Not upheld: claims handling, unreasonable delay in issuing guarantee of payment, unfair claim settlement complaint against Red Sands Insurance Company (Europe) Limited

Decision detail

Summary

Mr H complained about Red Sands's handling of his travel insurance claim after suffering severe back pain while abroad in March 2025. Red Sands initially declined the claim due to a policy coverage error, then delayed issuing a guarantee of payment to the hospital, forcing Mr H to pay for treatment himself. Red Sands subsequently settled the claim but declined reimbursement for various expenses including taxi costs, SIM card, hotel upgrade, and recommended massages. The ombudsman found Red Sands acted reasonably in requiring GP validation before issuing the guarantee and obtained this information promptly, and reasonably declined the additional claimed expenses due to lack of evidence, policy exclusions, or lack of medical necessity. The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman found that Red Sands acted reasonably in requiring validation checks before issuing a guarantee of payment, as this is standard practice for travel insurers. The ombudsman was satisfied that Red Sands obtained the necessary GP information as promptly as possible, receiving the consent form late Friday and sending the request early Monday with urgent follow-up. While acknowledging Mr H's distress, the ombudsman found Red Sands did not unreasonably delay the guarantee. Regarding the settlement, the ombudsman found Red Sands's refusal to reimburse certain expenses was reasonable: taxi costs lacked receipts, SIM card and transaction fees were excluded under the policy, and massages/wraps and hotel upgrades lacked medical evidence of necessity. The ombudsman also found Mr H did not end his trip early as required by the cancellation cover, as he remained abroad for the full duration.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website