Farm Insurance NZ :: News
SHARE

Share this news item!

Travel Insurance Dispute Highlights Pre-Existing Condition Clause

Travel Insurance Dispute Highlights Pre-Existing Condition Clause

In a recent case that underscores the importance of understanding insurance policy clauses, a man who cut short his vacation in the United States to be with his terminally ill sister-in-law has been denied an insurance payout.
The ruling, made by the Australian Financial Complaints Authority (AFCA), favored the travel insurer due to the claimant’s lack of coverage for pre-existing medical conditions of relatives.

The situation began when the policyholder purchased travel insurance for a family holiday scheduled to begin on December 12, 2023. Shortly after arriving in the U.S., the man was informed of his sister-in-law's critical health decline due to metastatic colorectal cancer. He returned home to be with her in her final days, later resuming his vacation on December 23.

However, upon claiming for the abrupt change in travel plans, the insurer, AWP Australia, denied the claim. They stated that the policy explicitly excluded coverage for incidents related to pre-existing medical conditions of the insured’s relatives. The sister-in-law’s diagnosis of cancer and a pulmonary embolism had been established for nearly a year prior to the start of the policy coverage.

The case highlights a common oversight among travelers: not accounting for family members' significant medical histories while planning their travels. Even though the policy allowed for early return and resumption of journey benefits, these did not apply as the sister-in-law's health condition predated the travel insurance policy.

The policyholder argued that the policy had not explicitly required him to disclose his sister-in-law’s medical background, which he felt was unfair. He also mentioned experiencing substantial financial hardship due to the rejection of his claim. Nevertheless, AFCA supported the insurer's decision.

In summarizing the decision, the AFCA ombudsman stated, “I acknowledge the complainant was not aware that [his sister-in-law] may fall seriously ill and pass away when he commenced his holiday. However, I am satisfied the exchanged information shows death was caused by her pre-existing medical conditions for the purposes of the policy. In the absence of any other information, I am satisfied the insurer is entitled to deny the claim.”

This resolution accentuates the criticality of reading and comprehending the exclusions present in travel insurance policies. Policyholders should be fully aware of what constitutes a pre-existing condition and how it may impact claim eligibility. The case serves as a cautionary tale for travellers to ensure all potential scenarios are accounted for in their insurance coverage. For further details, you can refer to the ruling as noted by Australian Financial Complaints Authority.

Published:Wednesday, 22nd Jan 2025
Source: Paige Estritori

Share this news item:

Insurance News

Travel Insurance Dispute Highlights Pre-Existing Condition Clause Travel Insurance Dispute Highlights Pre-Existing Condition Clause
22 Jan 2025: Paige Estritori

In a recent case that underscores the importance of understanding insurance policy clauses, a man who cut short his vacation in the United States to be with his terminally ill sister-in-law has been denied an insurance payout. The ruling, made by the Australian Financial Complaints Authority (AFCA), favored the travel insurer due to the claimant’s lack of coverage for pre-existing medical conditions of relatives. - read more
Dutton Calls for Urgent Solutions as Insurability Crisis Hits Halls Gap Dutton Calls for Urgent Solutions as Insurability Crisis Hits Halls Gap
22 Jan 2025: Paige Estritori

Peter Dutton, the leader of the Coalition, voiced pressing concerns over the growing issue of 'uninsurable risks' during a recent visit to the fire-stricken tourist town of Halls Gap in Victoria. The picturesque location, frequently visited by tourists, experienced significant bushfire disruptions over the Christmas holiday, highlighting broader insurance challenges. - read more
Storm Devastation: Over 11,000 Claims Filed in NSW and ACT After Severe Weather Storm Devastation: Over 11,000 Claims Filed in NSW and ACT After Severe Weather
21 Jan 2025: Paige Estritori

The recent onslaught of electrical storms that lashed across New South Wales (NSW) and the Australian Capital Territory (ACT) has resulted in a flurry of activity from the insurance industry, as shown by the impressive number of claims filed. In an eventful week of wild weather, the Insurance Council of Australia reported an influx of 11,366 claims tied to the severe storms that began on January 15. - read more
Severe Weather in Eastern Australia Sparks Insurance Claims Spike Severe Weather in Eastern Australia Sparks Insurance Claims Spike
17 Jan 2025: Paige Estritori

Recent storms sweeping across New South Wales and parts of Queensland have led to a surge in emergency calls and insurance claims, as residents grapple with the aftermath of strong winds, heavy rainfall, and hail. This extreme weather has posed significant challenges to numerous households and businesses, prompting a rallying cry for assistance. - read more
Broker Sentenced for Fraudulent Builders’ Insurance Scheme Broker Sentenced for Fraudulent Builders’ Insurance Scheme
15 Jan 2025: Paige Estritori

