Partially upheld: claim rejection and policy eligibility complaint against Great Lakes Insurance UK Limited
Financial Ombudsman decision DRN-6425654 of 2026-06-15T00:00:00+00:00. claim rejection and policy eligibility complaint against Great Lakes Insurance UK Limited. Outcome: Partially upheld.
Decision detail
| Reference | DRN-6425654 |
|---|---|
| Decision date | 2026-06-15T00:00:00+00:00 |
| Firm | Great Lakes Insurance UK Limited |
| Product | Travel insurance |
| Claim type | claim rejection and policy eligibility |
| Outcome | Partially upheld |
| Remedy | Refund of the premium paid for the policy with interest calculated at the time-weighted average Bank of England base rate plus one percentage point from the date the premium was paid until the date of settlement |
Summary
Mr D and Miss E purchased a single trip travel insurance policy from Great Lakes but Miss E was injured while on holiday abroad and made a medical claim. Great Lakes declined the claim on the basis that Miss E had already left the UK when the policy was purchased, contrary to the policy eligibility requirements. The ombudsman found that time-stamped evidence confirmed the policy was purchased after departure, making the claimants ineligible for cover, and therefore upheld the claim rejection as fair. However, the ombudsman ordered Great Lakes to refund the premium paid with interest, as the claimants never benefited from the policy and the insurer bore no risk of providing cover.
The Ombudsman's reasoning
The ombudsman found that the sales process was clear and fair in explaining the requirement to purchase before leaving the UK, and the policy terms were standard and not unfair. Based on time-stamped evidence, it was more likely than not that the claimants had already left the UK when purchasing the policy, making them ineligible for cover. Therefore, Great Lakes acted fairly in declining the claim. However, since the claimants never benefited from the policy and Great Lakes never bore the risk of providing cover, it was fair and reasonable to refund the premium with interest.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| Great Lakes Insurance UK Limited, all decisions | 176 | 30% |
| Travel insurance, all decisions | 7,560 | 37% |
Source
Read the original decision on the Financial Ombudsman Service website