Ridiculous travel insurance refusal for declared pre existing condition

[Slapdashsuitcase]

Looking for advice, my parents are going through complaint process with insurers but have had 2 levels of managers say no so far, They are tired and sad from ruined holiday so want to help.
They have travel insurance renewed through company for a few years. Company sends Them invite to renew, so its all through them not a broker or conparison website.. All pre existing conditions declared at start when first registered.
Parents had a holiday booked . One parent had to miss it due to flare up of declared health condition.
Insurance denied as they didn't redeclare existing health condition each year. My parents think there was nothing to indicate you had to redeclare it each year - same company its all on record.
Company are saying it is their mistake and won't pay out.
Do my parents have a leg to stand on? Is this a ridiculous deliberately obstructive rule. My parents asked them if this happens a lot and the call centre person admitted it had happened a few times so sureñy they know its unclear.

Any advice appreciated as they escalate.

Ombudsman?

I think they have to escalate through complaints process before it goes to ombudsman

For example, if it was diverticulitis and had flared up in 2019 and then stayed asymptomatic for 2 years and then it flared up in 2021 if you had not declared the 2021 flare up even though it was marked as a long term condition it changes the risk for 2022 insurance as the most recent flare up was not assessed. I think this is how they get away with it. Definitely fight it though.

Was it listed on the cover documents at each renewal?

Each policy is a separate one for each year. They should have declared it. There's no 'admitting', the person on the phone is agreeing that it could happen (that people could phone up and say it's not fair).

However, it might be cheaper for the company to pay than go to the ombudsman once they exhaust the complaints procedure.

Ombudsman or the guardian consumer rights person. It's a grey area unfortunately but either of the above will be their best bet. Perhaps the newspaper is better as they can also remind others eg my dp who I know hasn't told the bank!

Do they return a pice of paper or renew by phone ?

Could they ask to see copy / listen to conversation

If the question was "any changes " then obviously they don't have to redeclare

Do they a check the documents they get sent each year that the conditions are listed - our schedule listed pre-existing conditions

I agree that there is nothing lost in fighting it, but I have similar insurance and must declare all conditions each year to confirm that there have been no changes. The degree of risk assessed isn't just what the condition is, but the current circumstance, so if I had any deterioration, treatment changes etc, that would be relevant even though there are no new conditions. And it does tell me this when I get a renewal notice. I don't know how their insurers handle it, but it's clear in my paperwork that I have to check nothing has changed.

Thanks for the input.

So if everything else appeared to be prefilled from insurance company, it was on them to know that the pre existing conditions was not refilled on the form and to redeclare? I'll let my parents know. It would be free to escalate to ombudsman for my parents wouldnt it, so may be worth a shot.

Insurance is regulated by the FCA. The FCA is very hot on selling suitable products to people, and ensuring that customer vulnerability is taken into account in the sales and servicing activities of companies.

However, they don’t deal with individual complaints, so you need to threaten that you’ll take the case to the financial ombudsman service. You can’t do this until after you’ve gone through the complaints process. But what you can do is sprinkle your complaint with the magic words “vulnerable elderly” and make explicit that you intend to go to FOS.

as you’ve described it, it sounds like the company hasn’t been sufficiently clear and it’s unfair, but if they have clearly stated that customers need to update their health declarations, or that they need to check a policy document that clearly states that their medical history has been wiped, then you don’t have much room for complaint!

My parents are annoyed cause they are normally pretty savvy on this stuff.

I think your parents will need to request the company's 'final answer' before they can go the ombudsman.

Requesting the 'final answer' also let's the company know that you're planning to go to the ombudsman.

The company has to pay a fee, which I think used to be £800, for all cases referred to the ombudsman. This encourages companies to settle smaller claims in the customer's favour.

Please do a bit of research. I know the rules used to apply to banks, but there might be different rules for insurance.

You could also try a name and shame.

https://www.telegraph.co.uk/authors/k/ka-ke/katie-morley/

I renewed my insurance recently, they send you an invite to renew but you have to go through all your health history and check its still correct and nothing has changed or added on. So for example, with the diverticulitis you might have added that its 'current within the last 3 months' rather than 'diagnosis but managed and no symptoms within the last 3 months'

or whatever their terminology is.

It wont have made one jot to the premium I bet, but they wil find a way of not paying out because you didnt declare everything

Its why I dont really trust it