Cancelled cruise - insurance refuses to pay

[jay44]

Lets face it, alot of us have older parents who have been on some kind of medication within the last 6 months.

 

I so agree... but does this mean you daren't go on holiday just incase they may drop down dead?

 

I this this is just ludicrous, and my sister and I will take it all the way to the Ombudsman, and believe me, they know crap insurance policies when they hear one!

[cruiseco]

The travel insurance available to residents of the UK is totally different from what's available to US/Canada residents.

 

#1 It's cheaper.

 

#2 Why is it cheaper? Because it's almost impossible to get covered for pre-existing medical conditions.

 

UK-based insurers can and will ask for your complete medical hustory prior to issuing a policy. And if something isn't 100% declared prior to purchase it's automatic grounds for denial of a claim. They also have a nasty habit of not covering pre-existing conditions for those over 70.

 

It's nice paying less but you do get what you pay for.

[vmom]

The travel insurance available to residents of the UK is totally different from what's available to US/Canada residents.

 

#1 It's cheaper.

 

#2 Why is it cheaper? Because it's almost impossible to get covered for pre-existing medical conditions.

 

UK-based insurers can and will ask for your complete medical hustory prior to issuing a policy. And if something isn't 100% declared prior to purchase it's automatic grounds for denial of a claim. They also have a nasty habit of not covering pre-existing conditions for those over 70.

 

It's nice paying less but you do get what you pay for.

 

Interesting. Didn't know there was such a difference. Is Princess care insurance the same for the US and UK? Coverages the same? If so, then that may be the preferred way to go for UK residents.

 

I agree, I would rather pay more but be fully covered for my needs than pay less and be out of luck if something happens.

[MaryPoppinz]

WOW -- those are indeed some of the most restrictive terms I have ever seen! What is this "reasonably expected" clause??

 

 

I believe that means "We don't cover anything on which we might have to pay out a claim."

 

My condolences to the OP.

[JandD Mom]

To the OP,

 

It goes without saying I am sorry for your loss.

 

I think you have already put your finger on what you should be arguing with the insurance company. The condition that killed him is not the condition he had when you purchased the insurance. Therefore it wasn't a pre-existing condition for which they can deny the claim.

 

If, for example, he had a lung condition, and then died from blunt trauma caused by a car accident, the two are unrelated and the cause of death is a "new" condition. So you need to speak to his physician and, if s/he will provide a statement that the cause of death was a "new" and unrelated condition, then you probably will have a better chance at succeeding.

 

Best of luck to you and your family. I hope the new year brings you better times.

[vmom]

Jay44.

 

I am so sorry to hear of your loss and I appreciate you bringing this topic up. Its given me a lesson on insurance and what to be aware of when purchasing insurance. I never realized there were so many hidden clauses to be aware of.

 

I do hope you win your case. I agree with the previous poster that the heart condition was not a pre-exisiting condition and may be your best arguement.

Good luck to you in your case.

[cruiseco]

One huge difference between many UK and US coverages is their definition of a pre-existing conditions. Take this example:

 

The client has a brain tumor that's been growing for several years but starts causing problems right before he leaves on the cruise (after the insurance is purchased.

 

With US plans this would not be considered a pre-existing condition because the plan definitions it's not a medical condition until "there are symptoms that would cause a reasonable person to seek medicaL care or treatment." So even though the tumor really did exist at the time the policy was purchased the symptoms did not so it's not a pre-existing medical condition.

 

CSA uses this wording "manifested itself, became acute or exhibited symptoms which would have caused one to seek diagnosis, care or treatment;"

 

Travelex uses this" for which treatment by a Legally Qualified Physician has been sought or advised or for which symptoms exist which would cause a prudent person to seek diagnosis, care or treatment."

 

In the UK the definition is usually something like "any medical condition that exists at the time the policy is purchased WHETHER KNOWN TO THE CLIENT OR NOT,"

 

So in this case the client did not declare the tumor to the insurer at the time of purchase so the claim is denied. There is no state department of insurance that would let an insurer get away with that here in the US.

 

In the OP's case I'd bet that the insurer is hanging their hat on the theory that the heart condition that caused the death did exist when the policy was purchased -- even though there may have been no symptoms -- and not declared and thus not covered. They're brutal.

[MichCook]

Our condolences to you and your family. Insurance woes on top of grieving the loss of your father....

 

Is the insurance company "Shyster & Shyster"? Good luck with your efforts to reverse their denial of payment.

 

Unfortunately, these insurance policies aren't written in layman's terms. There are too many clauses in these insurance contracts for the average person to reasonably be expected to comprehend! I suffer from "insurance vertigo".

[UK Cruiser]

Jay - i would think you will be able to get your claim accepted.

 

As someone has already stated, every insurance company seems to start by saying "No" in the hope that people won't ask again.

 

My Father died a few months ago. He had been ill with lung problems for many years. We had flown to San Francisco to join our cruise a few days later, but he was taken ill and we had to fly home instead of joining our ship. Dad died of a bowel condition which was accepted as not being a pre-existing condition and our claim was met in full.

 

You really need to spell it our to the insurers (in words of one syllable!) that your Father's death was a separate condition and not pre-existing.

 

Good luck!

[jay44]

Thought I would bring you right up-to-date.

 

As dad died from a heart failure which he was not being treated for at the time, the insurance company are paying up!

[Colo Cruiser]

Thought I would bring you right up-to-date.

 

As dad died from a heart failure which he was not being treated for at the time, the insurance company are paying up!

 

 

 

Great to hear. :)

[mii]

That is fantastic. Thanks for telling us. Sometimes persistance does pay.

 

marilyn