Not upheld: Motor insurance, claim handling complaint against Astrenska Insurance Limited

Decision detail

Summary

Mr and Mrs H and Mr and Mrs S complained about Astrenska Insurance Limited's handling of a travel insurance claim following cancellation of a trip due to Mr H's son being diagnosed with a serious illness. Astrenska did not decline the claim but requested specific evidence including 12 months of medical records with the initial diagnosis date and formal accommodation cancellation documentation to assess whether the condition was pre-existing under the policy terms. Mr H provided treatment information and accommodation screenshots but not the specific evidence requested. The ombudsman found that Astrenska's requests were reasonable and clearly communicated, that the evidence provided was insufficient to determine pre-existing status, and that Astrenska was entitled to require such evidence before completing its assessment, therefore not upholding the complaint.

The Ombudsman's reasoning

The ombudsman found that Astrenska's initial request on 16 July 2025 clearly specified the need for 12 months of medical history and that the policy terms legitimately require evidence to determine whether a condition is pre-existing. The clinical information provided by Mr H, while showing treatment details, did not specify the initial diagnosis date and therefore was insufficient to assess pre-existing status. The ombudsman considered that Astrenska reasonably requested formal documentation with specific senders, recipients and dates for accommodation costs, as the screenshots provided did not demonstrate financial loss. While acknowledging the frustration caused by generic responses and piecemeal requests, the ombudsman concluded that such requests were necessary because the required information had not been provided.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website