Travel Insurance Claim HELP!!!

montybee

Will try to make this quick...booked a holiday. Mother-in-law admitted to hospital and had operation, was doing well so holiday was going ahead as planned. Bought travel insurance from broker who was informed of MIL being hospital inpatient and wanted insurance (I always buy travel insurance and have never needed to claim) as usual but also incase her condition changed for the worse. MIL became critically unwell so cancelled holiday. Now insurance company won't process claim as policy was bought after she was in hospital. I bought the policy on good faith that I would be going on holiday as MIL was doing so well.

Do I have any grounds to argue this with the insurance company???

ash23

It depends. Read the terms and conditions of the policy. It will most likely state that there is no cover for pre-existing conditions unless noted. If the illness isn't noted on the schedule of insurance then the issue isn't with the insurer but actually with the broker.

You can make a complaint to the broker and if you aren't satisfied with their findings, you'll get a final written response and you can take it to the Ombudsman.

If the illness is noted with the insurer then again, complain to them and if you're not satisfied, you can take a case to the ombudsman.

I have MS and have to buy a special policy from a special insurer and my illness is noted on my travel insurance documentation. I can buy a regular policy and tell them about my MS but they will only cover me for illnesses that are not MS related.

jaymcg91

Probably not a chance. They'd argue that you definitely had a suspicion you wouldn't be able to go given that she was already in the hospital, irregardless of what you say.

They will try anything to get out of paying a claim.

But as ash23 says, it does depend on what exactly what was in the insurance schedule - if the reason she is ill was on the schedule and you paid a larger premium - then maybe you'd have grounds to argue - but even then it'll be difficult given that she was already in hospital with said illness (aka it didn't flare up afterwards)

Atlantic Dawn

You may be entitled to a refund of the cost of the insurance if the broker incorrectly sold the policy, almost all calls are recorded so ask for a copy of the recording to verify this. All travel insurance policies I have taken out will not cover if your are currently undergoing medical attention or if you are awaiting the results of medical tests.

montybee

Can I argue that it wasn't a pre-existing condition that made her critically unwell or can they link it all back?

She was admitted with a UTI and constipation. In the days that followed a bowel obstruction was found (she had bowel cancer 5yrs ago that was managed with surgery only). But it was the development of sepsis post 1st operation that required 2nd operation and ventilation that ment she was critically unwell. My MIL has been cancer free for almost if not more than 5 yrs and had a recent colonoscopy that was normal. Because it was bowel 5yrs ago and bowel now does that qualify as pre-existing condition even though obstruction was not a cancer tumour??

I don't think im going to get anywhere based on the fact that insurance was bought after her hospital admission. They told me undiagnosed symptoms are not covered, surely that means they will never have to pay out to anybody on medical grounds???

ash23

They can look for medical records and link it back to previous issues.

In fact, even if you didn't know you had a condition but had symptoms of it before taking out your policy, it can be classed as a pre-existing condition. Did you not tell the broker she was in hospital? If so your issue is with the broker as they didn't sell you an appropriate product for your needs.

montybee

Yes Ash23 the broker was informed but no question was asked from broker re her condition so impossible to note on our policy. Will go back and mention this to broker but live in a small town and have been dealing with him for all my other insurance needs over the years so won't be arguing it with them.

pixiejess

montybee wrote: »

Yes Ash23 the broker was informed but no question was asked from broker re her condition so impossible to note on our policy. Will go back and mention this to broker but live in a small town and have been dealing with him for all my other insurance needs over the years so won't be arguing it with them.

Hi i would love to know what happened i am in a similar situation at the moment , just about to send off our claim form ,We booked a holiday in nov for august but only payed a deposit, in jan this year my partners dad was diagnosed with cancer all was going s well as could be expected and in june we contacted the travel agent and told them the situation , so by the end of june we had decided to pay up for the holiday and get insurance the girl in the travel agent said we would be completely covered if we had to cancel or come home , we payed just over €4000 !! a year worth of saving. Then 2 weeks ago my partners dad was told at a check up he didnt have long it came out of the blue as a check up in june had said it was a slow progression this is why we taught the holiday was going to be fine but took out insurance just encase as its a large sum of money. Things had changed dramatically in just over a month so we canceled our holiday. We got an email saying our holiday was cancled and we would have our claim forms in the post, The girl in the travel office went on to tell me that maybe the girl i booked with didnt fully understand the ins and outs of the insurance policy and she would have not recommended we booked it at all, so im panicking that we will have no case .

jaymcg91

You took out the insurance after the cancer diagnosis? Not a hope would an insurance company buy what you are saying happened?

