The Financial Ombudsman Service (FOS) has recently upheld the following complaint regarding annual travel insurance which we feel you may find of interest.

When Mrs X applied to buy annual travel insurance, she told the broker that she suffered from angina. The insurer involved agreed to cover her for this condition. However, several months later, her GP made a small alteration to the medication that she took for her angina, as she had begun to experience some minor side effects with the original dosage.

Mrs X had no further health problems until six months later, when she was admitted to hospital while on holiday abroad. She was suffering from chest pains, linked to her angina. Fortunately Mrs X recovered fairly quickly and was soon able to return home. It had never crossed her mind that there would be any difficulty in claiming back through her insurance policy, the medical expenses she had incurred while on holiday. However, the insurer involved refused to meet her claim. It said she had failed to comply with its policy condition requiring her to inform it of any changes in her health.  

The FOS noted that the policy condition in question was not stated clearly in the policy document and it had not been specifically pointed out to her when she bought the insurance. Moreover, the policy gave no explanation of what it meant by ‘change in health’. There was nothing to indicate that policyholders should tell the insurer about any change in medication. The FOS was satisfied that if the position had been clearly explained to Mrs X at the outset, she would have told the broker/insurer involved that her medication had changed. As a result, the insurer has been asked to elaborate on its policy wording and the broker involved was asked to ensure that customers were advised in all travel insurance sales that changes in health include any changes in medication.

In line with Treating the Customer Fairly (TCF), we should take an opportunity like this to learn from complaints and decisions by the FOS, even though the complaint is not directed at us. Anyone selling travel insurance should be made aware of this case and draw customers’ attention to the fact that any changes in medication should be advised to the broker/insurer throughout the life of the policy. 

Note : This article is intended for clients reference only and at no time involved T.I.C. (UK) Limited or any of its subsidiaries, its clients or staff members and has been used to highlight problems that could occur when purchasing  a travel insurance policy. AT TIC our staff are trained to highlight the importance of disclosing medical conditions or any other material fact that could invalidate a policy.