Insight into the Technicality Insurers Employ to Deny Claims, as Revealed by an Expert

Complaints about Travel Insurance Industry Tripled in Past Year

The travel insurance industry has seen a significant increase in complaints, with figures obtained by Sky News revealing that the number of complaints has tripled in the past financial year. This rise in complaints has raised concerns about unclear alcohol-related policies after two Australian women were denied claims following incidents involving alcohol consumption while on holiday.

Insurance Companies Denying Claims

Ella Cutler, a Western Australian Police officer, was left in an induced coma after falling off a cliff in Croatia. Despite having purchased travel insurance from RAC, her claim was denied due to her being under the influence of alcohol at the time of the accident. Similarly, Kylee Enwright, an Australian mother, suffered a catastrophic brain injury after falling at a hotel in Thailand. Her claim was also denied by Cover-More because she had alcohol in her system. These cases highlight the issue of insurance companies going to unreasonable extents to deny claims.

Uncertainty Surrounding Alcohol Consumption

The specific policies of insurance companies regarding alcohol consumption remain unclear. It becomes a grey area when determining how many drinks a person has had and how it may have affected their claim. Jodi Bird, an insurance expert, stated that travel insurers often try to investigate the details of alcohol consumption to determine its impact on the claim. This lack of clarity can lead to disputes between policyholders and insurers.

Responses from Insurance Providers

Tokio Marine, the insurance provider for Ella Cutler, stated that they are currently assessing her claim and providing support to her and her family. However, they were unable to provide further information about the specific policy or claim due to privacy reasons. Other insurance companies, such as Bupa and Allianz, declined to comment on the matter.

Specific Policies and Exclusions

When contacted by Sky News, insurance companies provided varying responses regarding their specific policies around alcohol. IAG entities review each claim on a case-by-case basis and consider the policyholder’s level of intoxication as a contributing factor. NIB stated that they have “very general wording” on their policy regarding intoxication. Medibank and Cover-More have product disclosure statements that exclude coverage if a person has a blood alcohol level of 0.19 per cent.

Increase in Complaints

The Australian Financial Claims Authority received 1,679 complaints about travel insurance in the 2022-2023 financial year, which is more than triple the number received in the previous year. While COVID-19 may have contributed to a decrease in travelers, 23% of the complaints were due to claim denials based on exclusions or conditions, and many complainants faced issues with the delay in claim handling.

Conclusion

The surge in complaints about the travel insurance industry, particularly regarding alcohol-related incidents, highlights the need for clearer policies and transparency from insurance providers. Policyholders should carefully review their insurance policies to understand any exclusions or conditions related to alcohol consumption. It is essential for travelers to be aware of their coverage and take necessary precautions to avoid claim denials.

Author’s Quote

“The rise in complaints about the travel insurance industry is concerning. It is crucial for travelers to understand their policy’s terms and conditions, especially regarding alcohol-related incidents. Clear communication and transparency from insurance providers are essential to ensure fair treatment of policyholders.” – [Author’s Name]

Author’s Conclusion

The increase in complaints about travel insurance highlights the need for improved policies and practices within the industry. It is important for insurance companies to provide clear guidelines on alcohol-related incidents and handle claims in a fair and efficient manner. Travelers should carefully review their policies and seek clarification if needed to avoid potential issues with claim denials.

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