/ Health, Money, Travel & Leisure

Doctor says you’re fit to travel, insurer doesn’t

Girl sat on suitcase with battered teddy bear

Who should tell you whether you’re fit to travel? Your doctor, who knows your medical history or an insurance company, which provides a service but exists to make money? The doctor every time, right? Perhaps not…

Customers might think so – but not travel insurers who prefer to rely on their own system of scoring medical conditions rather than the medical advice given to the customer.

In this month’s Which? Travel we highlight the problems faced by members who bought travel insurance policies and then believed they were covered for the trips they planned. But in between buying the policy and departing on the holiday they developed a new medical condition.

Members were told they were fit to travel by their doctor, but then had their medical cover removed or were told they could keep it in place only if they paid a much bigger premium.

New medical condition = no cover

It’s a common and growing problem – the Financial Ombudsman Service (FOS) is receiving up to 50 complaints a month on the issue, nearly double the number of three years ago.

The FOS said eight years ago that it was not generally fair or reasonable for insurers to behave in this way – unless the new condition represented a fundamental change in the risk being insured.

But one Which? member was told none of her previously insured conditions could be covered simply because she had a new minor condition of oesophageal reflux.

Another was insured for heart conditions, but when he developed a melanoma that his consultant said could be easily cured, his insurers told him neither the melanoma or the original heart condition could be covered.

An unfair system?

I don’t think this is fair, and it seems to be the result of insurers using a blunt instrument – the industry’s medical scoring system – to assess risk.

Thankfully, some insurers agree and believe that once a deal is struck, they shouldn’t vary the terms as long as the customer is not travelling against medical advice. We found policies with Axa Insurance, Freedom Travel Insurance and Miaonline.co.uk that put more emphasis on a customer’s individual circumstances rather than relying on an automatic scoring system.

Where do you stand? Have you been let down by a travel insurer when you thought you were covered? Or have you had good service that should be highlighted?

Comments
Member

The GP and Insurance companies are viewing the “medical condition” from very different view points.
The GP is considering whether the travel will make the condition worse or is likely to need urgent treatment.
The insurer is considering what the increased probability of a claim is due to this condition, even basic non- emergency treatment likely to lead to a claim many times greater than the premium or whether there is a significant increase in the holiday being cancelled or curtailed.

With travel insurance being sold/bought on a best price basis rather than best cover basis it is not surprising that insurers are really only interested in the lowest risk customers.

Member
Anne says:
5 January 2012

I think it’s reasonable to recalculate the claim, just as your contents insurance is recalculated if you’re burgled. But it’s not fair to just remove cover.

I have an incurable illness and it’s amazing how insurers vary – some want loads extra to cover it, some will exclude it, some will cover it for £10 more and the one I went with covered it for nothing more!

Member

When I was diagnosed with prostate cancer, which was discovered accidentally, three consultants advised that there was nothing to worry about for many years and that they would just monitor me by taking regular PSA blood tests. When I went to renew my anual travel policy,the insurer informed me that if I wanted cover to include prostate, the premium would be increased fivefold. They explained that it was because of the increased risk, but even though I advised them that my consultants stated that there was no risk, it made no difference. I asked them to specify what the increased risk was, so that I could determine whether to pay the additional premium or not and take the risk myself. They first said this information was data protected. I explained that I did not want to know any ones personal information, just what their claims experience was. They could not provide this information, but after pressing them, they advised that they took advice from an independent medical contractor. I have never been able to find out what the contractor knows about my condition that my three consultants did not.