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

CHU's 2025 Report Shows Stability in Strata Insurance Premiums Amid Climate and Regulatory Shifts CHU's 2025 Report Shows Stability in Strata Insurance Premiums Amid Climate and Regulatory Shifts
22 Jan 2026: Paige Estritori

CHU, Australia's leading strata insurance underwriting agency, has released its 2025 State of the Strata Market report, providing a comprehensive analysis of the current state of the industry. The report offers valuable insights into premium movements, the impact of weather events, regulatory developments, and emerging risks affecting strata insurance. - read more
ICA Calls for Strata Law Reforms to Address Rising Insurance Costs in Victoria ICA Calls for Strata Law Reforms to Address Rising Insurance Costs in Victoria
22 Jan 2026: Paige Estritori

The Insurance Council of Australia (ICA) has recently called for substantial reforms to Victoria's strata legislation, citing a direct correlation between inadequate governance and escalating insurance premiums for residents. With approximately one in five Victorians residing in strata-titled properties, the need for effective management and oversight has become increasingly critical. - read more
Sure Insurance Expands Strata Coverage to $20 Million to Enhance Affordability in Northern Queensland Sure Insurance Expands Strata Coverage to $20 Million to Enhance Affordability in Northern Queensland
22 Jan 2026: Paige Estritori

In a significant move to address the longstanding issue of insurance affordability in Northern and Regional Queensland, Sure Insurance has announced an increase in its residential strata insurance coverage from $5 million to $20 million. This strategic enhancement aims to provide body corporates and lot owners with more competitive premium options and improved access to essential insurance services. - read more
Artificial Intelligence: The Foremost Risk for Australian Enterprises Artificial Intelligence: The Foremost Risk for Australian Enterprises
22 Jan 2026: Paige Estritori

In a significant shift within the Australian business landscape, artificial intelligence (AI) has ascended to the top of the risk agenda for local enterprises. According to Allianz's annual global risk survey, 61% of Australian executives now identify AI as their primary concern, marking the first instance where this technology has led the risk list in Australia. This represents a substantial leap from its eighth-place ranking in the previous year. - read more


Life Insurance Articles

Understanding Your Insurance Needs at Every Life Stage Understanding Your Insurance Needs at Every Life Stage
Navigating the complex world of insurance can often feel daunting, but understanding the importance of life stage consideration when choosing life insurance is essential. As we journey through the various chapters of our lives, our financial responsibilities, dependents, and personal circumstances evolve. These changes invariably have significant implications for our insurance needs. - read more
How Illness Can Impact Your Financial Stability: The Role of Income Protection How Illness Can Impact Your Financial Stability: The Role of Income Protection
Life is unpredictable, and unforeseen health issues can strike at any time, profoundly impacting your financial well-being. An unexpected illness can bring not only physical pain but also financial strain as medical bills pile up and the capacity to generate income diminishes. - read more
Income Insurance Claims 101: How to Get Paid Without the Stress Income Insurance Claims 101: How to Get Paid Without the Stress
Welcome to 'Income Insurance Claims 101', where we navigate the ins and outs of securing your financial wellbeing in uncertain times. As a working Australian, one of the smartest moves you can make is safeguarding your income against unforeseen events that could leave you unable to work. That's where income protection insurance enters the scene – it's not just a policy, it's peace of mind. - read more
How Much Life Insurance Do You Truly Need? Assessing Your Personal Coverage How Much Life Insurance Do You Truly Need? Assessing Your Personal Coverage
There's often confusion surrounding the amount of life insurance one truly needs. Common misconceptions cloud our judgment, leading some to undervalue their coverage, while others may overinsure, unnecessarily straining their financial resources. It is a delicate balance to strike, and understanding the nuances of life insurance is pivotal to making informed decisions. - 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
Public Liability Insurance:
A very broad term for insurance covering liability exposures for individuals and business owners. It provides broad coverage, generally including all exposures for property damage and bodily injury.