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ombudsman news


featuring questions raised recently with our free, expert helpline for businesses and advice workers

Our customer's mother died while he was visiting her overseas. He's now staying longer to help sort things out, and he's claimed the cost of his flights under "cancellation and curtailment".

We've extended our sympathies - but when it came down to it, we didn't pay the claim. He's now made a complaint. Did we make the right call?

You told us that when your customer called to take out the policy, he asked if he’d be covered for a missed departure. You’re concerned this suggests he knew his mother was unwell before he left.

But it’s important to establish how much he really knew about his mother’s health. You might need to ask - sensitively - for medical evidence. We’d only agree it’s reasonable for you to turn down the claim if you can show he knew before he travelled that his mother had a medical condition.

It’s also important to think about the intention of the clause you’ve mentioned. Usually, “cancellation or curtailment” is there to cover the costs of someone having to cut their trip short if their relative falls ill or dies.

It seems you’d pay the claim if he was on holiday and his mother fell ill back in the UK. This situation is the opposite, but the costs are essentially the same. Thinking about what’s fair, it’s likely we’d say this claim should be covered.
Of course, if the complaint reached us, we’d need more information before making a decision. But let’s hope you can get things sorted before then.

More about our approach to travel insurance.

I’m an insurance broker. I’ve recently heard from a client who had a car accident driving a friend to the airport.

He’s made a claim, but the insurer won’t pay out. It turns out the friend had given my client £20 to cover petrol costs - but the insurance policy excludes damage caused while the car’s being used as a hire vehicle.

I’ve seen the policy and the term is there in black and white - I just don’t think it’s fair. Do you?

People take out insurance to give them peace of mind - knowing that they’re covered if something unfortunate happens. Equally, insurers put terms in their policies to exclude situations they don’t want to cover - which is generally considered to be a commercial decision.

Unfortunately, as you’ve highlighted, those black and white words can cause problems.
In your client’s case, the insurer has applied the policy terms very strictly - saying that by accepting money for petrol, he is effectively acting as a driver for hire.

But we’re here to look at what’s fair. And we’d say the insurer needs to look at the intention of the clause in question before using it to turn down a claim. This one’s probably there to stop claims from people who’ve been using their vehicles as an unlicensed taxi.

This doesn’t seem to be what’s happened here. From what you’ve said, your client was doing his friend a favour and accepted the £20 to cover his costs, rather than make a profit. So we’d suggest the insurer reconsider their decision.

image: ombudsman news

ombudsman news gives general information on the position at the date of publication. It is not a definitive statement of the law, our approach or our procedure.

The illustrative case studies are based broadly on real-life cases, but are not precedents. Individual cases are decided on their own facts.