Not upheld: claim settlement dispute and delay in payment complaint against Inter Partner Assistance SA (IPA)

Decision detail

Summary

Mr A complained that IPA took too long to settle his travel insurance claim for out-of-pocket expenses incurred while abroad and that it did not pay the full amount claimed. IPA had requested specific evidence including an itemised phone bill and detailed taxi receipts with hospital details as required by the policy terms. Mr A claimed approximately $800 for phone calls, food, drinks, laundry, and taxi costs. The ombudsman found that food, drinks, and laundry were not covered under the policy, and that Mr A had not provided the itemised phone bill or detailed taxi information required by the policy. IPA's request for evidence was reasonable and clearly communicated, and its decision to settle in October 2025 based on available evidence was pragmatic. The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman applied the relevant rules requiring insurers to handle claims promptly and fairly without unreasonably rejecting claims. The starting point was the policy terms which clearly specified what was covered and what evidence was required. For food, drinks, and laundry, there was no cover under the policy. For phone calls, the policy required evidence of calls to the Emergency Medical Assistance Service with an itemised bill, which Mr A did not provide. For taxi fares, the policy required receipts stating details of date, name and location of hospital, which Mr A did not provide. The ombudsman found IPA clearly communicated its evidence requirements and made a pragmatic decision to pay based on available evidence in October 2025. The delay was attributable to Mr A's failure to provide required documentation, not IPA's unreasonable conduct.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website