Not upheld: claim decline - not covered under policy terms complaint against Great Lakes Insurance UK Limited

Decision detail

Summary

Ms G claimed on her travel insurance policy after leaving her resort accommodation early due to a cockroach infestation that caused her a severe panic attack. She sought reimbursement for unused and additional expenses incurred as a result of changing her itinerary and returning home. Great Lakes declined the claim on the basis that the circumstances were not covered under the policy terms. The ombudsman upheld Great Lakes' decision, finding that the cockroach infestation did not fall within any of the specific insured events listed in the policy's curtailment and loss of holiday section, and that Great Lakes acted fairly and reasonably in declining the claim in accordance with the policy terms and FCA requirements.

The Ombudsman's reasoning

The ombudsman applied the test of whether the claim falls under one of the agreed areas of cover within the policy. The policy terms for curtailment and loss of holiday cover list specific insured events (death, bodily injury, illness, court attendance, armed forces/emergency services leave cancellation, home damage, or redundancy). The cockroach infestation and resulting panic attack do not fall within any of these listed events. The ombudsman found no other sections of the policy that would cover the circumstances. While sympathetic to Ms G's difficult situation, the ombudsman concluded that Great Lakes acted fairly and reasonably in declining the claim in accordance with the policy terms.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website