The Perth trip
Mary booked a trip to travel to Perth with her mother Pearl who was in her 70s. Mary booked the trip through the airline’s website and said she was asked for her and Pearl’s birthdates and passport numbers. Mary purchased travel insurance for her and Pearl at the same time.
Unfortunately, the trip to Perth had to be cancelled because Mary’s business sale did not proceed. Mary said she explained to All Claims Paid that Pearl would not be able to travel alone because she was elderly and needed Mary to travel with her. Mary and Pearl’s insurer did not cover their claim for costs incurred when their trip to Perth was cancelled because there was an exclusion clause under the policy which stated All Claims Paid would not cover losses because of financial, business, employment, professional or contractual obligations.
Mary and Pearl accepted All Claims Paid’s decision. However, Mary and Pearl were able to re-book a trip to Rarotonga for later in the year, and their travel insurance policy remained in place.
While on their holiday in Rarotonga, Pearl suffered from acute pancreatitis, a heart attack, and kidney failure, and tragically, she passed away.
The claim
Upon returning to New Zealand Mary lodged a claim with her travel insurer for the additional costs she incurred when Pearl fell ill and passed away in Rarotonga. The additional expenses totalling $11,900 were for accommodation, phone calls, rental vehicles, meals, hospital and doctor’s bills and repatriation of Pearl’s body to New Zealand.
The complaint
All Claims Paid declined the claim. It said the insurance policy only provided cover for travellers who were 59 years of age or less. Pearl was over this age.
Mary did not accept All Claims Paid’s decision. In her view, All Claims Paid was aware of Pearl’s age in May 2013 when it declined her first claim in relation to the cancelled trip to Perth. Mary said All Claims Paid should have highlighted to her that there would be no cover at all for Pearl for the Rarotonga trip. Mary said that while she was dealing with All Claims Paid to try and have her first claim covered, she mentioned several times that her mother was elderly.
Further, Mary was of the view that as the insurance was purchased at the time the overseas tickets were being purchased, and birthdate and passport details provided, the online booking/purchasing system should have highlighted that Pearl was over 59 years of age and that there would be no cover.
The investigation
All Claims Paid advised that under the insurance policy, there is no age restriction when travelling to Australia, but when travelling to Rarotonga, there was an age restriction.
Unfortunately, All Claims Paid did not have recordings of telephone calls between Mary and the airline when she was booking the trip to Rarotonga. All Claims Paid said if the issue of Pearl’s age was discussed, this should have raised a red flag with the airline (which was All Claims Paid’s agent), to advise Mary about the age restrictions in the policy, and give Mary further options around insurance cover.
In relation to the airline’s website automatically highlighting the issue of Pearl’s age, All Claims Paid said that when Mary made the new arrangements for the trip to Rarotonga, she did this through the airline’s contact centre and not online. Therefore, any notification around Pearl’s age would have to have been during those conversations. There was no online notification at the time Mary booked the original trip to Perth because the trip was to Australia, and Pearl was covered for travel to Australia.
For these reasons All Claims Paid reviewed Mary’s claim and decided to offer to pay the claim.
Claim by the estate
A further complicating factor was that most of the settlement sum (around $10,500) was payable to Pearl’s estate. Mary and her two sisters, Jenny and Jane, were the estate’s executors. However, the estate had already been wound up and Mary could not bank a cheque in the name of the estate. Further, Mary and Jenny’s relationship with Jane had soured and Jane had left to travel overseas, and did not give her family any contact details.
We arranged for Mary sign a settlement form including an indemnity from Mary to the insurance company against any claim for the insurance settlement payment, from any beneficiaries of the estate. Mary agreed to sign the settlement form and the complaint was resolved.