FWIW very sorry to hear about your partners dad .

Atlantic Dawn

pixiejess wrote: »

Hi i would love to know what happened i am in a similar situation at the moment , just about to send off our claim form ,We booked a holiday in nov for august but only payed a deposit, in jan this year my partners dad was diagnosed with cancer all was going s well as could be expected and in june we contacted the travel agent and told them the situation , so by the end of june we had decided to pay up for the holiday and get insurance the girl in the travel agent said we would be completely covered if we had to cancel or come home , we payed just over €4000 !! a year worth of saving. Then 2 weeks ago my partners dad was told at a check up he didnt have long it came out of the blue as a check up in june had said it was a slow progression this is why we taught the holiday was going to be fine but took out insurance just encase as its a large sum of money. Things had changed dramatically in just over a month so we canceled our holiday. We got an email saying our holiday was cancled and we would have our claim forms in the post, The girl in the travel office went on to tell me that maybe the girl i booked with didnt fully understand the ins and outs of the insurance policy and she would have not recommended we booked it at all, so im panicking that we will have no case .

Sorry to hear about your partners Dad.

Anything that was diagnosed or is awaiting tests prior to insurance and not declared when taking out cover would make the policy null and void.

To Elland Back

Atlantic Dawn wrote: »

Sorry to hear about your partners Dad.

Anything that was diagnosed or is awaiting tests prior to insurance and not declared when taking out cover would make the policy null and void.

It doesn't make a policy null and void. A policy is voidable at the discretion of the insurer for a breach of policy conditions, but they don't have to exercise that option

pixiejess

Atlantic Dawn wrote: »

Sorry to hear about your partners Dad.

Anything that was diagnosed or is awaiting tests prior to insurance and not declared when taking out cover would make the policy null and void.

you see i dont know if the travel agent declared it as i didn't even know who i was insured with until the claim forms came . But i had told the travel agent over the phone the full story and she recommended the insurance and said i would be covered 100% for cancellation prior to the holiday or if god forbid we had to come home. So i am assuming she declared it? I payed for everything over the phone from my bank account. Oh god this really doesnt look good at all

pixiejess

jaymcg91 wrote: »

You took out the insurance after the cancer diagnosis? Not a hope would an insurance company buy what you are saying happened?

FWIW very sorry to hear about your partners dad .

Yes he was diagnosed in january but it was a slow progression , we had a deadline in june to pay in full so i called the travel agent and explained why we hadnt payed she recommended the insurance and told me if we had to cancel or come home half way through we would get our money back ,she said 100% minus the cost of the insurance which seemed like a very safe option so we payed in full plus the insurance that day over the phone. Then the last week of july he had a routine check up and we were told he didn't have long and canceled our trip. when the claim forms came i got to see who we were insured with so i looked them up and the policy said we were not covered for terminal illness so i emailed the travel agent who said the girl we booked with didnt really know the ins and outs of the insurance policy . i dont know where that leaves us i feel duped by the travel agent . Thank you for your kind words

pixiejess

To Elland Back wrote: »

It doesn't make a policy null and void. A policy is voidable at the discretion of the insurer for a breach of policy conditions, but they don't have to exercise that option

This is going to sound completely stupid but what does this mean ? and thank you for helping

Cookie_Dough

pixiejess wrote: »

Hi i would love to know what happened i am in a similar situation at the moment , just about to send off our claim form ,We booked a holiday in nov for august but only payed a deposit, in jan this year my partners dad was diagnosed with cancer all was going s well as could be expected and in june we contacted the travel agent and told them the situation , so by the end of june we had decided to pay up for the holiday and get insurance the girl in the travel agent said we would be completely covered if we had to cancel or come home , we payed just over €4000 !! a year worth of saving. Then 2 weeks ago my partners dad was told at a check up he didnt have long it came out of the blue as a check up in june had said it was a slow progression this is why we taught the holiday was going to be fine but took out insurance just encase as its a large sum of money. Things had changed dramatically in just over a month so we canceled our holiday. We got an email saying our holiday was cancled and we would have our claim forms in the post, The girl in the travel office went on to tell me that maybe the girl i booked with didnt fully understand the ins and outs of the insurance policy and she would have not recommended we booked it at all, so im panicking that we will have no case .

