What to do if your insurer won’t pay out on your claim
Q | Why won’t my insurer pay up over my claim?
Should your airline or travel agent cancel your trip, your insurer might cite ‘force majeure’ or ‘act of God’ — the reasons that invalidate policies include severe weather, airline strikes and terrorist attacks. One of the main reasons an insurance claim is declined is because the insurer believes the customer has failed to give them all the relevant information. This is called ‘non-disclosure’. This information must be significant enough to mean your insurance provider would have needed to either amend your policy had they known about it or even refused to cover you at all.
Q | How do I know if I’ve got a case regarding my claim?
You can be pretty certain you have a case if you gave all possible and required information when taking out the policy (did you really read that small print?). In addition, you were accurate and detailed when making a claim — providing any receipts or police reports (written within 24 hours of the incident). Embellishing your losses may be tempting, but keep in mind the two British law graduates travelling in Brazil in 2009 who were given a fine for fraud and community service for making a false claim.
Q | Full disclosure: my insurer still won’t pay out.
It might be that your insurer believes you haven’t taken enough care — leaving your wallet on the front seat of your hire car, for example, or chucking your camera around like a yo-yo. This can also include being drunk at the time
the incident happened. Obviously these areas, especially since insurers don’t define ‘drunk’ in any quantifiable way, can provoke endless dispute.
Q | How do I end the endless dispute?
Once a claim is declined, chase it up quickly with a complaint. Phone and ask your insurer to explain why it has refused to pay. Keep records of the dates, times and people you speak to and follow it up in writing. Insurers are supposed to respond to complaints within eight weeks. According to a recent survey by ABTA, 12% of people with travel insurance made a successful claim, 3% of them recouping over £500.
Q | And if I feel that I’ve been rejected unfairly?
Contact the Financial Ombudsman, an independent agency offering a free service to settle financial complaints. Insurers must obey its decision. You can also take private legal action while the Ombudsman is reviewing your claim, but be aware that once it reaches a decision, this ruling is final. Travel insurance represents about 12% of all the insurance complaints with which the Ombudsman deals. Most of these disputes involved either the trip being cancelled or curtailed because of the illness, injury or death of one of the travellers or a close relative; one of the travellers being hospitalised during the trip and incurring medical expenses; or money, a passport or baggage being stolen or lost. Pre-existing medical conditions also play an important role in defining the cover payouts. To contact the Ombudsman, T: 0300 123 9123.