Two days before my wedding last May, my 23-year-old brother was diagnosed with terminal brain cancer and underwent emergency surgery.
I had bought cancellation cover 18 months previously from The Insurance Emporium (TIE) and immediately submitted a claim as we cancelled the wedding.
The staff expressed no sympathy, then lost the claim forms, requiring me to resubmit. I had to chase for updates continually.
Two months later, my claim was denied because my brother had suffered daytime drowsiness prior to the commencement of the policy. Doctors had found no cause for concern and made no diagnosis. The insurers decided these were symptoms of a tumour.
Last October, five months after the claim, the company said it would pay £9,000 to reflect the uncertainty of the medical evidence and the sensitive circumstances. Three weeks later it withdrew the offer. We have lost £22,000 and can’t now afford a new wedding date.
KW, London
This is heartbreaking and highlights the traps that lurk in many insurance contracts.
You told me that, in 2020 and 2022, your brother, a medical student, consulted doctors about a drooping eyelid and recurring drowsiness. He was referred both times to a sleep clinic and given advice on sleep hygiene. “No additional red flags,” confirmed a medical letter in 2022.
You bought the insurance policy in December 2023. The declaration form asked if anyone critical to the wedding, from flower girls to grandparents, had any previous or existing medical conditions. Your brother’s undiagnosed fatigue did not cross your mind. A separate list of exclusions included any claim arising from a pre-existing condition. Its terms and conditions define this as any illness that showed “clinical signs” before the policy commenced.
TIE accepts that it was not unreasonable to omit your brother’s fatigue on the form, given that doctors had given him a clean bill of health, but insists that his symptoms were, in retrospect, related to the tumour and that the exclusion therefore applies.
The terms and conditions strike me as vague, sweeping and confusingly worded in that the exclusion appears to cover every symptom and previous, or potential illness, of the entire wedding party at any point.
TIE’s letter of rejection, moreover, implies that conditions do not have to have been diagnosed to disqualify a claim.
This would allow it to diagnose with the benefit of hindsight if a claim is made. The Financial Ombudsman Service, which investigates complaints about rejected insurance claims, says it considers whether customers should reasonably have been aware of an undiagnosed pre-existing condition which might lead to a claim if symptoms were minor and unspecific. It states, by way of an example, that headaches do not necessarily mean an illness, but could later turn out to be symptoms of a brain tumour.
I put these points to TIE, which stood by its pre-existing condition exclusion and its wording. “To remain fair and consistent to all customers, we are not able to alter or waive this requirement for individual cases,” it says.
Nonetheless, it has rewritten its declaration form since your complaints, and customers are now specifically asked about conditions awaiting test results, or treatment, or any terminal diagnoses.
When I asked about the withdrawal of the £9,000 offer, the company agreed to reinstate it. It has already paid you £350 in recognition of service shortfalls. It is possible that the Financial Ombudsman Service would uphold your complaint and order a full payout.
However, there is also a chance that, since your brother had to seek medical help on several occasions before you bought the policy, it might decide that the insurer’s decision is justified and you could end up with less, or even nothing. You have therefore accepted the offer so you can focus on supporting him.
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