In early 2017 Jesse and Robin booked a holiday in Europe. On their way back, they planned to stop over in Hong Kong for two days. In April 2017, the couple purchased travel insurance for their trip.
Jesse and Robin enjoyed their European holiday and arrived in Hong Kong without any problems.
Stomach bug in Hong Kong
The day before Jesse and Robin were scheduled to fly from Hong Kong back to New Zealand, Robin contracted a violent stomach bug, and was too sick to fly. Jesse cancelled their flights, and booked extra accommodation so Robin could recover.
By the end of the day Robin was showing signs of improvement. Jesse and Robin were able to book new flights and return to New Zealand one day later than expected.
The cost of rebooking the flights and the extra night’s accommodation totalled roughly NZD $3,017.93. Jesse and Robin made a claim for their costs with their insurer.
The insurer declined Jesse and Robin’s claim, as they had not seen a medical professional before cancelling their trip, and did not have a medical certificate as proof of Robin’s illness.
Jesse and Robin disputed the insurer’s decision and complained to FSCL.
Jesse and Robin’s position
Jesse and Robin said it was unreasonable for the insurer to insist that Robin should see a doctor in the circumstances. Robin was very ill, and couldn’t be away from a bathroom for long. The closest doctor’s office was a half hour walk away, more than Robin could manage. Also, Robin had suffered from a stroke several years earlier, leaving her with limited mobility, making the walk particularly difficult. Jesse said he thought it was best to let Robin rest and recover, rather than push her to see a doctor.
The insurer’s view
The insurer relied on its policy, which said the insurer did not have to pay for cancelled flights, except where a trip was cancelled on the written advice of a medical professional.
When we reviewed Jesse and Robin’s insurance policy, we saw that the terms were clear. The insurer could insist on seeing a medical certificate as proof that cancelling a flight was necessary. Unfortunately for Jesse and Robin, the insurance policy is their contract with the insurer, and we must have regard to the terms of the contract when we make our decision.
We found that it was not unreasonable for the insurer to insist on sighting a medical certificate in this case. There were ways Jesse and Robin could have seen a doctor without taking a difficult half hour walk. They could have organised a house call, and had the doctor visit their hotel, or they could have called a taxi to take them from the hotel to a medical centre.
We sympathised with Jesse and Robin’s situation – we understood they were doing what they thought was best in the circumstances. However, we found that the insurer was entitled to require a medical certificate. The insurer had not acted unreasonably or unfairly when it declined Jesse and Robin’s claim.
We recommended that Jesse and Robin discontinue their complaint.
Travel insurance policies often require a medical certificate as proof of an illness or injury. Even if you’re not so sick you need medical treatment, it’s worth seeking a medical certificate if you think you might have to claim against your insurance.
If it seems like you might need to make a claim, it is usually a good idea to contact your insurer, and to see what steps they recommend you take. This can help you make sure you check all the right boxes, and can help your claim go as smoothly as possible.