Aloha Hawaii
Mike and Margaret had decided to travel to Hawaii between 24 January and 19 February 2015. Margaret would fly out on 24 January and go to Los Angeles for a week and then on to Honolulu. Mike would fly direct to Honolulu on 31 January.
On 18 August 2014 Mike and Margaret purchased their travel insurance policies with Galahad Insurance (Galahad). Mike and Margaret disclosed a couple of health ailments and agreed with Galahad that these would not be covered. Margaret did not disclose that she had a history of leg ulcers.
Mike and Margaret were very excited about the trip. Unfortunately, in January before they were due to travel Margaret developed a leg ulcer which then became infected. Margaret sought medical treatment and was advised that she should not travel. Margaret and Mike cancelled their planned trip and postponed it till later in the year. Mike and Margaret contacted Galahad to claim for their non-refundable losses.
Galahad declined Mike and Margaret’s claims. Galahad reviewed Margaret’s medical evidence and found that she had a history of leg ulcers and this was a pre-existing medical condition and therefore was excluded from cover. Mike and Margaret accepted that Margaret’s condition was probably pre-existing but they did not agree with Galahad’s refusal to pay Mike’s non-refundable losses.
Mike and Margaret complained to FSCL.
The investigation
We asked Galahad to provide all its correspondence with Mike and Margaret and the full wording of all relevant insurance policies. We also reviewed Margaret’s medical evidence.
We agreed with Galahad that the medical evidence, doctor’s notes and hospital visits all supported that Margaret’s history of leg ulcers was a pre-existing medical condition. We also checked the policies and confirmed that as Mike and Margaret were to be travelling home together, staying together in Hawaii, and as Mike had cancelled his trip because Margaret had been unable to travel, it was reasonable for Galahad to consider Margaret and Mike were travel companions. This meant that Galahad was not required to reimburse Mike’s loss.
The result
We discussed the policy interpretations with Mike and explained that Galahad’s obligation to cover his travel costs was directly linked to Margaret’s pre-existing medical condition and therefore could not be covered under the policy.
Mike and Margaret agreed that Galahad had acted reasonably under the policy and they agreed to withdraw their complaint.
The lesson
Many travel insurance policies have clauses that extend beyond your own health and wellbeing and can exclude cover for pre-existing medical conditions of your family, travelling companions and people on whom your travel depends. If you cancel your travel because of another person’s pre-existing condition it is likely that your expenses won’t be covered by your insurer. Remember to read your policy carefully and if you are concerned that a travelling companion’s medical condition may impact your cover, then your travelling companion should disclose the medical condition to the insurer and negotiate with the insurer to ensure there is cover.
