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Old 03-01-2018, 04:38 PM
ceeby ceeby is offline
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Travel Insurance Legal Help

Hoping someone on here can help me please!

Had to cancel my honeymoon to Bermuda back in September, a couple of days before I tripped up the stairs at home and landed on my wrist badly spraining it. Pain was very bad and could not dress myself properly (doing buttons up etc) and knew that I couldn't make the holiday as there was no way I could pull or lift cases or ride the scooter we had hired for when we got out there.

Cancelled the flights and got all but 80 back from BA which was good, but could only get the security deposit back on the property which left me 5500 out of pocket. Filled in the claim form about a week later, and thought i had better get some supporting evidence so I photographed my wrists for comparison, and went onto the pushdoctor site so that a GP could see the sprain and also to confirm that I had been taking the right steps to care for it. He confirmed it was a bad sprain.

Insurer has led me on a merry dance, and I have been truthful with them from the start, but after sending me to get more doctors reports and generally being a pain in the backside they have now declined my claim saying that I should have got a not fit to travel certificate before the holiday. Their terms and conditions state that you have to be examined by a doctor for a not fit to travel certificate but this does not state that it has to be before the travel date.

I'm going to write to the CEO tomorrow as I have asked for their escalation process but they have ignored my last three emails. I am confident that if I issued a court claim against them I would have a good chance of being successful, as legally I don't think their reasons for declining me a payout have much legal merit, this coupled with the fact that they knew the facts of my claim right from the very start but still made me jump through hoops before declining my claim has pissed me off a lot.

I would welcome any views from BBS'ers before I fire a letter off or start legal proceedings
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Old 03-01-2018, 04:41 PM
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I'm puzzled. Surely if you want to claim that you are not fit to travel, then that claim only has merit if you make and verify it before you are due to travel?
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Old 03-01-2018, 04:53 PM
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For an expensive holiday, I'd have been straight round the doctors the next day for a formal diagnosis, rather than on some website a while after.
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Old 03-01-2018, 04:53 PM
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Originally Posted by Maz View Post
I'm puzzled. Surely if you want to claim that you are not fit to travel, then that claim only has merit if you make and verify it before you are due to travel?
unless of course it was all at the last minute things were in a panic and you were flying around to recover as much as possible and do the right things by many agencies?

seems reasonable to me and good luck with the claim ceebee and bad luck hope you managed to enjoy the rest of the nuptials?
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Old 03-01-2018, 04:56 PM
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If the T's and C's omit the condition that the "Not Fit To Travel" Certificate has to be provided before the travel date then you may be in with a shout. Did you speak to Pushdoctor before your travel date?

Maz, if policy it is as above, then, for example, if you broke your leg prior to travel date and had hospital records proving as such, then why would the claim be without merit?
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Old 03-01-2018, 04:57 PM
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unless of course it was all at the last minute things were in a panic and you were flying around to recover as much as possible and do the right things by many agencies?
No, I don't buy that. I have made a number of insurance claims in a whole number of areas, and I would certainly never leave it a week after an incident to make a big claim, never mind to begin to provide evidence for it.

I don't mean to sound at all unsympathetic to the OP, but I can certainly see why the insurance company aren't immediately responding with a cheque in the post.

Quote:
Originally Posted by ChiswickEagle View Post
Maz, if policy it is as above, then, for example, if you broke your leg prior to travel date and had hospital records proving as such, then why would the claim be without merit?
I don't think that it would. It would be evidenced that the damage happened before the travel date. In this instance, I'm not too sure we have this evidence.
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Old 03-01-2018, 04:57 PM
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I would suggest this is pretty easy did you follow the terms and conditions or if it would be unreasonable because you were unable to do so you did so as soon as possible afterwards....
Reading you post personally I dont think you have a leg to stand on in the claim....with the amount of money at stake , why did you not phone them before you cancelled the trip. Be interested to hear the result. I think the clue may well be if they decide to defend the claim and if so be careful regarding them claiming costs could cost you a lot more.
However all the above is my personal opinion only but I would seek advice from a professional before issuing any claim.
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Old 03-01-2018, 05:03 PM
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Log complaint with Financial ombudsman service and they will contact the insurer. Terms and conditions will apply and you're responsible for reading them. They can ask for reasonable info before assessing claim and that in itself is no reason to uphold it. From what you've said about Ts&C's it doesn't put a time restraint on when you should have seen doctor. Guess they will ask things like why didn't you visit Gp or a&e. Big dough...good luck
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Old 03-01-2018, 05:19 PM
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You must go through their formal complaints procedure first. If they fail to provide details then send your complaint recorded to customer services and mark it clearly COMPLAINT

Then bullet point why they are wrong with evidence and why they should pay - be really careful on this bit - match their policy and procedures precisely to your circumstances and dates

Clearly you will not always be in a position to obtain a not fit to travel certificate before the event - incapacitated by an accident for example

Simple facts nothing more nothing less. State what you want them to do about it and give them 28 days to respond. State you will take it further to the ombudsman.

Any failure to respond is a serious black mark against them.

Getting money out of some travel insurance companies is a nightmare
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Old 03-01-2018, 05:23 PM
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Declaring an interest, I've worked in this industry for 24 years.

Policyholders of household, vehicle or life insurance would never put up with some of the obstacles plonked in your way by travel insurers.

All though are now signed up to something called "Treating Customers Fairly" and this is pretty robust in defence of the policyholder. Maz is right though to say you really should have got in touch ASAP. IE first business day after it became apparent that you weren't going to be able to travel. All travel insurers have a 24 hour emergency number but, as you hadn't yet travelled, they would simply have referred you to the claims line to call when open. You didn't so that's that.

