Travel insurance won't pay out - say condition was pre-existing

[dacouc]

Read very carefully how the Insurer word the declaration about existing medical conditions and pay particular attention to whether it just relates to those who are travelling or asks about non travelling members of family (It will typically refer to non travelling persons on who the trip would depend or words to that effect).

 

Most companies have a tight wording that asks about non travelling persons, but most companies did not include this until recently and there are still companies that don't ask about non travelling family members.

 

The law of the land specifcally states that Insurers have to ask clearly worded questions that ask specific questions, if they don't ask a clear & specific question then they cannot rely on it. You are legally not obliged to volunteer any information that they have not asked clear and specific questions about

[dacouc]

It's a good complaint letter, concise and devoid of emotional blackmail.

 

Just to add to Uncle's comments.

 

I would remove the words"Serious Illness" from the penultimate paragraph, their flow chart does not ask for serious illnesses but simply medical conditions. It's a much wider term encompassing minor ailments including as others have noted bunions.

 

Using "Medical Conditions" might be helpful if it goes to the Ombudsman, they tend to look at how the Insurers word questions / statements, how Joe Public may interpret this and whether it's overall fair.

 

I would also reference the relevant Ombudsman case number 105/1, it shows you've thoroughly researched your situation and it would not be unusual for the person handling your complaint to not be aware of that case.

 

The Ombudsman will certainly take into account that they specifically provide a list of certain medical conditions (Including Breathing / Heart conditions) when asking about the health of travelling persons. But they do not provide a list when asking about non travelling persons.

 

Feel free to refer to that when making your complaint, it may help swing the case, especially if the person handling it has any experience as to how the Ombudsman may view the case.

 

Bear in mind, the Ombudsman is not a cut and dry win as they will look at the whole case which we are not neccessarily aware of. But have no fear the Ombudsman does look at what's fair and expects a high standard from the Insurer who after all are the professionals.

 

If it does go to the FOS, they tend to move at a similar speed to continental drift, so don't expect a swift answer from the FOS