Legal expert about for advice ref travel insurance company?

[sheel]

Breadvan72 said:

If you scan and email me the policy wording including all the get outs I will have a shuftie.

http://www.staysure.co.uk/travelinsurance-portlet/doclib/STS11/erv/policywording.pdf
Hi I have tried to scan the policy but its much too large,I have attached the pdf link above, hopefully it will lead to the correct PDF

Thanks Richard

[anonymous-user]

You had already booked the trip before you received your diagnosis, so your call to the insurer was not mandated by the policy. Cover is excluded in respect of a condition that arises after the contract is made but only in respect of a trip booked after the condition arises. See 1 c on page 57. The insurer appears to me to be in breach of the contract. If it helps, tell the insurer that you have been so advised by an experienced barrister.

EDIT: sorry, I goofed, see below.

Edited by anonymous-user on Tuesday 9th September 11:21

[JustinP1]

Breadvan72 said:

You had already booked the trip before you received your diagnosis, so your call to the insurer was not mandated by the policy. Cover is excluded in respect of a condition that arises after the contract is made but only in respect of a trip booked after the condition arises. See 1 c on page 57. The insurer appears to me to be in breach of the contract. If it helps, tell the insurer that you have been so advised by an experienced barrister.

I love PH.

[Amateurish]

Playing devil's advocate, what about page 13 where the policy states that "5. The insurance will NOT cover you when you are
traveling with a Terminal Prognosis."

[Amateurish]

Also page 57: "No section of this policy shall apply in respect of: 1. claims arising as a result of the following:... e. you, ...
• have been given a terminal prognosis at the time of purchasing your policy and/or before commencing travel."

[sheel]

Amateurish said:

Playing devil's advocate, what about page 13 where the policy states that "5. The insurance will NOT cover you when you are
traveling with a Terminal Prognosis."

Fair comment but when the trips were booked there was no terminal prognosis, they were then advised as per the terms and condition's of my illness when it became apparent, there is a mistake within their procedures but they accepted and agreed with my condition all of which is thankfully recorded, I would assume that the problem they have now is the underwriters wont honour what their operator agreed to

[anonymous-user]

My apologies OP, but I cocked up. This will teach me to give advice on the hoof on a mobile phone. They have got you on page 57 1 e.

This leaves you with the publicity angle because of the assurance you were given in the phone, but on the contract the insurer is right, and what was said on the phone was not contractual in effect.

[anonymous-user]

JustinP1 said:

Breadvan72 said:

You had already booked the trip before you received your diagnosis, so your call to the insurer was not mandated by the policy. Cover is excluded in respect of a condition that arises after the contract is made but only in respect of a trip booked after the condition arises. See 1 c on page 57. The insurer appears to me to be in breach of the contract. If it helps, tell the insurer that you have been so advised by an experienced barrister.

I love PH.

Not so lovable when wrong!

[JustinP1]

Breadvan72 said:

JustinP1 said:

Breadvan72 said:

You had already booked the trip before you received your diagnosis, so your call to the insurer was not mandated by the policy. Cover is excluded in respect of a condition that arises after the contract is made but only in respect of a trip booked after the condition arises. See 1 c on page 57. The insurer appears to me to be in breach of the contract. If it helps, tell the insurer that you have been so advised by an experienced barrister.

I love PH.

Not so lovable when wrong!

My love does not wane.

You took your time out to help. That's what counts.

To be honest, it's a pretty poorly written set of terms regarding this issue. Through the sections It's referred to 'terminal diagnosis', 'terminal prognosis' and 'Terminal Prognosis', the last of course indicating that there would be a description of the term somewhere. There's not.

Seems like the OP will be able to claim for the cost of the holidays though, even though he can't be insured.

Maybe the pressure can be ratcheted up to force the issue with threatening the regulator. If they are stuffed for the considerable cost of the holiday anyway, maybe if they don't inure they might offer a settlement over and above which might provide a war-chest to mitigate some risks if going uninsured.

[TwigtheWonderkid]

It looks like a very poor quality policy. My annual travel policy is based on my health at the time of taking out the policy, and any illness I get after that point is not even disclosable until the following renewal. The only exception to this is an exclusion if travelling against medical advice, which seems fair enough.

But my policy works both ways. If I had cancer when taking out the policy, and paid a massive premium for the cover because of my poor health, and then a month into the policy found out I didn't have cancer at all and it was all an horrific misdiagnosis, I wouldn't get a refund.

[sheel]

All information provided by others rightly or wrongly is at their own free time and is most gratefully received.

I will travel next week without insurance if needs be and as I said I will do so using my own discretion
The trip to Oz is a different matter and I probably would be foolish to travel this distance without cover,it was booked via credit card so if worse comes to worse I can look to them for costs if the insurance wont play ball

I will continue to pursue the current insurers and will use the publicity field, its their mistake and others need to be aware of the stigma attached to being ill

On a brighter note, being self employed I covered myself with varying amounts of critical/terminal policies attached to life policies, I am happy to report that they have all been paid with no question. this dose help to restore fair in some companies

[anonymous-user]

In your situation I would spend it all on Ferraris, sky diving, coke and hookers etc. I hope you have a good trip.

