Upheld: Travel / life insurance claim disputes complaint against Wakam
Financial Ombudsman decision DRN-6280721 of 2026-06-23T00:00:00+00:00. Travel / life insurance claim disputes complaint against Wakam. Outcome: Upheld.
Decision detail
| Reference | DRN-6280721 |
|---|---|
| Decision date | 2026-06-23T00:00:00+00:00 |
| Firm | Wakam |
| Product | Other regulated product |
| Claim type | Travel / life insurance claim disputes |
| Outcome | Upheld |
| Remedy | Wakam must: (1) Pay Mr M his claim subject to remaining policy terms; (2) Pay interest on the claim from the date veterinary fees were paid until settlement using simple interest and the time-weighted average method; (3) Pay £100 compensation for distress and inconvenience caused by the claim decline; (4) Provide a tax deduction certificate for the interest awarded. |
Summary
Mr M claimed on his Wakam pet insurance policy for treatment of acute haemorrhagic gastroenteritis in August 2025, but Wakam declined the claim citing a pre-existing condition exclusion based on the pet presenting with intermittent diarrhoea on 1 April 2025 (within the waiting period). The ombudsman upheld Mr M's complaint, finding that the clinical records and veterinary opinion demonstrated the April diarrhoea was resolved and unrelated to the August condition. Wakam was directed to pay the claim plus interest and £100 compensation for the distress caused by the unfair decline.
The Ombudsman's reasoning
The ombudsman accepted the vet's clinical opinion that the acute haemorrhagic gastroenteritis in August 2025 was not related to the intermittent diarrhoea in April 2025. The April condition was resolved following probiotic treatment, with the pet gaining weight and showing no further gastrointestinal symptoms by 29 April. The subsequent symptoms recorded in April (grass eating, possible nausea) were not clinically connected to either the April diarrhoea or the August condition. The ombudsman found no evidence to support Wakam's assertion that the pet was presenting with ongoing symptoms of AHD from April onwards. The fact that the vet was seeing several cases of AHD in the area suggested an environmental cause rather than a pre-existing condition.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| Wakam, all decisions | 269 | 51% |
| Travel / life insurance claim disputes, all decisions | 20,052 | 31% |
| Other regulated product, all decisions | 47,449 | 30% |
Source
Read the original decision on the Financial Ombudsman Service website