Is it fair to insist you visit a doctor before your scheduled departure date? In your case, possibly. But what if you're taken ill on the morning of a Boxing Day ski trip. How could you get the supporting documentation in support of your claim then? It would be impossible.

I would suggest you follow the complaints procedure detailed on the policy. Keep detailed records of any unanswered correspondence and push them to formally decline your claim and confirm that this is their final decision.

If the underwriter is UK based (even with UK travel insurance, this is not always a given) you can then refer to the ombudsman. At that point, I would expect them to capitulate as it costs them money to defend their position. Obviously if you were making a wholly spurious claim (and it's clear you're not) then they might allow the ombudsman to opine.

Hope you get satisfaction, but if you want to PM me, feel free.
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Old 03-01-2018, 05:43 PM
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Thanks for your replies so far, some good advice. The boxing day ski trip is a good example of how this can not be followed to the letter.

My claim is for cancellation due to an injury, and there is specifically no mention of when a not fit to travel letter should be obtained. I called the insurance company on the day of travel and they never sent out a claim form. I have emails requesting it and a log of the initial call on my phone. They really are a bunch of shysters!
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Old 03-01-2018, 05:46 PM
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. I called the insurance company on the day of travel and they never sent out a claim form. I have emails requesting it and a log of the initial call on my phone. They really are a bunch of shysters!
That puts you in a very strong position - in fact I would expect you to win

Out of interest why did BA refund you? if not a fully flex ticket (presumably it wasn't if 80 was held back) - then someone has accepted your claim already - further evidence

Like I said its all in the 'facts' carefully documented
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Old 03-01-2018, 06:43 PM
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That puts you in a very strong position - in fact I would expect you to win

Out of interest why did BA refund you? if not a fully flex ticket (presumably it wasn't if 80 was held back) - then someone has accepted your claim already - further evidence

Like I said its all in the 'facts' carefully documented
Thanks for that, the BA Tickets were first class purchased with avios points, so I got the points back to my account, and a refund of the 1000 odd taxes with an admin fee of 40 per person. That is part of the flexibility of those tickets so unfortunately I don't think I can use that in my case against them.
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Old 03-01-2018, 06:48 PM
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Going right back to basics, what does the policy wording say about cancelling due to illness / being unfit to travel ? Does it specify anything ? In other words does a sprained wrist constitute ‘being unable to travel’ ?

As a matter of interest, who is the underwriter ?
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Old 03-01-2018, 06:49 PM
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Just to add, I have emailed them requesting any internal escalation process that they have that I could explore, or if they don't have that then if they could provide me with their service address for the issue of court claim forms.

Three emails sent to the address I have been dealing with them on, not one single response.
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Old 03-01-2018, 06:59 PM
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I fell ill on the day of my honeymoon and was not allowed on the plane. Insurer refused to pay as my GP could only presume the case of my sickness after the event (food poisoning). Gave up in the end. Travel insurance isn't worth the payment it's written on.
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Old 03-01-2018, 07:03 PM
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You really want to be careful with this legal stuff.

1) because it can get people's backs up unnecessarily
2) because you need to explore the formal complaints procedures first (otherwise courts will throw your claim out)
3) because it reads like a silly bluff to most people (not least because companies tend to have more resources to deal with them).

As for not hearing from them, bear in mind the time of year, and the chances that they may be a bit busy. You may find the telephone is far more direct and helpful in getting you the answers that you want.
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Old 03-01-2018, 07:12 PM
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You really want to be careful with this legal stuff.

1) because it can get people's backs up unnecessarily Understood but I have tried to engage with them, with no reply
2) because you need to explore the formal complaints procedures first (otherwise courts will throw your claim out) Have asked for their formal escalation procedures, ignored.
3) because it reads like a silly bluff to most people (not least because companies tend to have more resources to deal with them). Yes, I understand this, but I am quite happy to proceed through the courts on this,
as I feel they have a case to answer. If they want to treat it light a bluff that will only add to the strength of my case in my opinion.


As for not hearing from them, bear in mind the time of year, and the chances that they may be a bit busy. You may find the telephone is far more direct and helpful in getting you the answers that you want. I have been on this since September, last email was end of November. Telephone may be quicker, but I prefer to have a record of what I have been trying to achieve so it can be documented.
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Old 03-01-2018, 07:26 PM
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Yes, I understand this, but I am quite happy to proceed through the courts on this,
You can't go through the courts with this until you have exhausted their own complaints procedures.

I note the point about the allegedly-ignored (only allegedly because we don't know for sure that they have been ignored) emails. But you can't say you have exhausted the complaints procedures until you have tried other modes of communication.

Telephone is good : but you might also find that a letter, with its overtones of formality, is even more effective.

Finally, you really should be considering the Financial ombudsman, who is generally much faster (and certainly much cheaper) than the legal system. There is a time limit involved (I think it may be six months from complaint) so you'd need to act fast if you wanted to take this route. Generally speaking, both parties lose if a matter proceeds to court
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Old 03-01-2018, 07:49 PM
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You can't go through the courts with this until you have exhausted their own complaints procedures.

I beg to differ on that one, otherwise they could simply withhold their internal escalation process from me for ever (or simply keep ignoring me) which means I would never have a form of redress.

I am attempting to engage with them but they are refusing to communicate with me. It may be that court action is all I can do. I will make a point of pre action civil procedure rules though.
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