Any travel insurance experts here?

the whistler

Looking for advice on this.

I booked a holiday several months ago and took out travel insurance. My wife and I have several medical issues which were all fully declared and accepted by the insurance company.

Two questions asked were .

1. Any joint replacements
2. Anyone on waiting list for future operations.

With reference to q1, my wife had undergone a toe operation to replace worn out cartilage (arthritis) around 18 months earlier, so I answered yes to this.

With reference to q2 I answered no as at the time there were no future operations planned.

These answers were accepted by the insurance company.

Unfortunately the previous operation wasn't very successful, and after a visit to outpatients last week, the surgeon offered my wife another operation to insert a different type of joint. She agreed to this and has therefore been put on the waiting list for a future operation expected to be in about three months time.

As the holiday is next week, I perused the insurance documents to check everything was in order and noticed the clause that any changes to medical conditions must be notified, so I called the insurance company and advised them that the answer to q2 had now changed. I was advised that any claim relating to the toe condition would now not be covered.

I would say that the likelihood of any such claims would be pretty much zero as I can't imagine anything happening to my wife's toe which would require any treatment prior to her proposed operation.

However it seems strange to me that the insurance company can effectively change the policy in respect of a medical condition which pre existed and was accepted at the time of purchase.

I know every policy is different, but in general, would an insurance company have the right to do this? It seems to they are changing what is in effect a contractual document. As I understand it, a travel policy is meant to cover the holiday and also anything occurring prior to the holiday.

BT Bob

I'm no expert, but I do have some experience of medical conditions relating to travel insurance.

Firstly, I'd say you absolutely did the right thing in telling them. Had you not done so, and needed to claim (even an unrelated claim) there's every chance they've have refused to pay out due to non-disclosure.

My wife and I each have annual travel policies linked to our bank accounts and 2 years ago, each had to notify the company that we had issues - in her are it was bowel cancer (successfully treated) and in my case it was gallstones and an operation scheduled to remove my gallbladder.

We both had our policies amended to cover these at additional premium cost - which was fine - so I'm surprise your company hasn't done the same.

LV426

It's my understanding that - because you were covered for the toe - they would be bound to offer you this choice:

You go and you'd have to cover anything related to the toe yourself, or
You cancel and claim a full refund of monies paid and not refundable.

It is this last bit to which I believe you have an absolute right, under the original cover that applied before the condition "changed".  They have carefully failed to mention this and have offered you only the first option.

However, I suspect that this response is more or less automatic, and comes from CS advisers, rather than anyone who actually applies any judgement - on the basis that 90% of people will simply accept what they are told.

The one time I was in similar circumstances, I told the "adviser" that, if they refused cover for the changed condition, I would put in a full cancellation claim and they'd be liable for all of that; in my case it was about £2k.  That prompted a VERY quick "please hold while I talk to the underwriters" followed by an endorsement in my favour.  Of course - a certain payout of £2k vs. the "risk" of a claim on my changed condition seems like a no-brainer.

the whistler

Thanks for the replies.

Emails and phone calls have been flying here there and everywhere today.

The holiday is a cruise and the cruise line insist upon full cover for all pre existing conditions and could if they wish cancel the holiday.The insurance company have refused to cover the toe condition so I have emailed them an ultimatum. They restore the cover (which is very low risk to them) or I or the cruise line cancel the cruise because I can't meet the cruise line conditions, and I then I make a full claim for cancellation which will cost them around £8k (yes I know it's an expensive cruise!) The ball is now in their court to make a decision.