Insurance companies do not get rich making it easy for people to make claims but sometimes the hoops they insist we jump through are shamefully insensitive, if not absolutely impossible.
We have long stressed the importance of travel insurance on this page mainly because barely a week goes by without us hearing from readers who could have saved themselves a lot of money, hassle and heartache by simply spending 30 or 40 quid on a policy before a planned trip away.
But sometimes we hear stories that make us question the worth of the policies, and we have such a story this week.
A reader whom we shall call Mary was prompted to contact us after finding insurmountable obstacles placed in her way when she tried to make a claim under her travel insurance policy after her brother died earlier this summer.
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He was in his mid-50s and received a cancer diagnosis last year at around the same time she renewed her annual travel insurance policy with a company she had been with for several years.
While she was obviously very concerned to hear about her brother’s condition she was relieved to learn that the illness was very treatable.
Mary and her husband travelled abroad in February and April of this year and did so secure in the knowledge that they had the protection of their travel insurance policy if anything went wrong. The good news was nothing untoward happened.
The even better news was her brother was responding very well to his treatment and was able to attend multiple sporting fixtures and a range of family functions while he received care primarily as an outpatient.
At the start of the summer Mary and her husband booked a weeklong holiday in Croatia and were due to travel in August.
Then things went very wrong.
“Sadly and unexpectedly while still being treated for his cancer, my brother died on the day we were due to travel,” she writes. “The suddenness of his deterioration resulted in us only cancelling our holiday the day before we were due to leave.”
While Mary has no complaints about the speed with which the insurance company made contact with her after she lodged her initial claim and found its representatives “professional”, she has serious concerns about how the claim is being handled.
“Firstly they are insisting as an ‘absolute necessity’ that to process our claim they need a medical certificate to be completed. I have a problem with this form. It seeks data that I believe is my brother’s private medical history which is not my prerogative to request,” she says.
She also notes that the declaration on the form she has been sent by the insurance company requires his GP to sign a document that states: “I confirm that I have obtained the explicit consent of the data subject to share this information for the purposes of validating and administering the claim”.
Mary points out that her brother’s GP cannot possibly sign this declaration as the patient – Mary’s brother – is dead.
“To provide evidence to the company that ours was not a vexatious claim, we provided them with a copy of my brother’s death certificate, which I believe should be adequate,” she continues.
She has another issue – one that may give many people pause for thought. It relates to the exclusions contained in the terms and conditions that the vast majority of us never read.
The concerning clause says cover will not be offered if a claim is made connected to “any medical condition for which a close relative or travelling companion are receiving or on a waiting list for or have the knowledge of the need for surgery, treatment or investigation at a hospital, clinic or nursing home”.
Mary wonders if this means that “if any member of my or any other person’s family is receiving cancer or other treatment, that relatives covered under this travel insurance cannot go on holiday or abroad for work, pleasure or whatever reason?”
She notes that she had booked the holiday in June for August “with no worries regarding my brother’s illness” and says the [insurance company] representative “suggested he was saving me the trauma of getting the medical certificate form signed as he believed our claim would be unsuccessful because of the exclusion clause quoted above”.
Mary says that she fully understands “that as yet our claim hasn’t been rejected and I haven’t addressed my concerns through the company complaints procedures but I am writing to you seeking your advice and or intervention because as a fellow human being, with your knowledge and experience, you understand that when people are traumatised by bereavement and loss, it is particularly hard to navigate bureaucracy and regulation that ordinary people don’t fully understand.”
We have contacted the company Mary took out the policy with and they are looking into it right now.
But we are not optimistic that her holiday will be covered as we have highlighted this exclusion clause before.
It is all too common and providers are happy to put all the benefits of their policies’ front and centre on their websites while doing what they can to be more discreet about the get-out clause that saves them from paying out.
One of the commonly found clauses excludes cover for “any medical condition for which a close relative or travelling companion has received a terminal prognosis [or] any medical condition for which a close relative or travelling companion is receiving or on a waiting list or has the knowledge of the need for surgery, treatment, or investigation at a hospital, clinic or nursing home, [or] any medical condition which a close relative or a travelling companion is aware of but for which they have not had a diagnosis.”
Quite how people are supposed to know the full medical histories of all their family members – including brothers, sisters, mothers and fathers – and be aware of all the illnesses all those people have whether or not they have been actually been diagnosed with them seems like a question the broader travel insurance sector would do well to answer.
[ Is travel insurance a waste of money or the best €100 you’ll ever spend?Opens in new window ]
