlier"? Are they saying that they think you knew about your illness before you took out the policy? Or that you should have notified them about the illness or cancelled the holiday dinner than you did? (For example if you'd cancelled the holiday sooner could you have got most or all of your money back?)

I was thinking the latter. That’s why the dates are important

im leaning towards OP should have informed in December time. 

I don’t know if it’s the way it has been written but if OP was undergoing test in January/February and a trip booked for mid feb

by waiting so long it’s cost insurer more

XRS200

You said they are not paying for now.  What exactly have they said?

sheramber

The OP should have notified them of the diagnosis in December as that was a change in his medical information which could  affect his premium. 

That will be stated in his policy document. 

killerkiwi

This all happened very quickly. By the time I was told not to travel,[ I spent a lot of money privately to try and get the consultants okay to travel.]. When the scan appointment was made and I was told not to travel it was to close to travel date to get cancellation refunds. My whole point is that when the holiday was booked and payed for the condition was not known about. Then surely this means I'm covered. The whole process of dealing with the NHS system was so time consuming on getting the actual diagnosis correct that time simply ran out. I will go to the FOS if my complaint is not upheld, Thanks for all your comments

cw8825

killerkiwi said:

This all happened very quickly. By the time I was told not to travel,[ I spent a lot of money privately to try and get the consultants okay to travel.]. When the scan appointment was made and I was told not to travel it was to close to travel date to get cancellation refunds. My whole point is that when the holiday was booked and payed for the condition was not known about. Then surely this means I'm covered. The whole process of dealing with the NHS system was so time consuming on getting the actual diagnosis correct that time simply ran out. I will go to the FOS if my complaint is not upheld, Thanks for all your comments

You must tell us If any of the following happen after you purchase your policy, or before booking any new trips or before starting a trip: • you are diagnosed with a new medical condition.
• you experience new or recurring symptoms or have an undiagnosed condition. • your doctor, or consultant adds to or changes your prescribed medication. • you receive inpatient medical treatment. • you are now awaiting a diagnosis, investigation, test results or medical treatment. A member of the team will ask you specific questions about your medical condition(s). This may result in an additional premium to allow cover to continue, or we may add additional Terms and Conditions to your policy or exclude cover for the newly diagnosed condition or for the condition that has undergone significant change. We may require you to obtain a Medical Report from your doctor, or consultant to allow us to assess whether cover can continue. Obtaining this Medical Report is at your own expense. Based on our assessment of the medical information supplied to us, we will decide whether we can continue to insure you, and on what basis. If we are unable to continue to provide cover, or if you do not wish to pay the additional premium you will be entitled to make a claim under Section 1 (Cancellation) for costs which cannot be recovered elsewhere for trips booked prior to the change in health. Alternatively, you will be entitled to cancel your policy, in which case, we will refund a proportionate amount of your premium.

.https://www.staysure.co.uk/wp-content/uploads/2024/06/Staysure-Travel-Insurance-Signature-PD-JUN24-V20-Web-1.pdf?_gl=1*1xagux8*_up*MQ..*_ga*MTczMDgxNDczNi4xNzQxOTUzMTY1*_ga_RR232R3VD2*MTc0MTk1MzE2NS4xLjAuMTc0MTk1MzE2NS4wLjAuMA..

Taken from the staysure policy book from last summer

good luck with the complaint

killerkiwi

additional payments were charged when I informed them initially of the condition. They actually doubled my premium. I supplied a full medical report. All of these items were covered. Do you work for stay sure

killerkiwi

They also issued a new validation certificate with all the health issues covered. So they were still happy to take the money. At no time did they refuse cover. Just charged more