[sheel]

Breadvan72 said:

In your situation I would spend it all on Ferraris, sky diving, coke and hookers etc. I hope you have a good trip.

An attitude like mine!!!! I seriously bent my Tiv a few weeks back just to add to all the ste that's arrived in life recently, due to the illness I can no longer drive but for a project to keep me motivated I am rebuilding it and guess what, its going to look to dogs doda when its finished gota have something to keep you going!! thanks for your help

Richard

[Goody13]

Doesn't Australia have some reciprocal arrangement with the UK? In fact, just found this http://www.humanservices.gov.au/customer/enablers/... and this http://www.nhs.uk/NHSEngland/Healthcareabroad/coun... Not sure what their views are on pre-existing conditions though so that would need a little more research.

If they would cover any necessary treatment you may need whilst abroad, then your worst-case scenario is repatriation. This would be expensive but probably a reasonably known cost, and if you have had your other insurance payouts you at least, presumably, have a fund for this.

You may as well go and do what you want as long as you feel well enough.

A friend of mine was diagnosed with MND in 2008. He had to give up his job, sold his house, and travelled and travelled for about 4 years. He is now in a wheelchair and can't do a great deal for himself, but as I have told him, he has travelled more in those 4 years than most people do in 70-80 years. I guess my point is to enjoy yourself as much as you can.

[TwigtheWonderkid]

Breadvan72 said:

In your situation I would spend it all on Ferraris, sky diving, coke and hookers etc.

And after you've done that, you should treat yourself.

[TwigtheWonderkid]

sheel said:

On a brighter note, being self employed I covered myself with varying amounts of critical/terminal policies attached to life policies, I am happy to report that they have all been paid with no question. this dose help to restore fair in some companies

Those policies can be expensive but are great when called upon. A mate of mine got £270K on a critical illness policy for a cancerous brain tumour, that he, against the odds, ended up surviving with very few long term effects.

[TwigtheWonderkid]

swerni said:

I got a significant amount of cash for one of my bks, which on balance, I think was a fare trade.

Chemo dragged on a bit, but at least I didn't have any hair to lose.


Keep your sense of humour !!!

I used to do business with a firm that made artificial testicles, to be put in after a cancerous one was removed. They're not cheap, about £100 each....or 3 for £250.

[sheel]

Im a happy bunny in my 54 years ive done loads met great people had a ball worked hard and made a good life docs I weeks ago told me the average time for my illness is 12 weeks my response was bks ive never done convention a d wont start now !!

[TwigtheWonderkid]

sheel said:

Im a happy bunny in my 54 years ive done loads met great people had a ball worked hard and made a good life docs I weeks ago told me the average time for my illness is 12 weeks my response was bks ive never done convention a d wont start now !!

That's the spirit, if you can't give up punctuation now, when can you?

All the best for the time that's left. Enjoy.

[dacouch]

Breadvan72 said:

You had already booked the trip before you received your diagnosis, so your call to the insurer was not mandated by the policy. Cover is excluded in respect of a condition that arises after the contract is made but only in respect of a trip booked after the condition arises. See 1 c on page 57. The insurer appears to me to be in breach of the contract. If it helps, tell the insurer that you have been so advised by an experienced barrister.

EDIT: sorry, I goofed, see below.

Edited by Breadvan72 on Tuesday 9th September 11:21

You're on the right lines.

The Ombudsman has very specific guidance notes for Insurers in these situations eg you take out a policy and book a holiday and your health subsequently changes.

Basically the Ombudsman expects the Insurer to offer cover possibly with an extra premium, if the Insurer is not prepared to do this the Ombudsman will expect them to pay the costs of cancelling the holiday.

"ongoing duty of disclosure

Some insurers try to exclude from cover not only pre-existing medical conditions but also any medical conditions that arise between the start of the policy and the start of the trip.

We generally take the view that this is not fair and reasonable - particularly if these terms were not brought to the consumer's attention when they took out or renewed the policy.

Alternatively, when a trip is cancelled or curtailed due to a connected person's medical condition, the insurer may refuse a claim - if it says the policyholder should have informed it of the situation at the earliest possible stage.

We agree that a policyholder should not delay in cancelling their holiday once they are aware they need to. But this may not always be immediately apparent when someone else's state of health is involved, particularly if there is no cause for concern at the onset of the condition.

If there has been an unjustified delay, we may decide that the correct outcome is for the insurer to pay the cost of cancelling the holiday at the earlier date, leaving the consumer to meet the rest of the cancellation costs."

http://www.financial-ombudsman.org.uk/publications...

This one explains the overall picture well http://www.financial-ombudsman.org.uk/publications...