Compare Life Insurance :: 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

Strata Communities Endorse Call for Enhanced Resilience Reforms Strata Communities Endorse Call for Enhanced Resilience Reforms
15 Feb 2026: Paige Estritori

Strata communities are at the forefront of Australia's resilience battle, facing escalating costs, declining coverage, and prolonged recovery periods following disasters. Strata Community Association Australasia (SCA) has expressed strong support for the Insurance Council of Australia's (ICA) recent call for coordinated, long-term resilience reforms to protect communities from these challenges. - read more
Artificial Intelligence Revolutionises Australian Insurance Sector Artificial Intelligence Revolutionises Australian Insurance Sector
15 Feb 2026: Paige Estritori

The Australian insurance industry is undergoing a significant transformation, with companies increasingly integrating artificial intelligence (AI) into their operations. This shift aims to enhance efficiency, improve customer service, and strengthen risk management practices in a rapidly evolving market. - read more
Budget Direct Triumphs as 2026 Insurer of the Year Budget Direct Triumphs as 2026 Insurer of the Year
15 Feb 2026: Paige Estritori

Budget Direct has been honoured with the inaugural 'Insurer of the Year' title at the 2026 Finder Provider of the Year Awards, marking a significant achievement in the Australian insurance sector. This accolade underscores the company's commitment to delivering exceptional value and service to its customers. - read more
Australian Insurers Face Growing AI and Cybersecurity Challenges Australian Insurers Face Growing AI and Cybersecurity Challenges
15 Feb 2026: Paige Estritori

Recent findings from the PwC Insurance Banana Skins Survey reveal a concerning trend: Australian insurers are increasingly falling behind their global counterparts in preparedness for emerging risks, particularly those associated with artificial intelligence (AI) and cyber threats. The survey indicates that local insurers are now 6.6% less prepared than their international peers, marking the widest gap observed in recent years. - read more


Life Insurance Articles

DIY Review Checklist for your Income Protection Insurance DIY Review Checklist for your Income Protection Insurance
If you have an income protection insurance plan already - or are thinking about buying one, then you need to be aware that these policies require regular maintenance and careful scrutiny to ensure that they adequately meet your needs. Unfortunately, many people purchase income protection insurance policies only to find out about their shortcomings at claim time. - read more
Who Needs Disability Insurance? Who Needs Disability Insurance?
If you are like most people on this planet, you are not financially free. You would not be able to stop working and still support yourself and your family from your financial resources. Your continued ability to work to earn an income would therefore be one of your greatest assets. - read more
Strategies to Use Life Insurance in Funding Shareholder Agreements Strategies to Use Life Insurance in Funding Shareholder Agreements
Shareholder agreements lay the cornerstone for stable business relationships and continuity in Australia. Acting as a contract among business owners, these agreements set forth the expectations, rights, and obligations of all parties involved. They are particularly vital in delineating clear paths for dispute resolution, succession planning, and the transfer of ownership shares under varied circumstances, including the untimely death or departure of a shareholder. - read more
Income Protection vs. Life Insurance: Tax Differences You Should Consider Income Protection vs. Life Insurance: Tax Differences You Should Consider
Have you ever wondered how income protection insurance can affect your taxes? It's an often-overlooked aspect of managing your finances that could make a substantial difference. Understanding your insurance options is crucial in making informed decisions that benefit your long-term financial health. - read more


Start Here !
life insurance
Apply now for your free Insurance assessment and price comparisons!

Start Here

Life Cover Amount:
Postcode:


All quotes are provided free and without obligation. We respect your privacy.
Knowledgebase
Occupational Hazard:
A risk associated with the nature of a particular occupation, which may affect insurance premiums.