In a significant legal crackdown, a broker has been sentenced for his involvement in selling fraudulent builders’ warranty insurance to construction firms in New South Wales. This case underscores the urgent need for regulatory vigilance in the insurance sector. - read more
LA Wildfires Set to Shatter Insurance Loss Records LA Wildfires Set to Shatter Insurance Loss Records
14 Jan 2025: Paige Estritori

Recent wildfires in Los Angeles are projected to lead to unprecedented insured losses, potentially exceeding $20 billion USD (approximately $33 billion AUD). This alarming situation underscores the escalating risks associated with natural disasters, as communities brace for the fallout from this catastrophic event. - read more


Farm Insurance Articles

Natural Disaster Preparedness: Insurance Tips for Farmers Facing Adversity Natural Disaster Preparedness: Insurance Tips for Farmers Facing Adversity
In the heart of New Zealand's pastoral verdure, the significance of preparedness for natural disasters is paramount for the farming industry. The distinct landscape, while providing an idyllic backdrop for agricultural pursuits, is not without its challenges. Farmers are often at the mercy of nature's unpredictability, making disaster preparedness not just prudent but essential for the continuity of their livelihood. - read more
Customizing Your Farm Insurance: Tailoring Policies to Fit Unique Agricultural Needs Customizing Your Farm Insurance: Tailoring Policies to Fit Unique Agricultural Needs
Those who work the land know that every farm has its own heartbeat - its unique rhythm defined by the crops it yields, the livestock it nurtures, and the natural environment it exists within. Recognizing this individuality is crucial, especially when it comes to safeguarding your agricultural investment with the right insurance policy. - read more
Securing Your Farm's Future: Top Estate Planning Tips for New Zealand Farmers Securing Your Farm's Future: Top Estate Planning Tips for New Zealand Farmers
New Zealand's farming community forms the backbone of its thriving agricultural sector, yet many overlook the critical importance of proactive estate planning. With farmland often being held within families for generations, securing its future is not just a financial concern, but a deeply personal one as well. - read more
Protecting Your Farming Future: Why Machinery Breakdown Coverage is Essential Protecting Your Farming Future: Why Machinery Breakdown Coverage is Essential
Farming is a vital part of New Zealand's economy and cultural heritage, representing a way of life for thousands across the country. With its unique landscapes and diverse climate, New Zealand farmers are renowned for producing a wide array of high-quality products that serve not only the nation's needs but also supply a multitude of international markets. - read more
Risk Management and Insurance Options for Farmers Risk Management and Insurance Options for Farmers
Risk management is the practice of identifying, assessing, and prioritizing risks followed by coordinated efforts to minimize, monitor, and control the probability or impact of unfortunate events. In farming, risk management involves various strategies to protect the financial health and operational stability of the farm. - read more
From Droughts to Floods: Understanding Weather-Related Coverage in Farm Insurance From Droughts to Floods: Understanding Weather-Related Coverage in Farm Insurance
Australian farmers face a unique set of challenges due to the vast and varied climate conditions that sweep across the continent. From the scorching heat and prolonged droughts of the Outback to the tropical storms and torrential rains of the northern regions, weather-related risks are an integral part of agricultural life in Australia. - read more
Protecting Your Farming Future: Why Machinery Breakdown Coverage is Essential Protecting Your Farming Future: Why Machinery Breakdown Coverage is Essential
Farming is a vital part of New Zealand's economy and cultural heritage, representing a way of life for thousands across the country. With its unique landscapes and diverse climate, New Zealand farmers are renowned for producing a wide array of high-quality products that serve not only the nation's needs but also supply a multitude of international markets. - read more
Natural Disaster Preparedness: Insurance Tips for Farmers Facing Adversity Natural Disaster Preparedness: Insurance Tips for Farmers Facing Adversity
In the heart of New Zealand's pastoral verdure, the significance of preparedness for natural disasters is paramount for the farming industry. The distinct landscape, while providing an idyllic backdrop for agricultural pursuits, is not without its challenges. Farmers are often at the mercy of nature's unpredictability, making disaster preparedness not just prudent but essential for the continuity of their livelihood. - read more
Customizing Your Farm Insurance: Tailoring Policies to Fit Unique Agricultural Needs Customizing Your Farm Insurance: Tailoring Policies to Fit Unique Agricultural Needs
Those who work the land know that every farm has its own heartbeat - its unique rhythm defined by the crops it yields, the livestock it nurtures, and the natural environment it exists within. Recognizing this individuality is crucial, especially when it comes to safeguarding your agricultural investment with the right insurance policy. - read more

Need a Quote?
Start your free farm insurance quote comparison here.

Start here

Farm Type:
Postcode:

Knowledgebase
Insurance Deductible:
the amount that an insured is required to contribute toward an insurance claim as stipulated in an insurance policy. Otherwise known as the "policy excess".