Travel insurance

MyRealNameToo

TELLIT01 said:

I think I recall previous instances where a total refusal to payout has been rejected by the FO where the condition/medication had no bearing on the condition being claimed for.  Hopefully somebody will be along to either confirm or correct that.

That must be pre-CIDRE as the law is now black and white that "no bearing" is irrelevant. 

It simply comes down to if it's careless, reckless or intentional that the OP didnt declare it. So we need the OPs explanation as to why they made what is technically a fraudulent application. 

Yorkshire_Dangermouse

sheramber said:

Yorkshire_Dangermouse said:

On a slight tangent, but we had to cancel a vacation earlier in the year due to the sudden death of my father-in-law shortly prior to our scheduled departure date.  He wasn't coming with us on this vacation.

Made a claim on our travel insurance,  and we're currently waiting for a final death certificate, following which the insurer wants to check whether the cause of death was related to anything in his medical history.  So not only does the insurer look at anything in the medical history of the travellers, but also any immediate family members (which give rise to a claim)...

Raises an interesting question as to what medical questions we need to ask family members before a holiday to be able to disclose as pre-existing conditions!

You need to read the policy document carefully to know what cover is provided  and any exclusions. 

Well yes indeed - there was only a declaration required of pre-existing medical issues for the travellers, no requirement for any other individuals (not that I would have known, or have any right to ask).

I'm entertaining their position at the moment, as it is clear there is nothing in his medical history which was relevant to his death (as we now know).

Donut_65

Because taking out the policy in April of this year,my partner hadn't been to see his doctor in 3 years, I should have said he was on medication for painkillers, but his brain aneurysm had nothing to do with his pain killers,Axa have phone again and said,that when they phoned today.its not their final decision and I will have to wait another 5 days for the final decision.so fingers crossed 🤞 

Donut_65

What is CIDRE legislation?

elsien

Consumer Insurance (Disclosure and Representations) Act

If an insurer wants to know something, they should ask you about it.  If your partner was taking regular painkillers, he was taking them for a reason to deal with a particular health condition.  So that comes back to what specifically you were asked when you took out the insurance.

Brie

Yorkshire_Dangermouse said:

On a slight tangent, but we had to cancel a vacation earlier in the year due to the sudden death of my father-in-law shortly prior to our scheduled departure date.  He wasn't coming with us on this vacation.

Made a claim on our travel insurance,  and we're currently waiting for a final death certificate, following which the insurer wants to check whether the cause of death was related to anything in his medical history.  So not only does the insurer look at anything in the medical history of the travellers, but also any immediate family members (which give rise to a claim)...

Raises an interesting question as to what medical questions we need to ask family members before a holiday to be able to disclose as pre-existing conditions!

I asked my travel insurance provider a number of years back about what to do if I had to cancel if my dad died.  I said that he had a heart condition - had it for decades at that point - and was not well but not in hospital or anything.  And they said yes as he was a close relative we would be covered for cancellation if anything happened.  They then realised he didn't live in the UK and said that meant that while he was my father he obviously wasn't that close to me as we lived so far apart!!  As they had at that point highlighted the portion of the T&Cs that said a parent was considered a close relative I asked where it said that the relative had to also live in the UK.  They couldn't so went back to agreeing that we would be covered.     All of which just goes to show that the person you talk to about these things often doesn't know what's in the T&Cs themselves.  And I have yet to see any insurance policy wanting to know about my relatives' health or whereabouts!

Mark_d

Donut_65 said:

I purchased travel insurance by AXA for myself and partner, unfortunately we couldn't go on holiday as he took a brain aneurysm 4 weeks before flying, so I put in a travel insurance claim to Axa,Axa have phone me today saying that my claim has been rejected due to me not disclosing medication that my partner was on for an injury 25 years ago 
Is it worth appealling their decision??

It's usually worth appealing because it's not going to cost you anything and you might get the payout you're after.

If your partner has been been taking medication for something brain-related then you'd be unlikely to get anywhere

Donut_65

TELLIT01 said:

Was this medication your partner was only taking 25 years ago or medication they are still taking for the old injury?

It was medication for an injury he had 25 and ago,on repeat prescription 

elsien

GPs don’t normally give repeat prescriptions for 25 years without reviewing. So when did he last need to speak to the GP about this continuing on repeat? 

it may not make a difference if it turns out to be not relevant but this is something you need to be really careful with insurance because if he’s been taking prescribed medication for that length of time it’s hard to argue. It’s not a pre-existing condition.

So you need to be able to argue that the questions that were asked didn’t cover this scenario.

MyRealNameToo

Donut_65 said:

Because taking out the policy in April of this year,my partner hadn't been to see his doctor in 3 years, I should have said he was on medication for painkillers, but his brain aneurysm had nothing to do with his pain killers,Axa have phone again and said,that when they phoned today.its not their final decision and I will have to wait another 5 days for the final decision.so fingers crossed 🤞 

So why didnt you declare the medication?

You may also want to have a word with your doctor, guidelines require at least an annual appointment for anyone with repeat prescriptions so you shouldn't have been allowed to go three years without one. 

Donut_65 said:

What is CIDRE legislation?

Its a fraudian misspelling of CIDRA - https://www.legislation.gov.uk/ukpga/2012/6/contents

The law covering consumer insurance and what insures must/mustnt do and also what remedies they have for customer fraud.