Marco and his partner, Fia, had been travelling overseas when Fia fell ill. Marco and Fia visited several doctors while they were travelling. On Marco and Fia’s return to New Zealand, Fia visited her GP and was referred to a specialist. Fia visited the specialist in February 2024, who also referred Fia on for further testing.
A couple of days later, Marco used his credit card to book flights for him and Fia, which activated the complimentary travel insurance that came with Marco’s credit card. Marco and Fia were due to depart nine months later.
However, a couple of weeks later, the specialist discovered a suspicious mass in Fia’s throat. The specialist recommended that Marco and Fia cancel their travels because it was unlikely that Fia would be well enough to travel in nine months’ time. A week later, the specialist told Maro and Fia that an MRI had revealed a tumour in Fia’s throat.
Over the following weeks, Marco cancelled his and Fia’s flights and submitted an insurance claim for his and Fia’s cancellation costs. The insurer declined Marco’s claim.
Marco complained to FSCL.
Dispute
The insurer applied the policy’s pre-existing condition exclusion clause to decline Marco’s claim. The insurer told Marco that even though Fia had not been diagnosed before Marco booked the flights, Fia had been referred to a specialist for further testing which suggested that Fia had a health issue that could impact their travel plans. The insurer said that Marco and Fia should have waited until Fia’s testing was complete to book non-refundable travel, because it was reasonably foreseeable that Maro and Fia’s travel would have to be cancelled due to Fia’s health.
Marco thought that the insurer’s decision to decline his and Fia’s claim was unfair because Fia’s diagnosis was unforeseeable. Marco said that though Fia had been unwell, they had no way of being aware of Fia’s condition at the time he booked the flights.
Review
We reviewed the information Marco and Fia provided the insurer to support their claim, the parties’ correspondence, and Marco’s travel insurance policy wording. We found that the insurer was entitled to apply the policy’s pre-existing condition exclusion to decline Marco and Fia’s claim.
We explained to Marco that, even though Fia’s diagnosis was not foreseeable when he booked their flights, it was reasonably foreseeable that their travel plans may be affected by the results of Fia’s ongoing medical tests.
We suggested that Marco and Fia discontinue their complaint.
Resolution
Marco and Fia decided to discontinue their complaint following our review.
Insights for consumers
Pre-existing medical condition exclusion clauses are common in travel insurance policies. If you are concerned that the health of a travel companion could impact your plans, it is best to wait before booking non-refundable travel or, make sure you declare all medical conditions to the insurer even though you may not regard the condition as serious.
