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The Ombudsman for Short-Term Insurance warns consumers about the pitfalls of travel insurance

18 December 2009 The Ombudsman for Short-Term Insurance

The Ombudsman for Short-Term Insurance urges consumers to familiarise themselves with the terms and conditions of any travel insurance policy they may purchase before they travel and warns of the common pitfalls of travel insurance. “If you are being treated medically whilst overseas and think that your ailment could be seen as a pre-existing medical condition by your insurer, remember to obtain a full report from the doctor who has treated you before you leave the medical facility”, says Brian Martin, The Ombudsman for Short-Term Insurance. The Office recently dealt with a complaint where the insured had consulted a specialist in 2006 after she noticed a lump in one of her breasts. A mammogram and biopsy were carried out. The insured was advised that there was no evidence of cancer. In the early half of 2007 the insured took out a travel policy for a planned trip to Malawi. However shortly before her proposed departure the insured was diagnosed as suffering from breast cancer and her trip was cancelled.

The insured filed a claim in terms of the travel policy but liability for the claim was declined by the insurer on the grounds that the insured suffered from a pre-existing condition which was excluded in terms of the policy. After appealing to the Ombudsman for assistance, the complaint was reviewed and the Ombudsman ruled that at the time the insured took out the policy, she was not suffering from breast cancer and could not be seen to have a pre-existing condition. “Our opinion was that the insured was entitled to be indemnified as provided for by the policy and the insurer subsequently agreed to settle the insured’s claim. It is absolutely imperative that consumers scrutinise the wording of their policy in particular to the sections relating to pre-existing conditions, says Brian.”

Should your personal effects be stolen whilst you are on holiday, remember to report the incident to the nearest or local police station wherever you are staying. A common complaint received by the Office is that once the insured has returned home, they have filed a claim for their stolen personal effects, only to have their claim rejected as they did not report the matter to the local police overseas.

If you are taking out travel insurance check the age limitations stipulated in the policy to ensure that you qualify. Some insurers allow for additional top up cover to be purchased.

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