Sorry to hear you news.

I would think the travel insurance company may not pay on in this case unfortunately, on the basis that-

-The travel insurance was purchased after the diagnosis (many insurance companies would have exclusions such as not covering any claims arising as a result of an illness known to you before purchasing the insurance, certain illnesses may also be excluded)

-If the insurance was also purchased after booking the holiday the insurer may not cover any costs incurred before taking out the policy as effectively you had no insurance coverage when incurring the costs. (apologies if this is not the case)

You should find out which insurance company the travel agent placed the travel insurance with and examine the policy wording you (should have) received from them/the travel agent when paying for the policy. At the end of the day the travel agent is just an agent (similar to a broker) and the contact is between you and the insurance company directly.

You should also have a look at the website for your travel insurance company to get info on their claims procedure.

Review everything you received and signed from the travel agent when booking the holiday and taking out the travel insurance.

If you are send off the claim form and documents keep copies for yourself in case you need them or they get lost etc in the post.

Best of luck.

To Elland Back

pixiejess wrote: »

This is going to sound completely stupid but what does this mean ? and thank you for helping

Not stupid at all. It means that if a policyholder did not disclose the correct facts (misrepresent) at the time the policy was taken out, the insurer can decide to cancel the policy from inception. It can, however decide to leave it live. If for instance, you had baggage stolen, that aspect of cover is unrelated to the health issue and they should pay up.

pixiejess

Cookie_Dough wrote: »

Sorry to hear you news.

I would think the travel insurance company may not pay on in this case unfortunately, on the basis that-

-The travel insurance was purchased after the diagnosis (many insurance companies would have exclusions such as not covering any claims arising as a result of an illness known to you before purchasing the insurance, certain illnesses may also be excluded)

-If the insurance was also purchased after booking the holiday the insurer may not cover any costs incurred before taking out the policy as effectively you had no insurance coverage when incurring the costs. (apologies if this is not the case)

You should find out which insurance company the travel agent placed the travel insurance with and examine the policy wording you (should have) received from them/the travel agent when paying for the policy. At the end of the day the travel agent is just an agent (similar to a broker) and the contact is between you and the insurance company directly.

You should also have a look at the website for your travel insurance company to get info on their claims procedure.

Review everything you received and signed from the travel agent when booking the holiday and taking out the travel insurance.

If you are send off the claim form and documents keep copies for yourself in case you need them or they get lost etc in the post.

Best of luck.

Hi we never signed anything or knew who were insured with the travel agent didn't send us anything she just sent us a reciept by email for our payment . we played over the phone through our bank account . thank you for you advice I will make copies of everything that is a great idea . I don't know would the email from the travel agent saying her collegue didn't understand the insurance policy when she sold us the holiday help our claim ? Thank you again this was very helpful

Cookie_Dough

pixiejess wrote: »

Hi we never signed anything or knew who were insured with the travel agent didn't send us anything she just sent us a reciept by email for our payment . we played over the phone through our bank account . thank you for you advice I will make copies of everything that is a great idea . I don't know would the email from the travel agent saying her collegue didn't understand the insurance policy when she sold us the holiday help our claim ? Thank you again this was very helpful

Hi there,

I would say to definitely keep the email as backup. Is there any insurance company name on the claim forms? I would say just send the claim forms & whatever else has been requested & see where you stand when you get a response.

Perhaps someone on here who specialises in travel insurance would be able to give more accurate advice but I would have thought the travel agent were acting as an agent for whatever insurer so travel agent should have provided you with policy details on their behalf along with receipt etc when you paid so I would think the travel agent are negligent in that regard however the claim against the insurance company would be between you & them (rather than travel agent) so the email from travel agent may not help.

However this is just my opinion (which could well be wrong) I understand this is a tough time for you & your family so I'm not intending to put negative thoughts into your head.

I would say, as before, keep copies of anything you send, & wait for a reply before thinking the worst. Just sent the claim form & keep the email for yourself. As it stands you acted in good faith and entered into an agreement based on the advice of the travel agent & the travel agent has led you to believe you would be covered so wait until you hear otherwise.

Try not to worry as you haven't even sent the forms off yet.