Disputing a claim decision

Travelling without insurance is foolhardy at best, but what happens when you have problems before you even depart for your trip? Following diagnosis of a serious illness, Val is finding it difficult to see the point of travel insurance.

Q. Val

I was booked to travel with a group of friends, but have been told by my cardiologist that I require immediate surgery and therefore have had to cancel my trip. I had no idea about any heart condition when I booked my trip. My problem is that at a time when I don’t need excessive stress, I have been informed that I will receive a refund on travel, which only equates to about 50 per cent. This is not what I needed to hear, but I suppose it is better than nothing. Is there anything I can do? 

A. While this has happened at a time when you do not need the extra stress, you obviously still wish to resolve the issue with your insurance company. You should consider taking the following steps:

1.   Appoint someone to deal with the insurance company on your behalf. This could be a friend or relative. Advise your insurance company that this person has full authority to get information on your behalf.

2.   Ask your insurer to provide substantiation of why it is only refunding 50 per cent of your travel costs. Request that it highlights clauses in your contract that allows it to do this.

3.   Review this substantiation and request clarification where required.

4.   If you don’t agree with the ruling, you should contact the Financial Services Ombudsman and ask it to review your claim. You can find out more at www.fos.org.au.

Have you had difficulties with your insurance company? Were you able to resolve them?