A couple complain that their holiday cancellation claim is turned down unfairly because of a pre-existing medical condition

Travel Insurance

We look at Mr and Mrs Norris' complaint which arose after they cancelled their holiday because Mrs Norris was taken ill.

What happened

Mr and Mrs Norris cancelled their holiday because Mrs Norris was taken ill shortly before the start of their trip. The couple had bought a travel policy from their travel agent at the time they booked the holiday. They put in a claim for the cost of cancelling it.

The insurer asked why they’d cancelled their holiday, and they described the symptoms of Mrs Norris’s illness. The symptoms suggested to the insurer that Mrs Norris had a digestive disorder called diverticulitis.

The insurer asked for details of Mrs Norris’s medical history. Her GP confirmed that she’d been diagnosed with diverticulitis five years ago. She’d also seen her GP about the condition six months before the couple had booked their holiday and bought the policy.

The insurer turned down the claim on the grounds that the policy excluded claims 'arising or resulting from a medical condition or related illness that the policyholder should reasonably have known about before the purchase of the policy’.

Mr and Mrs Norris complained that the insurer was being unreasonable. They said Mrs Norris had been in good health at the time they took out the policy and they weren’t aware that she’d been diagnosed with diverticulitis.

Our decision

It was clear from the medical evidence that Mrs Norris had been diagnosed with diverticulitis five years before she’d bought the holiday. She’d also been to her local hospital several times since then to have tests and see a consultant about the condition.

We thought that even if the couple didn’t understand the medical terminology relating to the condition, they would have known that Mrs Norris sometimes had symptoms that were serious enough to need hospital treatment.

The couple confirmed that when they’d bought the policy the travel agent asked both of them some questions about their health. We were unable to establish whether the agent had also explained the significance of the policy exclusion for pre-existing medical conditions. However, we noted that there was a clearly worded statement about the exclusion on the front page of the couple's policy document.

We did not uphold their complaint.