Parents’ travel insurance refusing to pay out - what can they do?

[89DaysToLoseIt]

well, more specifically, my mother’s insurance.

my mum and dad have had separate insurance policies for about three years now, after my mum’s insurance refused to insure my dad due to his health conditions. my mum stayed with them as they offered her a good price. a few months ago, they had to cancel a trip because my dad was taken ill.

my dad’s policy has paid out straight away after the submission of a medical report. my mum’s insurance is refusing to pay out on the basis of my dad (who’s not insured with them), having not disclosed his health conditions to them! what’s their recourse here?

Then your parents need to go straight to the FOS if they have received a final response or the complaint has been with the insurance more for than 8 weeks. The FCA state that travel insurers have to treat their customers fairly it doesn’t sound like your mothers insurance are doing that.

His insurance policy is covering his costs.

of course she couldn’t go. Her husband had just had his heart restarted and was pumped full of morphine and a huge dose of beta blockers. He required care for 48 hours after.

Because they should have made it clear at that time she wouldn’t be covered. They didn’t.

Years ago when I was looking at a single trip travel insurance the t's and c's of one policy stated that I wouldn't be covered for cancelling the holiday if the cancellation was due to a predictable issue (including an elderly relative at home dying - because an elderly person dying was predictable).
In other words if it was foreseeable that your father's health would decline and it was foreseeable that he would be unable to travel then that policy would not have paid out, unless the possibility of the trip being cancelled because of your father's existing condition was specifically insured against.
Could this be what they are saying (although not very clearly)? That as your mother did not declare her travelling companion's (your father) pre-existing health issues on her current policy she is not covered?
Insurance companies don't link previous policies or declarations as I found out during a very long telephone conversation with my insurance company when they wanted to charge me for changing a policy.
If this is the case then she may indeed not be covered.

I think you are going round in circles here. Others have quoted the insurance policy wording and you are ignoring this. Why can’t you download the policy and attach here and someone can help.

You are also relying on bank account insurance polices which aren’t known to be good for anyone travelling with existing illnesses or people who are travelling with them.

I’m not with her at the moment. Her policy does not have this term in it. There is no such term. If there was, they would have taken the hit.

The only thing is that assumption would be incorrect, and they have had the documentation from his doctors to show that this was entirely random and unforeseen. His AF had been medically controlled for well over a decade when this episode happened.

Unless she asked the specific question 'Would you cover me for my husband's illness, even though you won't insure him for his own illness' and they replied 'yes' she would be expected to rely on the terms and conditions to check that he was covered.

The T&Cs that others have posted say that she would have had to declare the third party's conditions. You are arguing that they were declared by your father when they refused to insure him - so surely, there's your answer - they were declared, the insurer refused to cover them.

Once you are with your mum, find the exact wording. This is what it turns on and you have said that what’s in the public domain for Aviva is not her wording so it’s basically not possible to give you good advice without knowing what is in the agreed terms.

Again, incorrect.

thwy refused to cover him. Not her.

OP, I have a few insurances that I took out years ago. Every so often, I am sent booklets of small print updates to terms and conditions which quite often don’t get filed properly. Are you sure your mother has kept all the updates to her policy.
I think you may be talking at cross purposes for the insurance. When your mother took out the insurance as a single person, she would be required to notify them of any health conditions of person close to her whose illness would stop her travelling. The insurance company would have to accept these people’s health conditions, effectively insuring these people from illness when your mother went on holiday. Is this what the insurance company is saying about refusing your father insurance.

They refused to cover his medical conditions. His health led to the trip being cancelled. Don't you see that, if this were a genuine loophole, everyone would be using it? Relying on the healthier person's cover to cover any unhealthy person they might decide to go on holiday with?

This is the nub! You just dont see it. You also seem to think that a few years ago they refused cover for your Dad and therefore when your Mum brought in her own name somehow they should have crossed referred this info.

Bank insurance cover is known to cover basics and not more complex situations.

I had travel insurance claim refused over and over for a variety of incorrect reasons. Each time I made a complaint I got 100 in compensation. It was for medical costs as I fell ill when I was away. They finally paid it in full when they could no longer fob me off. It has been an eye opener and took so much effort. It has made me very wary.

As others have said, the fact you have not confirmed the bank makes it difficult to advise as we cannot check the terms.

Aviva provide travel insurance through a number of banks - Nationwide, Barclays, TSB, Lloyds, M&S Bank, HSBC and others. The terms vary from bank to bank. Under the Nationwide policy, for example, OP's father would indeed be an insured person as he is her mother's partner, notwithstanding the fact that his own insurance was refused. However, one thing all the policies I have looked at have in common is that they require her father's medical condition to be disclosed. The fact it was disclosed years ago when they refused to insure him separately is unlikely to be enough.

The problem is that as far as I am aware AF has a high rate of reoccurrence and it becomes more common with age. So the insurance company could argue that it was predictable.
However you say that your father's insurance is covering your mother's losses so surely she can take it as a lesson learned and has, thankfully, not lost anything.
And most importantly your father is recovering.

Absolutely you must declare those things! It’s usually every hospital visit and every GP visit for the last two years.

I somehow think the OP is realising that she is actually wrong hence the reluctance to say which bank.Trying to rely on info given years ago doesn’t mean that the insurer needed to be responsible for this.

My DH has a life limiting illness. There is no
way I would consider splitting my insurance over two different companies so we use the same
specialist insurance company

FCA complaint, dont mess around.

The FCA does not handle consumer complaints so complaining to them would be a waste of time. It would be FOS. Regardless, OP probably just needs properly talking through the policy wording as it is unlikely her mum is covered. To the extent she is actually covered, she will need to share the policy wording for anyone to be able to confirm how best to approach the insurers further.

Advising to escalate a complaint to an ombudsman or regulator without the basic information as to the agreement is just a bit silly.

What’s the point of the post if they haven’t done this yet? Your dad’s insurance will cover it, so you said. Or as you seem totally convinced they are wrong then the ombudsman will find in their favour. What is it you are asking of Mumsnet?

As you say though, this is a normal term for insurance - and so the benefit of being permanently covered by your bank means that you will have had insurance before that first appointment for investigations so if that happens after you book your holiday, you’re covered.

As it happens I claimed on my bank travel insurance last week and they’ve already agreed to pay out (although it was just for a GP appointment and prescription for something clearly not related to a pre existing condition).

But how would her parents even know about this to declare it? I don’t tell my parents every time I go to the doctors for antibiotic cream so it’s definitely not declared in their insurance… and how far do you go? Spouse? Children? Parents? Grandparents? Grandchildren? Siblings? Cousins?

You put down anyone whose illness or death would affect your travel plans.
edited for typo

But I don’t know every GP appointment my parents have had for the last 2 years and I’m not sure I’m reasonably expected to know and declare those, when my insurance terms in no way ask that.