We'd like to remind Forumites to please avoid political debate on the Forum... Read More »
📨 Have you signed up to the Forum's new Email Digest yet? Get a selection of trending threads sent straight to your inbox daily, weekly or monthly!
Flexicover direct insurance refusing to pay out.
binka
Posts: 35 Forumite
Any advice?
It's for a travel insurance claim.
My daughter had an accident skiing, was rescued off the piste and taken to hospital with a suspected broken arm. Was in the hospital ten minutes, a dr poked her arm and said it was fine. The rescue cost 450 euros, the hospital 40 euros.
We sent in the two receipts for the money we paid.
They say we need a medical report, now it doesn't say in their policy or their claim form anything about a medical report. I could understand if it was for a huge operation, etc but that part is 40 euros.
Anyway then I decide to translate the receipt from the hospital. It's a big a4 official thing in French, the dr has signed it and it has 40 euros charge on the bottom. It's called a fieulle DES soins, which I've been told translates as signed medical report and is the standard medical report that French hospitals hand out. The dr has ticked malade, which I think is illness. But this report doesn't seem good enough and they won't pay. I've told them I'm going to take them to court and report them to the financial ombudsman.
Is this my next step?
It's for a travel insurance claim.
My daughter had an accident skiing, was rescued off the piste and taken to hospital with a suspected broken arm. Was in the hospital ten minutes, a dr poked her arm and said it was fine. The rescue cost 450 euros, the hospital 40 euros.
We sent in the two receipts for the money we paid.
They say we need a medical report, now it doesn't say in their policy or their claim form anything about a medical report. I could understand if it was for a huge operation, etc but that part is 40 euros.
Anyway then I decide to translate the receipt from the hospital. It's a big a4 official thing in French, the dr has signed it and it has 40 euros charge on the bottom. It's called a fieulle DES soins, which I've been told translates as signed medical report and is the standard medical report that French hospitals hand out. The dr has ticked malade, which I think is illness. But this report doesn't seem good enough and they won't pay. I've told them I'm going to take them to court and report them to the financial ombudsman.
Is this my next step?
0
Comments
-
You have to go through their complaints procedure first - to let them decide if they have made a mistake. Regrettably with some companies this is almost SOP - to weed out the fraudulent claims. Since the fees for an FOS ruling are more than the costs involved I suspect that they will come round to your position.
The complaints procedure is in the policy document.
(As a cynic, I could say - "now you know why they are relatively cheap")0 -
Thanks for your reply. The good news is that after a snotty email from me last night they have "decided on this occasion to settle".
However they do state that the medical report I've provided isn't sufficient as it doesn't specify the details of the accident and its my responsibility to ensure the Dr does that. Which I find worrying as their policy doesn't state this anywhere I can see, and the report was all in French so I had no idea what it said.
I certainly wouldn't use them again and I appreciate what you're saying about cheap companies......just not sure more expensive ones are any better. I believe it was the underwriters who were arguing the toss and I think they're AXA. So they underwrite a lot of the firms don't they?
But lesson learned to get a detailed report even if the policy doesn't say you need to.0 -
To be fair, a policy couldn't specify what is needed in every possible claim circumstance. It will however require you to satisfy them that an insured event has occurred and a loss has been suffered.Which I find worrying as their policy doesn't state this anywhere I can see
I really don't see how a doctors report of the accident would help. Presumably a doctors report would just repeat you or your daughters description. The receipts must surely justify your story so I'm glad they have agreed to pay.
If they have an emergency line, you could have contacted them and got authorisation at the time. Understandably not the first thing on your mind at the time though.0 -
Thanks for your reply. The good news is that after a snotty email from me last night they have "decided on this occasion to settle".
However they do state that the medical report I've provided isn't sufficient as it doesn't specify the details of the accident and its my responsibility to ensure the Dr does that. Which I find worrying as their policy doesn't state this anywhere I can see, and the report was all in French so I had no idea what it said.
I certainly wouldn't use them again and I appreciate what you're saying about cheap companies......just not sure more expensive ones are any better. I believe it was the underwriters who were arguing the toss and I think they're AXA. So they underwrite a lot of the firms don't they?
But lesson learned to get a detailed report even if the policy doesn't say you need to.
Yes - there are a few companies that are after travel insurance - AXA, MapFre, White Horse for instance. My understanding was that AXA was gradually pulling out of the market, but it will take time for agreements to come to an end.
AXA normally have good cover and service - but sometimes you can get caught on 'delegated authority' schemes that possbly have a profit share element. If that is the case you should be advised of the position by the provider as there is a conflict of interest.
I suppose the proof of the pudding is the claims experience - an Insurance broker can help if you go to a local broker - the prices aren't that much more (if any) and the policy cover is usually far better as the internet travel insurance policies tend to be engaging in a race to the bottom - increasing excesses to reduce premiums.
(I am an insurance broker, so my views are probably prejudiced, and have launched a new travel insurance policy - underwritten by Mapfre - this month aimed at providing better cover and service than others online)0 -
I tried 2 different brokers last year for travel insurance and neither could give me all the cover I requested at a reasonable cost. Quotes ranged from £300 to over £500 and that wasn't to cover anything serious like cancer.
I eventually got the cover I needed online.0
This discussion has been closed.
Confirm your email address to Create Threads and Reply
Categories
- All Categories
- 351.6K Banking & Borrowing
- 253.3K Reduce Debt & Boost Income
- 453.9K Spending & Discounts
- 244.5K Work, Benefits & Business
- 599.8K Mortgages, Homes & Bills
- 177.2K Life & Family
- 258.1K Travel & Transport
- 1.5M Hobbies & Leisure
- 16.2K Discuss & Feedback
- 37.6K Read-Only Boards