Natalie had planned a trip for herself and her children to visit family in Indonesia from the end of June to the end of July. Natalie purchased travel insurance from Fly Safe Today (FST) for her intended trip.
In April Natalie’s doctor referred her to a gynaecologist due to an abnormal cervical smear result. The local hospital wrote to Natalie advising she could expect an appointment within the next four months.
In May Natalie saw her doctor, who recommended she cancel her trip. The doctor told Natalie the appointment was very important and she should not miss it. Natalie cancelled her trip the next day.
Ten days later Natalie received another letter from the hospital advising Natalie that she had an appointment for 8 June. The letter also advised Natalie she could reschedule the appointment if she was unable to attend.
On 1 June Natalie submitted a claim to FST for $3,796.89 – the cost of the non-refundable air tickets. Natalie sent a medical certificate from her doctor with her claim stating she had been referred to a gynaecologist in April and would be prevented from travelling. The certificate referred to anxiety, post-traumatic stress disorder and depression as the diagnosis of Natalie’s illness.
FST declined the claim, referring to their general exclusion of cover for anyone suffering from a mental illness. Natalie did not accept this decision and contacted FSCL.
Natalie said she cancelled her trip because she received a letter from the hospital saying she would have an appointment in the next four months and she regarded it as very important she attend the hospital appointment. Natalie was warned she would receive an appointment for a date when she would be away on her trip and did not realise she would receive an appointment so quickly.
Natalie did not accept depression was a factor in her decision to cancel the trip. Her doctor clarified his earlier letter by stating that he told Natalie not to miss her appointment, and this had made Natalie anxious to cancel her trip as she did not have an appointment yet.
FST considered it was entitled to decline Natalie’s claim. FST referred to both the exclusion of mental illness clause, as well as the letter from Natalie’s doctor saying Natalie had suffered from depression in the past. FST believed this indicating a pre-existing medical condition excluded from cover under the policy. FST believed Natalie’s pre-existing depressive condition made her more susceptible to depressive illness, and more likely to cancel the trip as a result of the illness.
FST also observed that the appointment was on 8 June and would not have interfered with Natalie’s travel plans.
When assessing the merits of a case we must give fair regard to the law and industry practice. Under FST’s policy wording the definition of mental illness was very broad and includes depression, anxiety and stress as well as “disorder of thought form…which impairs either temporarily or permanently the mental function of a person’. We considered the doctor’s description of the anxiety Natalie experienced following the hospital referral was captured by this definition.
We considered FST had no legal obligation to compensate Natalie for her cancelled trip. However, FST offered Natalie $500 in as a goodwill settlement in recognition that Natalie, for whom English was a second language, had been disadvantaged by not understanding the hospital system. Natalie accepted the $500 in settlement of her complaint.