To think my insurance should cover me nearly dying?!

Another thing to bear in mind is that even if the proposal was found to be sound, there is an onus on the insured person to limit their liability/costs, so using a private hospital when they could have used a cheaper/free state hospital could also result in refusal to pay out.

Try Rip Off Britain on BBC1. They are very good with cases like this.

I think it depends on what they asked you to declare. Did they ask you if you have ever had any stomach issues?

Well, she did have an appendix...

J/K.

OP, there should be an appeals process, I would look into that.

I'm sorry to hear you are going through this, OP. Insurance companies can be an utter disgrace, as I have said many times before on these threads where people are quick to condemn others for not having adequate travel insurance.

The OP has done all the right things and yet still they are not paying out.

IBS can’t be diagnosed; only suggested after other tests rule out other possibilities.

OP you seem to be focussing on the insurance and ignoring the very good advice from several PP's saying that this should all be covered by the reciprocal heathcare agreement between UK and Australia. You need to register with Medicare, but then the majority of costs will be covered. You can register with Medicare now, even after your treatments. The only reason I can think of why you might not be covered by Medicare is if you were treated in a private hospital. For clarity, please can you confirm if the hospital was private or public?

The costs of doing so would push up everyone's insurance premiums and would probably cripple the NHS whose staff would be inundated with requests for millions of peoples' medical records. It's clearly not a good idea. Far better for insurers (and the NHS) to just trust policyholders to be honest and then not pay out when it turns out they weren't!

It would also cause delays to people taking out a policy. At the moment, you can take a policy literally a few minutes before your holiday, but if the insurer needs to ask for medical records from the NHS, you're realistically going to have to apply for the policy several weeks ahead of your holiday.

And how do comparison websites work? Will each different insurer all have to ask for the NHS records before they give you a quote. So each GP surgery gets potentially 10/20 requests from lots of different insurers.

You've really not thought it through.

Look on your medical records and declare what’s on there.

Fortunately the Ombudsman also takes the view that it's ridiculous to expect people to remember every cough and cold

Absolutely, @anyolddinosaur, and while every case will vary that's why I mentioned it's nothing new for the Ombudsman to overturn an insurer's decision

As for the "insurance included" thing with the banks, as said before they don't ask about existing conditions because they don't need to. Somewhere on the account application form there'll be a "T&Cs accepted" box to click and those T&Cs will probably say existing conditions are excluded from the insurance portion - and whille many don't read T&Cs that's no skin off the bank's nose

The problem is that it doesn’t matter whether the IBS symptoms are linked to the current issue. Insurance companies ask you to declare everything and will refuse to pay if they find you’ve been dishonest.

Whether this particular case will be upheld by the Ombudsman is anyone’s guess - OP will have to go through the formal complaints procedure before the Ombudsman can get involved.

This is what worries me. There can't be a person one country who hadn't had a vague issue that never got diagnosed as and I don't know what a doctor even made as a diagnosis if any.

So genuinely what do you put on the form? I scraped my knee when I was seven and have a scar?

You have admitted your own mistake "I’ve never had any issues that should be relevant" which suggests that there were issues that you didn't declare because YOU thought they weren't relevant. If the insurance proposal asks for literally everything, then you declare literally everything! It's not up to you to unilaterally decide what is or isn't relevant.

I was in this situation with my exH who was ill in Vegas....insurance refused to pay. Raise a complaint, and keep pursuing it....we eventually had our case before the financial ombudsman (I didn't know there was different levels until we got there!) but we went to the top and they paid so it's definitely worth carrying on with. Our bills totalled around $47,000 when they all arrived (that was on top of what we'd put on credit cards while we were there!) so don't lose hope, they should pay out....good luck!

Because they wouldn’t make as much money that way

I’m just going on my own experience.

Because they are dealing with hundreds of new policies every day, but only relatively few claims.

This is exactly what they do. Someone my DF knew refused to take out any insurance except that which was legally required because insurance is the biggest legalised crime organisation in the world.

Appendicitis has absolutely nothing to do with IBS anyway.

Sorry, but you will have to keep fighting them. Perhaps try one of the newspaper money advice columns.

i have mine through my bank account - it uses Aviva, and it did ask me if i had any pre-existing conditions and whether i'm currently under investigation for anything.

If an insurer can get access to your medical records when you make a claim why can’t they just do it when you take out the insurance as well and make everyone’s life easier. Insurance is a total state sanctioned legally enforced racket.

DH used to work for the FOS and dealt with many, many insurance complaints. This wouldn't be the first time it happens. Is your insurance underwritten by UK Insurance Ltd by any chance? We have 2 different sets of friends/family who had an absolute NIGHTMARE with them - including a couple where she ended up in intensive care in Peru whilst on honeymoon. This genuinely wouldn't be the first time an insurance company refuses to pay a perfectly valid claim.

First step - ask for your insurance's formal complaint procedure. Submit a formal complaint, in writing (can be via email if they share an email address in their complaints procedure).
Once you exhaust the formal complaint process, THEN you can raise a complaint through the Financial Ombudsman Service.

All the info you need is here: https://www.financial-ombudsman.org.uk/consumers/how-to-complain

Good luck OP.

how horrendous! I hate insurance companies! Can you get your doctors in Australia to state that this was an acute emergency that could not have been predicted and having some symptoms of IBS several years ago would not have predisposed you to acute appendicitis?
definitely pursue this and don’t give up

You have to go through the insurance official company's complaints procedure before you can go to the ombudsmen.

Unfortunately, insurance is a highly unethical industry. They are there to make profit and their business model is based on them paying out in as few instances as possible, at the expense of the policy holder.

Be prepared to fight, and keep everything in writing. The insurance company will be counting on a high percentage of people backing down when they first deny the claim, so don't be afraid to persevere!

I hope you're feeling better soon.

I'm disabled and can't even REMEMBER all the things that have medically happened to me in my lifetime. I have been in and out of hospitals and doctors since birth, it would be IMPOSSIBLE for me to declare every single thing.

It also ties back into the thread about people who 'stupidly' travel without it when they have a pre-existing condition when like I explained then its likely because they couldn't get it. As this thread shows even if they did it likely would have cost a fortune and still found a reason not to cover them in an emergency anyway.

There was a recent ombudsman decision in favour if the insurance company were a poor woman, collapsed on holiday and was found to have a brain tumour requiring emergency surgery. The brain tumours a sort that's almost certainly going to kill her.

Reason for her claim being denied: she'd recently started HRT. Completely unrelated but she hadn't thought to update her insurers on starting a medication not for an illness but at ease a stage of life!

Very sad, and shows what these insurance companies can get away with.

There's also a toddler who into yesterday was stuck in Mexico, who out of the blue had a brain hemorrhage. They disclosed hospital visits for bronchitis and jaundice as a baby, but seemingly didn't give all the dates, so because mum messed up the admin, baby wasn't covered. They had to fundraise to cover the costs of getting her back to a UK hospital.

I'm really sorry OP, I hope you get somewhere with appeal, but what these insurance companies can get away with is scandalous.

I wouldn't know the reason for the sniping posts, just that they are. You are giving some really poor information on this thread and I can't see how that helps the OP.