Most people take out travel insurance before they go on holiday in order to cover unforeseen events such as loss of baggage, theft of valuables, and accidents and illnesses that might prevent them from going on holiday or cause them to cut their holiday short and return home. I always take out travel insurance. As I travel a lot I have a whole-year policy.
In November 2005 I booked a holiday in Barbados in order to be able to attend my daughter's wedding in May 2006. In February 2006 I had to cancel the holiday as a massive tumour had been identified in my abdomen and had to go into hospital for major surgery. I therefore submitted a claim to American Express, with whom I have whole-year travel insurance underwritten by AXA. The claim was for the reimbursement of the £240 deposit I had paid for the holiday, but it was rejected on the grounds that I had a pre-existing medical condition at the time of booking the holiday. AXA quoted the relevant exclusion clause in the travel insurance policy document, which stated:
"Pre-existing medical conditions known to you prior to booking your trip, for which you are awaiting test results or on a waiting list for an operation, consultation or investigation."
It was indeed true that I was waiting for a consultation with a specialist, which my GP had applied for when I visited him for advice in September 2005 concerning what appeared to be a bladder infection. My GP had already prescribed antibiotics, which appeared to have resolved the problem, but there were some indications that the problem had not been fully resolved and he decided to refer me to a consultant urologist just to be sure. It did not appear to be a major problem and I did not see the urologist until early December 2005. There followed a series of tests and scans over a period of three weeks, and finally I was told by the urologist in January 2006 that I had a massive, probably malignant, abdominal tumour that would have to be removed by surgery. This came as a complete shock to me, as I had not suffered any pain or other symptoms since I first visited my GP for advice in September 2005. The operation was scheduled for 1 March 2006, and it was only after the tumour had been removed that it was identified as a very rare form of cancer, a mucinous adenocarcinoma of the urachus, one of a group of cancers known as Pseudomyxoma Peritonei (PMP) that affects around one in a million people. See my full story here: PMP: a Survivor's Story
I therefore argued with AXA that my pre-existing condition was not "known" to me at the time of booking my holiday - indeed it could not have been known as it was so unusual and unsuspected - and that therefore I had a valid claim. I pointed out that I appeared to be fit and well at the time of booking my holiday in November 2005 and had no reason to suspect that I would require major surgery. An exchange of around a dozen letters between AXA and myself over a period of five months got me nowhere. AXA flatly refused to accept my arguments and were extremely unhelpful. Finally, I went back to American Express Customer Services, pointing out that I was a long-standing American Express cardholder and that I was displeased with AXA's refusal to honour my claim. Customer Services were much more sympathetic and I was awarded an ex gratia payment of £240, the amount that I had originally claimed. So my claim was not actually accepted, but my persistence in arguing over the interpretation of the word "known" in the relevant exclusion clause paid off.
The moral of this story is that you need to read exclusion clauses in travel insurance policies very carefully.
Because of the problems I had had with AXA I began to look for a travel insurance company that would be prepared to insure people with serious pre-existing medical conditions. My wife Sally and I had planned a visit to Switzerland in September 2006 and I was anxious to cover both of us adequately. SAGA kept coming up in my searches, and they said they were prepared to insure Sally and me. SAGA allows policyholders to specify medical conditions which they already have or which are under investigation, and then the premium is adjusted accordingly. Their insurance policy was not cheap, however. I had to pay around £110 per person for the two-week holiday.
SAGA's policy includes an exclusion clause that is similar to AXA's exclusion clause as quoted above, except that the phrase diagnosed or undiagnosed appears in place of the word known, which is much clearer - and then (as I have indicated above) they allow you to specify an existing medical condition and to override the exclusion clause for an additional premium. But SAGA's charge of £110 for a single trip compares unfavourably with the £75 I pay American Express for whole-year insurance, including skiing. So in June 2007 I approached American Express again to find out where I stand regarding my current medical condition. The good news is that I have it in writing from American Express that they are happy to continue to insure me as long as I don't make a claim that is directly related to my existing medical condition. In other words, I am insured if I break my leg while skiing or if I lose my baggage, etc. So, as I am now fit and well and being checked regularly for a recurrence of cancer and therefore highly unlikely to plan a holiday if there is the slightest indication that I might be unfit to travel, I am sticking with American Express.
Updated 24 February 2008
© Graham Davies 2008 under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 UK: England & Wales Licence.
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