Not upheld: Travel / life insurance claim disputes complaint against Aviva Insurance Limited

Decision detail

Summary

Mrs W claimed on her travel insurance policy after her father became seriously unwell during a trip abroad, forcing her to extend her stay and incur additional costs. Aviva declined the claim, stating the circumstances were not covered under the policy terms. The ombudsman examined the policy and found that the cancellation clause only applies before a trip starts, and the emergency medical clause only covers insured persons, not relatives. Although sympathetic to Mrs W's difficult situation, the ombudsman upheld Aviva's decision to decline the claim as it correctly applied the policy terms. The ombudsman found the £150 compensation offered for poor service to be reasonable and did not uphold the complaint.

The Ombudsman's reasoning

The ombudsman examined the policy terms to determine if the claim fell within agreed areas of cover. The cancellation clause only applies before a trip starts, and Mrs W was already travelling when the incident occurred. Section B only covers the health of insured persons, and Mrs W's father was not named on the policy. The circumstances did not fall within any other section of the policy terms. While sympathetic to Mrs W's difficult situation, the ombudsman concluded Aviva correctly declined the claim in line with the policy terms.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website