In February 2023, Mia bought flights to Denmark with her credit card. Mia’s flight purchase activated the complimentary travel insurance that came with her credit card.
In October 2023, Mia flew to Denmark. While Mia was travelling, she chipped a tooth unexpectedly. Mia’s chipped tooth was causing her a lot of pain, so she decided to visit a dentist in Denmark rather than waiting until she returned to New Zealand.
The dentist carried out a partial root canal on Mia’s chipped tooth and gave Mia a temporary filling. The dentist explained to Mia that he could not complete the root canal at the time, so Mia would have to visit a dentist once she returned to New Zealand to have the root canal completed.
Mia returned to New Zealand and visited her dentist to have the root canal completed. A couple of days later, Mia lodged a claim with the insurer for the cost of her emergency dental treatment in Denmark. The insurer accepted Mia’s claim.
Over the following weeks, Mia’s New Zealand dentist completed the root canal procedure. Once the root canal was complete, Mia made a claim under her travel insurance policy for the cost of the treatment she received in New Zealand. Mia thought her travel insurance would cover the cost of her further dental work because the policy included cover for ongoing treatment.
The insurer declined Mia’s claim for the cost of her ongoing treatment. Mia complained to FSCL.
Dispute
Mia thought that the wording of the travel insurance policy was ambiguous. Mia read the travel insurance policy as providing cover for the ongoing dental treatment she received in New Zealand, and she wanted the insurer to accept her claim.
The insurer disagreed with Mia’s interpretation of the insurance policy. The insurer said that the policy wording was clear and was not intended to cover Mia’s ongoing treatment once she had returned to New Zealand.
Review
We looked at Mia’s insurance policy wording and agreed with Mia’s view that, unless the travel insurance policy was read in careful detail, it could be misinterpreted. However, we did not think that the insurance policy wording was so unclear that the insurer should have to accept Mia’s claim for her dental treatment in New Zealand. When read as a whole, the policy was sufficiently clear that while the cost of emergency dental treatment while travelling was covered, the cost of ongoing dental treatment once the insured was back in New Zealand was not covered.
We found that Mia’s dental treatment was outside the scope of her travel insurance policy.
Resolution
We recommended that Mia discontinue her complaint. We also suggested an improvement the insurer could consider making to the policy wording to avoid any future risk of misinterpretation.
Insights for consumers
Travel insurance policies are generally not designed to cover loss, including ongoing dental treatment, that occurs after the travel period ends.
