I fought for months but MoS helped win my travel cover claim
Victory at last for grieving husband – and a warning over payout delays
HOLIDAYMAKERS who have a claim rejected on their travel insurance should prepare to fight. The Financial Ombudsman Service received nearly 3,000 complaints about holiday cover in the year to April, according to figures just published – and it ruled in favour of the traveller in more than half of cases. The Mail on Sunday reports on the case of a widower who battled – and won. AN ELDERLY widower whose wife died after an accident on holiday has been forced to wait seven months before finally receiving a £20,000 payout due to him from his travel insurer – with The Mail on Sunday’s help.
Peter Hicks, 83, and his wife Jean, 80, who had difficulty walking, were on a cruise in the Mediterranean in July last year when Jean fell, breaking her leg and dislocating her ankle.
They were in a cabin designed for disabled people, but Jean fell while getting out of bed. She was admitted to hospital in Barcelona where her leg was operated on.
The couple returned to Britain after five weeks and Jean was admitted to hospital in King’s Lynn, Norfolk. Her leg became infected, affecting her organs, and doctors amputated it in an attempt to save her life. But tragically she died a month later.
Peter, a retired owner of a heating engineering business, says claiming on his travel insurance was gruelling. ‘The insurer asked me repeatedly for the same information, which brought back all the memories of what had happened to Jean,’ he says.
‘And even though they had full access to Jean’s medical records and spoke to our doctor and hospital consultant, they still dragged their heels over paying the personal injury claim.’
Before travelling, the couple had bought a single-trip, joint travel insurance policy through broker Staysure. The plan was underwritten by insurance company Mapfre Assistance.
Peter contacted Mapfre on the day of the accident, and informed the company of Jean’s death within six days. But it was only after a wait of seven months that Mapfre agreed to send a cheque covering the personal accident clause of their policy.
Although Peter answered requests for information promptly, Mapfre frequently took a month or more to take the claim to the next stage.
Its last move – to get a second opinion from an independent doctor – took three months. Although the insurer chased the doctor twice, it refused to speed up the processing of the claim. The second opinion was only provided and the claim completed after The Mail on Sunday took up Peter’s case.
The Financial Ombudsman Service, which settles disputes between customers and their insurers, takes a dim view of insurers taking months to settle personal accident claims, and says that asking for medical information not related to the claim can be an indication that an insurer is ‘fishing’ for reasons not to pay out.
Martyn James, a spokesman for the Ombudsman, says: ‘We expect insurers to do all they can to resolve a claim quickly and in a straightforward manner – particularly when someone is having to cope with the loss of a partner or family member. Unless there are very good reasons for a delay, it’s absolutely unacceptable for this kind of claim to drag on for months.’
Mapfre also rejected part of Peter’s claim. Despite advising him to keep all receipts for spending while he stayed in Spain to be with Jean, the insurer refused to pay for his meals and fares to and from the hospital, saying this type of expense was covered by a Hospital Benefit of £800, which it had already paid to Peter.
In a statement the broker Staysure apologised for the delay in completing Jean’s personal injury claim and confirmed that Mapfre has now sent the full £20,000 personal accident payment to Peter. Staysure has also agreed to cover Peter’s expenses – about £500 – as a gesture of goodwill. The firm added: ‘Since last year, all new Staysure clients have policies underwritten by ERV Insurance.’