Help needed – Emergency Holiday Cancellation Claim Rejected:x

2 days before my husband and I were due to go on holiday, my Mum had a sudden and totally unexpected heart attack. As my Mum is an 81 year old widow and I am her only carer, we had no choice but to cancel.

My Mum has never had a heart attack before, but for the past 15 years or so, she has had angina and hypertension and other unrelated health problems, which she takes regular medication for.

We went to Co-op Travel to cancel, they were very sympathetic, and contacted the Insurance Company on our behalf. A few days later we received the claim form from Europ Assistance which we completed, it included a section for my Mum’s GP to complete regarding her health and medication.

A month or so later we received a letter offering me “their condolences for my recent loss” (although Mum is still very much alive, and has made a good recovery) saying that they would not be able to pay out because “the Health Requirements section of your policy clearly states that there is no cover for any claims arising directly or indirectly from a pre-existing medical condition, known to you prior to the commencement of the period of insurance, affecting any close relative, travelling companion who is not insured under this policy or person with whom you intend to stay whilst on your trip”

And “It is noted from your documents that at the time the insurance was issued your mother had been taking three cardiac medications. As the medications would be directly or indirectly related to the heart attack which was the cause of cancellation, we are regrettably unable to make any payment on this occasion.”

I feel aggrieved because anyone can have a heart attack young or old, and not everyone who has angina will have a heart attack, and not everyone who has a heart attack has angina.

Please can you advise?

Chrisdol

I can see why the insurers have declined the claim, but I think they make some assumptions that may be unreasonable.

It looks like a standard letter that assumes you had enough clinical knowledge of your mothers condition to enable you to make an informed judgement when booking the holiday. This is clearly not the case, and it seems to me to be unreasonable for an insurer to make this assumption. Not only is it unlikely that anyone who is not a doctor or other health professional would have the knowledge, many older people either do not discuss such things fully, or they are poor historians.

Write back and ask them to reconsider on the basis that you were not aware that your mother's condition was likely to change.

Thanks for that ScarletPimpernel, do you think that I should send the details as they appear in this post?:?

Kind regards,

Chrisdol

Have a look at the following links to see if they help from the FOS Website

annual travel insurance

issue 56 - complaints about travel insurance

Log-on to the Website and search (travel claims/cancellation) to see if there are any cases similar to yours. If so you can look at the decision made to see if it is in your favour. In any event, if you are not happy you can complain to the Ombudsman after you have exhausted the complaints procedure with the insurer. Europe Assistance are only a claims handling agency - not the actual insurance company!

Thanks Mooreda,

I read through loads of case studies and found one almost exactly like mine where the Insurer rejected the claim, but the Ombudsman upheld the claim and made them pay up in full. I am going to include it in my letter asking them to reconcider my claim.

Thanks once again,

Kindest regards, Chrisdol