A London couple who were forced to cancel a trip to Uganda after their son was unexpectedly diagnosed with hepatitis have described their incredulity after InsureandGo refused their £1,440 cancellation claim because he had a pre-existing condition: teenage acne.
Tom Bennett* and family say InsureandGo, one of the biggest travel insurers, used a clause buried in its terms and conditions to say that because he was being treated for the skin condition before they bought the policy, it won’t pay the cancellation claim. The trip was cancelled because of the hepatitis, which had not been diagnosed before they bought the insurance.
After taking several further weeks to re-examine the case, InsureandGo told Money it stands by the decision. It said paying out “would be highly unethical and unfair to other customers”.
The Bennetts had hoped to spend August on a two-week independent tour of Uganda. After making several bookings, including the flights, in June, they did the prudent thing, and bought an InsureandGo “silver” travel policy. Tom was meticulous in filling in the application form, disclosing a pre-existing cardiovascular condition, and the cost was adjusted upwards to £110.
“In April our son, who was to join us on the trip, had seen the dermatology team in our local hospital to explore a potential treatment for his acne. Further tests followed, but there was no indication that anything serious was wrong – until late July, when a liver biopsy was carried out, and he was diagnosed with autoimmune hepatitis. This meant he had to be admitted to hospital immediately and the trip was off,” says Tom.
Most of the hotel and other bookings were cancellable, he says, but the £1,440 cost of the flights was not, so they claimed. But after waiting over 10 weeks for it to be processed, it was denied.
InsureandGo, part of the giant Mapfre group in Spain, had used a term in the policy that excluded any medical claim if anyone covered was “receiving or waiting for any medical tests or treatment for any medical condition or set of symptoms that have not been diagnosed”.
In September, it reported global revenues of £18.6bn for the first nine months of 2019, with profits of £330m.
“Obviously, at no stage when we bought the policy did we expect there to be anything seriously wrong with our son. We would not have carried on planning, booked hotels, laid out the route, applied for visas etc. The wording is so deliberately vague it gives the company the right to reject payment under just about every possible scenario. Buying this insurance was so pointless, we might as well have thrown the money out of the window,” he says.
Robert Vines, also from London, contacted Guardian Money after spending over two months trying to get InsureandGo to pay his claim. He and his wife had been on a Turkish holiday in August when she collapsed and was rushed to hospital. After a series of tests she was given medication for hypertension. He paid the bill, but says he’s been battling ever since to get back his £2,300.
“In October they informed me that they had received all the necessary information and that I would hear in a couple of working days. I have spoken to them on six further occasions but nothing ever happens. I feel they are just doing everything they can not to hand over the money,” he says.
After our intervention he was paid, and the firm apologised for the delay. It has also refunded him the £150 excess it had deducted.
In 2015 we reported on the case of Joe Greensmith, from Lowestoft who was forced to borrow £3,000 to pay for a life-saving treatment in Hanoi. InsureandGo had refused to pay for the treatment, claiming his problems stemmed from a pre-existing condition. It refunded him after the Guardian intervened.
Last year InsureandGo refused to pay Philip Jenkins from Wales after the “beast from the east” dumped so much snow on his village that he couldn’t physically get to Bristol airport to start a ski trip. It said he wasn’t covered. After a year, the Financial Ombudsman Service (FOS) decided he was, and awarded him more than £830. “Don’t give up on your claim … this is exactly what they hope you will do,” he wrote.
Figures from the FOS appear to bear out the view that the company may, in some cases, be wrongly denying claims . It said this week that it currently finds in favour of the consumer in 44% of Mapfre complaints compared to 30%, the average of all general insurance, or 34% of travel cases.
InsureandGo says: “The terms of our policy, and those of most other travel insurance policies, make it clear we can’t provide cover for a claim if it relates to anything the customer was aware of before taking out the policy, unless it was declared and accepted by us. For this reason we’re unable to cover the cost of Mr Bennett’s cancelled air fare.”
It is expected the Bennetts will have to take their case to the FOS.
* Not his real name
Email your experience of claiming on an InsureandGo policy – good or bad – to consumer.champions@theguardian.com
