I filed a $414 (£359) travel insurance claim with Axa last October after suffering dehydration in the US. Ten months later, it still has not been dealt with. I had provided all the requested paperwork, including three years of medical history from my GP, and in January I was called to be told my claim had been approved.
Nothing arrived, so I called again in March. After an hour, I was told the claim was still being processed.
In May, I then received an email stating it had been refused, and requesting five years of medical records to see if that would change the outcome. I duly did so, and got confirmation of receipt in June.
That was the last I heard. I’ve emailed, and calls just drop after ages stuck in the queue.
LH, London
Customer experiences on the review website Trustpilot tell a similar story of indefinite waits in the telephone queuing system, calls cut off and emails ignored. It’s likely you’d be marking the anniversary of your claim in limbo if I hadn’t roped in the press office.
Axa did not address my questions about staffing levels, nor did it explain the verbal promise to pay out in March, but it did admit that you had been let down. It says that your claim was refused because you did not declare a previous urinary tract infection (UTI) when you took out the policy.
However, it will now pay out to make up for its poor service. You insist that, although your doctors in the US initially suspected a UTI, the subsequent lab report diagnosed dehydration.
Pre-existing medical conditions are a vexed issue for travellers. Application forms require customers to detail every ailment for which they’ve sought medical advice over the past two years or more, and insurers can seize on a forgotten minor illness to refuse paying out for an unrelated major one.
The application form for your policy required you to list any conditions for which you’ve been prescribed medication over the past two years. I find it troubling, therefore, that Axa required your medical records for the past five years. I put this to the company, which replied evasively that it had initially asked for two years’ worth.
According to the Financial Ombudsman Service, an insurer can reasonably reject a claim that has nothing to do with a pre-existing condition, if they can show that they would not have allowed the policy to be taken out had the condition been disclosed. Axa tells me that, had it been aware of your previous UTI, it would have sold you a different policy.
Martyn James of complaints website Resolver says some insurers delve into medical records looking for a reason to avoid a payout. “It’s called fishing,” he says, “and it’s probably more widespread that we know, because most people just accept it when a claim is refused.”
Price comparison websites tend to steer customers to the cheapest insurance options that appear, in summary, to have them covered for most eventualities.
It’s in the terms and conditions, which few fully read, that a myriad of exclusions and restrictions are detailed. It’s therefore essential to read them and declare every ailment you can recall, however insignificant – even if it risks increasing the premium.
Email your.problems@observer.co.uk. Include an address and phone number. Submission and publication are subject to our terms and conditions
