Insights
Sometimes, like in Christina’s circumstances, the consumer wants to share their experience and recommendations to ensure that others do not have the same negative experience. We are able to help facilitate these conversations, if the participant and consumer are willing.
If your travel insurer requests information to support your claim, such as medical records, it is important that you provide that information as soon as you are able to, to ensure that your claim can be processed efficiently.
What happened?
In July 2024, while in Thailand, Christina started feeling unwell and went to the hospital with what she thought were heart attack symptoms. Christina was admitted and was diagnosed with gallstones requiring surgery to remove her gallbladder.
Christina made a claim with her travel insurer for the cost of the surgery, but, after spending three days in hospital without confirmation from her insurer and feeling like she had no other option, Christina discharged herself and returned to New Zealand. Christina had gallbladder surgery within forty-eight hours of returning to New Zealand.
Christina complained that the cause of the delay in confirming her cover was that the travel insurer insisted on confirming that her gallstones were not a pre-existing condition, which would be excluded from cover under the policy. Christina said that by the time the insurer decided they needed this information, it was after 5pm on a Friday and her general practitioner’s office was closed for the weekend. Christina said that this made a stressful situation worse, and she had already disclosed and paid a premium for her pre-existing conditions (unrelated to her gallbladder), so this made it seem like the insurer did not trust her.
Christina said that once she had notified the insurer that she was going to discharge herself, the insurer then gave her approval, conditional on her signing an unlimited indemnity, that would mean that she would be responsible for the costs if she ended up not having cover. Christina said that it was unreasonable for the insurer to ask her, while she was in hospital and was vulnerable, to sign an unlimited indemnity.
Christina’s claim was ultimately accepted within forty-eight hours of her returning to New Zealand. She did not receive payment for approximately one month, despite the insurer saying it would take ten working days.
Christina said that she was fortunate that she could afford to discharge herself and return to New Zealand for the surgery but was concerned that others might not be so fortunate.
Christina complained to FSCL about her experience.
How did FSCL suggest that the complaint should be resolved?
While discussing the complaint with Christina, Christina explained that her primary concern was making sure other people did not have the same experience that she had. She wanted the insurer to review and reconsider the processes that they use.
We suggested to Christina that it might be helpful for her to have the opportunity to speak directly to the insurer about her experience, her concerns, and to give recommendations for how the process could have been handled better in the future. The insurer agreed to speaking with Christina, and they both reported that the call had been productive.
Christina confirmed that the call with the insurer had resolved her complaint, and we closed our file.
