16 November 2012

Travel insurance didn’t pay out for COPD

On World COPD day, the importance of disclosing pre-existing medical conditions like COPD was highlighted by a recent ruling by the Financial Ombudsman.

It's World COPD day! That's Chronic Obstructive Pulmonary Disease for those happy to be unfamiliar with the abbreviation. COPD is a blanket term and includes lung diseases such as chronic bronchitis and emphysema. It is the sixth most common cause of death in the UK responsible for 30,000 deaths annually and affects approximately 900,000 people in the UK.

The WHO estimate that COPD is currently the fourth most common cause of death in the world but will become the third leading cause by 2030. Key risk factors for COPD are tobacco smoking, indoor and outdoor air pollution and exposure to occupational dusts and chemicals.

In the most recent issue of the Financial Ombudsman news, the ombudsman reports on some of the complaints that have been upheld and some that had to be rejected.

One of these cases involved Mr and Mrs P who booked a holiday to Thailand. They took out an annual travel insurance policy. Two days into their holiday Mrs P fell ill having trouble breathing. She was admitted to hospital and diagnosed with a chest infection. At this point Mr P contacted the insurer to ask for help.

The insurer contacted Mrs P's doctor in England and five days later, rejected the claim as she had an undeclared pre-existing medical condition. Her medical records showed that she had been diagnosed with COPD a few weeks before the insurance policy had been taken out.

Having had their claim denied, Mr and Mrs P approached the Financial Ombudsman with two complaints. Firstly that they had not deliberately given misleading information. Secondly that the length of time the insurer had taken to reject the claim had exposed them to build up additional medical expenses.

While the Ombudsman accepted that Mr and Mrs P had not deliberately set out to mislead the insurer about the COPD, the wording of the policy was very clear that the COPD should have been disclosed. On the second point of the delay making the decision, the Ombudsman found that the insurer had waited three days to receive the information from Mrs P's GP and therefore the five day delay was reasonable.

The Ombudsman rejected their claim.

This case clearly demonstrates the importance of full disclosure of medical conditions and the potential additional expense of not doing so. It is possible that their insurer would not have felt able to offer cover if Mr and Mrs P had disclosed the diagnosis of COPD, but in the event, that should have driven them to find an insurer that would. As it was, the insurer had rightly identified a risk factor that would increase the chance of a claim and had made it clear that the policy would not be suitable for the condition.

Getting Travel Insurance covering COPD is not hard and milder conditions can be covered for very reasonable rates. There are also policies available to cover the more serious cases. Compare COPD Travel Insurance policies to get the most appropriate cover and the best rates.