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personal finance

‘I had a brain tumour, but my insurer wouldn’t pay up’


When Ken Burridge* was rushed by ambulance to Kerry Hospital in Tralee, Ireland, suffering from headaches and poor coordination last July, a series of scans soon revealed the worst – he had a brain tumour. His consultant was clear – he needed to be repatriated by air ambulance to a specialist unit at Charing Cross hospital in London.

But when the family tried to use his InsureandGo travel insurance to arrange and pay for the repatriation, the insurer’s staff repeatedly refused, initially claiming that he had failed to disclose prostate cancer when he bought the policy eight years earlier. Yet the family have a copy of a letter in which they told the insurer about this condition.

In the face of the insurer’s refusal to act, and on the advice of the consultant, the family paid £13,189 out of their own pocket to get him repatriated to London – and have been battling to get the firm to pay more than the £3,000 it has offered.

An employee at InsureandGo also contacted Guardian Money to reveal what they describe as the unethical way the firm operates. What this person told us chimes closely with the Burridges’ experience.

The employee says the company, when faced with a medical claim, will “retro-screen” the customer for any previous medical condition, and if it finds one, will try to use this to reduce its payout – irrespective of whether the condition contributed to the claim or not.

“Any non- or mis-declared medical conditions will have a bearing. If they can find a reason to say that you didn’t pay the full premium at the outset, they will use that. The claim is then ‘settled’ proportionally. So say you paid 85% of what you should have paid had you declared your asthma, Mapfre [InsureandGo’s parent company] will only pay 85% of the bill. They do this to every claim due to a misinterpretation of the [regulator’s] ‘treating customers fairly’ rules,” the employee says.

The employee adds: “This stance results in incredibly unfair scenarios to consumers. For example, if you are in a car crash in south-east Asia but didn’t declare your asthma you end up liable for 20% of £30,000 bill for something that had nothing to do with your accident. If you had a heart attack but didn’t declare you’re knee replacement, you could be liable for a proportion of the final claim, which in the US or some private hospitals could be a huge sum. There are countless examples of this, and it is incredibly unethical, and unfair to the policyholders.”

We put these claims to InsureandGo. It said it works “very hard” to look after its customers abroad, and that its “takes these comments very seriously”.

In a statement, it said: “It’s important to remind people just how vital declaring pre-existing medical conditions is when buying any travel insurance policy, as insurers need to be able to accurately assess the risk of covering someone.”

The Burridges are furious at what they say was shameful treatment.

“First the company’s medical panel said we had not declared Ken’s previous prostate cancer medical history on the insurance application form,” says Burridge’s daughter, Helen. “This was untrue as he had declared it in writing several years earlier and we even had the letter to prove it.

“They claimed that his brain tumour was pre-existing, which is untrue. They then claimed he has asthma which is also not true. They then claimed that Ken’s policy was the ‘basic package’ and would not cover the repatriation costs, which was nonsense. We have refuted each of their reasons for not being able to settle for the full amount, by providing them with a letter from Ken’s GP in London confirming Ken’s health record, a letter from Ken’s consultant in Kerry, but they just won’t pay more than the medical escort they would have recommended,” she says.

InsureandGo told Money that, faced with the family’s request, his medical information and past medical history were needed before making a decision, claiming this “is necessary for customer safety”.

“It was confirmed that the family had arranged a private air ambulance, although InsureandGo advised against this. InsureandGo has since paid them £3,000 as, given the diagnosis, the means of repatriation would have been a commercial flight with nurse escort”.

* Burridge is not his real name



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