Not upheld: Travel / life insurance claim disputes complaint against Europ Assistance SA

Decision detail

Summary

Mr and Mrs B purchased travel insurance through company L and paid the holiday balance after Mr B was injured, believing they would be covered. The claim was declined because Mr B was over 64 years old and the policy had an age limit of 65. The ombudsman found that Europ Assistance had provided sufficient information about the age limit during the sales process, including prompts to check the policy and access to full terms and conditions which Mr and Mrs B confirmed reading. Although the ombudsman acknowledged that other insurers have automated systems to prevent over-age sales, there was no requirement for Europ Assistance to have such a system. The complaint was not upheld, but the ombudsman found Europ Assistance's offer to refund the premium to be fair and reasonable.

The Ombudsman's reasoning

The ombudsman found that Europ Assistance provided sufficient information about the age limit during the sales process, including prompting customers to check the policy if over 65 and providing a 14-day cancellation period. The policy documentation clearly stated coverage was only for persons aged 64 and under, and Mr and Mrs B confirmed they had read these terms. While other insurers may have automated systems to prevent sales to over-age customers, there is no requirement for Europ Assistance to have such a system, and the information provided was sufficient to alert customers to the age restriction.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website