Watchdog steps in over holiday op row

Amanda Crook

September 26, 2009

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Jean Edwards, left, with her daughter Lynn Fletcher on the family holiday before she fell ill

INSURANCE watchdogs are to intervene after a company refused to pay the £18,000 medical bill of a great-grandmother lying unconscious in a Turkish hospital.

Jean Edwards, 73, from Middleton, near Rochdale, bought a travel policy online before jetting off on holiday and ticked a box to declare existing health complaints.

But the insurance company, EHIC Plus, says Jean did not give enough details and claims the policy is not valid - even though her present illness is not related to previous problems.

Jean's family have complained to the Financial Services Ombudsman and the British Insurance Brokers Association, who are both looking into the issue.

EHIC Plus said on their website that they were 'recommended' by finance expert Martin Lewis - but after the M.E.N. alerted him the 'endorsement' was removed.

Insurance

Mr Lewis, of moneysavingexpert.com, said: "Disclosure is one of the big issues in insurance. The company should ensure it has asked you the right questions, and the obligation is on it. Sadly companies, big and small, often have a 'get as much money in and pay out as little as possible' mentality."

Jean had to have a life-saving operation to remove a blockage in her bowel after suffering excruciating stomach pains 10 days into the family break. She was put on a life-support machine in the intensive care ward of a private hospital in the Turkish city of Bodrum and has been unconscious for two weeks.

Her family say they can't afford to pay the bill. Officials there have been shocked by travel insurance company EHIC Plus's refusal to pay.

EHIC Plus say Mrs Edward's £38 policy isn't valid because, although she ticked a box to say she had suffered from heart and breathing conditions and gave details of medication, she did not properly declare all her illnesses. Samy Massoud, from EHIC Plus, said: "This claim was declined by underwriters on the basis of non-disclosure of relevant material facts."

A spokesman for the Financial Services Ombudsman said: "We are making informal approaches to try to help resolve the situation." A spokesman for the British Insurance Brokers Association said: "We will do whatever we can to resolve this problem."

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Acid, Chadderton (26/09/2009 at 15:53)

Martin Lewis is right. Insurance companies nowadays look for the slightest reason not to pay out. If this is a new health problem then what's their gripe? They're just another part of the 'fat cat' culture. Good Luck to Mrs Edwards. I just hope everything works out for her.

Very Blue in Spain, Spain (26/09/2009 at 22:12)

If the insured's illness was unrelated to any previous medical history the company should not only be made to pay the medical bills but should be penalised in some way for attempting to renage on the claim.

Ed from Davyhulme, Manchester (27/09/2009 at 09:28)

and her policy was probably also invalidated because she didn't inform them she would be wearing sun glasses on holiday - after all, that could put pressure on her nose and cause all sorts of problems (dizziness, fainting, nasal polyps etc.!! Good to see the insurers are upholding the tradition of 'small print' restrictions which gets the industry such a bad name. I could quote examples where the insurer has been tremendously generous in its interpretation and been magnanimous particularly where older people are concerned. EHIC Plus should realise that the bad publicity here will destroy their reputation - if they have one. They need urgently to review their decision to avoid total disaster to their business.

Salford Ken, Adelaide, South Australia (27/09/2009 at 11:06)

Well we all now know who NOT to insure with.

manfat, manchester (27/09/2009 at 12:01)

typical.....your insured for every possible outcome.....just as long as you do not to try an claim!

to the point, bury (27/09/2009 at 13:42)

What is a pre existing medical condition?
I had chickenpox at the age of 5 and bumped my head this morning.
Surely existing means NOW, not 20 years ago.
The best question would be ‘are you being treated of any medical condition now’

RT, UK (27/09/2009 at 14:05)

You get the feeling that many Insurances have become like this.

All is great and wonderful until you have to claim. More gloss then delivery.

Squire of Newton, Newton nr. Hyde (27/09/2009 at 15:06)

EHIC Plus, that's one travel insurance company to give a very wide berth.
I hope once they have been forced to pay out, they cease to trade.
Good riddance to a bad travel insurance company ...one of many i'm afraid to add.

chriso, manchester (27/09/2009 at 17:06)

Its not real insurance anymore, we are being ripped off by some tune here?
The question is, you are either insured or your not?
What is the point of offering people insurance, theres so many catch out questions its a wonder your covered for anything, the insurance companies don't like losing money and will go to extremes not to pay out, this lady is seriously poorley you should pay out or close your business.

She paid her money and gets nothing in return, i suspect they developed the format from the goverment because they too are a bit like that. you pay in and get nothing in return, my fault was getting made redundant.

sunshine girl (27/09/2009 at 17:22)

I dont live in the UK anymore however relatives would love to come to the cayman islands and see me. but the medical insurance for some of them costs more than the flights due to "previous illnesses". therefore they are reluctant to come to this beautiful island in the sun so every year i come back to boring old cold and rainy england.

Knowsleyman, Paphos (27/09/2009 at 19:05)

I am a retired Insurance Broker, living in Cyprus, and made a comment on the original story.

Since then I have logged on to this company's websight and got a quote from them for myself.

In the past year I have needed hospital treatment fo 3 differing conditions and these were declared in the most general of general terms. The questions the site asks are quite specific and they were answered yes, but without full details being requested.

I could not believe that I was offered cover for just over £41.00.

With my health record it is not possible to obtain appropriate cover for such a low amount without a greatly increased excess or exclusions.

It would appear that the insurer will seek to avoid any claim, other than very minor ones, in the hope that they will go away. But, I would add that they are not on their own in that respect.

Clearly to be avoided!!!!!!!!!!!!

Albert Square, Republik of Mancunia (28/09/2009 at 19:20)

Was it last year that a lady from around these parts slipped on a marble floor at her hotel, cracked her head and was in intensive care in the USA for a few weeks - running up a massive medical bill? Her insurance company said because she had a glass or two of wine with her meal, she was under the influence of alcohol and that invalidated her claim. Ok, if she had been on the pop all day, you could understand, but she WAS on her hols and a glass or two of wine should be acceptable. I think after all the bad publicity, the insurance paid out ' as a gesture of goodwill ' - but it does appear to be like getting blood out of a stone.

mike356 (29/09/2009 at 08:59)

38 pound seems a very small sum to be insured for anything substantial. She must have virtually declared she was totally ihealthy. She will lose in the end.

anna bradley (19/08/2010 at 05:20)

after reading this im not bothering with ins, just use my european health card,im going on a coach so they must have ins for there passengers ,in all my life i have always had ins and never used it to claim a penny,iif i die on holiday then ive told my husband to leave me there .if im ill and need treatment i will battle it out with the british gov ,ive paid enough ni for heaven sake,its a sham now getting money from an ins compant ,not just travel but house and contents is the same, i hope the ins companys fold up and then they might just start using a bit of compassion and pay out for people like this poor lady, i wish her well bless her,

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