Our client experienced a travel claim loss when they had an illness which led to an ‘attack’ while on an overseas trip. They sought treatment at the local hospital and were released on the same day.
Subsequent to the above illness, they had to cancel an upcoming trip which meant they had considerable out of pocket costs.
PSC Reliance lodged their claim and the travel insurer denied the claim on the basis that client didn’t require further medical treatment and there was no evidence this illness would prevent our client from travelling on their upcoming trip. The insurer’s reasoning was that the policy only covered illnesses that were known and not ones that may occur in the future such as a medical attack.
On our client’s behalf, we argued the policy should respond as our client had been diagnosed with an illness which led to attacks they could not control, and it was unclear what future treatment for these would be. As such, we argued that it would be dangerous for our client to travel as should they have an attack while on a plane or overseas there could be a fatal outcome. As such, we strongly believed this met the policy requirements for a claim due to medical reasons.
Unfortunately, the insurer maintained their decision, so we then requested this claim be referred to their Internal Dispute Resolution panel for an independent review. After reviewing all of the supporting medical documents we provided and reviewing our position, the original decision was overturned and the claim was accepted. The costs incurred by our client were then paid!
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