Travel insurance query
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Foxtrotter
Posts: 18 Forumite
I booked a holiday several months ago and took out travel insurance. My wife and I have several medical issues which were all fully declared and accepted by the insurance company.
Two questions asked were .
1. Any joint replacements
2. Anyone on waiting list for future operations.
With reference to q1, my wife had undergone a toe operation to replace worn out cartilage (arthritis) around 18 months earlier, so I answered yes to this.
With reference to q2 I answered no as at the time there were no future operations planned.
These answers were accepted by the insurance company.
Unfortunately the previous operation wasn't very successful, and after a visit to outpatients last week, the surgeon offered my wife another operation to insert a different type of joint. She agreed to this and has therefore been put on the waiting list for a future operation expected to be in about three months time.
As the holiday is next week, I perused the insurance documents to check everything was in order and noticed the clause that any changes to medical conditions must be notified, so I called the insurance company and advised them that the answer to q2 had now changed. I was advised that any claim relating to the toe condition would now not be covered.
I would say that the likelihood of any such claims would be pretty much zero as I can't imagine anything happening to my wife's toe which would require any treatment prior to her proposed operation.
However it seems strange to me that the insurance company can effectively change the policy in respect of a medical condition which pre existed and was accepted at the time of purchase.
I know every policy is different, but in general, would an insurance company have the right to do this? It seems to they are changing what is in effect a contractual document. As I understand it, a travel policy is meant to cover the holiday and also anything occurring prior to the holiday.
Two questions asked were .
1. Any joint replacements
2. Anyone on waiting list for future operations.
With reference to q1, my wife had undergone a toe operation to replace worn out cartilage (arthritis) around 18 months earlier, so I answered yes to this.
With reference to q2 I answered no as at the time there were no future operations planned.
These answers were accepted by the insurance company.
Unfortunately the previous operation wasn't very successful, and after a visit to outpatients last week, the surgeon offered my wife another operation to insert a different type of joint. She agreed to this and has therefore been put on the waiting list for a future operation expected to be in about three months time.
As the holiday is next week, I perused the insurance documents to check everything was in order and noticed the clause that any changes to medical conditions must be notified, so I called the insurance company and advised them that the answer to q2 had now changed. I was advised that any claim relating to the toe condition would now not be covered.
I would say that the likelihood of any such claims would be pretty much zero as I can't imagine anything happening to my wife's toe which would require any treatment prior to her proposed operation.
However it seems strange to me that the insurance company can effectively change the policy in respect of a medical condition which pre existed and was accepted at the time of purchase.
I know every policy is different, but in general, would an insurance company have the right to do this? It seems to they are changing what is in effect a contractual document. As I understand it, a travel policy is meant to cover the holiday and also anything occurring prior to the holiday.
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Comments
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Yes , their condition for cover was no to question 2Ex forum ambassador
Long term forum member0 -
But at the time of taking out the policy the question was answered correctly I.e. No
Every time a medical condition is declared and 'accepted' the insurance company add an additional premium and therefore agree to cover that condition. For the additional premium, surely they accept the risk of that condition.
But let's look at it another way.
A traveller has a heart condition, which is fully disclosed. The insurance company accept the condition and add a premium for this. A week before the holiday, the traveller suffers a heart attack and has to cancel the holiday so he advises the insurance company who then say sorry we can't cover that condition now. So the traveller cannot claim for the lost holiday!0 -
Your example is not the same.
With the heart attack the person is claiming.
You are not claiming merely wanting cover.
There are some holidays that officially wont let you travel without full cover. A cruise ship is the example im thinking of where in theory you could need to be airlifted from the ship at great expense.
I beleive in this scenario I.e. lack of covere means you need to cancel, then the insurer would need to cover you cancellation claim.
Pragmatically if the risk is near zero, Id just go, but I think the answer your looking for is that if withdrawal of cover was an actual issue and youd been honest the theyd have to pay cancellation if they are effective stopping you go8ng by withdrawing cover.
Of course in that situation one should ask the insurer what they will to do (cover or cancel) and get authorisation before cancelling.
I spoke to my insurer yesterday about an issue that could be potentially important.
I asked them to put a note on my account and also wrote down the name, time and date so if there is a dispute I can ask for the call transcript.
Let me give you an example. Person has heart attack a few weeks before cruise. Cruise ship require full covere as costs of helicopter airlift are expensive.
Insurer may in this situation withdraw cover but pay for cancellation of the holiday.0 -
The travel insurance is actually to cover a cruise holiday. The cruise company do insist on travel insurance, but apart from asking the insurance company name and policy number, they don't ask for any other details.
The point I'm really trying to make is that at the time of taking out the policy, the pre existing condition was declared and the risk accepted by the insurance company for an additional premium. The insurance covers the holiday and also the period between taking out the policy and the travel date, so anything occurring between these times should still be covered as they have accepted the risk of the pre existing condition and therefore honour there side of the contract.
In this case the condition is relatively minor and the chances of it affecting the holiday are pretty remote, but it concerns me that the insurance company can change their level of cover once the policy is agreed and paid for.0 -
If you now choose not to travel because you no longer are covered then they will pay your cancellation costs
Your choice whether or not to continue your trip without the full cover0 -
Your choice whether or not to continue your trip without the full cover
In some circumstances full cover is required by one of the parties e.g. cruise ship.
Still your choice I guess but you may have to sign a false statement to travel without cover.0 -
Foxtrotter wrote: »The travel insurance is actually to cover a cruise holiday. The cruise company do insist on travel insurance, but apart from asking the insurance company name and policy number, they don't ask for any other details.
The point I'm really trying to make is that at the time of taking out the policy, the pre existing condition was declared and the risk accepted by the insurance company for an additional premium. The insurance covers the holiday and also the period between taking out the policy and the travel date, so anything occurring between these times should still be covered as they have accepted the risk of the pre existing condition and therefore honour there side of the contract.
In this case the condition is relatively minor and the chances of it affecting the holiday are pretty remote, but it concerns me that the insurance company can change their level of cover once the policy is agreed and paid for.
But you have changed the conditions on which the the policy was agreed.
They might have charged an additional premium but in this case they have declined to give any cover.
If you are not happy with this you can make a formal complaint. If they do not answer you within 8 weeks or you are not happy with their reply you can take it to the Financial Ombudsman.0 -
I checked the cruise line terms and yes they ask for full medical cover for pre existing conditions.
This evening I have emailed my travel agent and asked them to discuss with the cruise line for a definitive answer.
I have also emailed the insurance company and advised them that if the cruise line cancel the cruise, I will be making a full cancellation claim which is in the region of £8000. I have asked if they would prefer to pay this or retract their cover cancellation. I wonder which they will choose?
My only other option now would be to forget the existing policy and try and take out a policy with a different company!0 -
Why would the cruise line change their terms and conditions.
Health care on cruise ships is private so why would they the risk of uninsured passengers when medical expenses could be massive.
It!!!8217;s not obvious what the insurer will do but the bills for treatment or say a helicopter airlift could be massively bigger.
I!!!8217;d be looking for alternative quotes In your shoes (not with a massive amount of hope but surely it has to be tried).0 -
I'm not really sure a helicopter rescue for an arthritic toe would be required, but I will be looking for an alternative policy today.0
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