A travel policyholder who cancelled a holiday in Europe after a cancer diagnosis will not be covered for his losses after failing to show when he first knew of his condition.  

The man bought the policy with Lloyd’s Australia on July 20 2023.

But he called off his trip after receiving the diagnosis a few days before his July 25 departure date, and sought $7869 cover for the cancellation.  

Lloyd’s did not dispute the diagnosis but requested information to confirm the condition was not pre-existing or known to the claimant before buying the policy.  

It asked for copies of hospital admission records regarding when a biopsy was conducted, consultation notes from his GP and copies of medical reports relating to his cancer.  

The man provided a form from his oncologist confirming the diagnosis based on a biopsy completed at 8pm on July 20 – hours after the policy was issued.  

However, he did not provide any other requested information.  

Lloyd’s told the Australian Financial Complaints Authority the man’s failure to provide relevant medical records led it to believe his condition was pre-existing.  

The claimant said he would not have booked the holiday if he had known about the cancer, and he only began showing symptoms on July 20, when he started coughing blood.  

AFCA acknowledges this but says the man should have supported his position by providing the requested information, and he has not adequately explained why he could not.  

“The complainant has not said the records requested by the insurer are not relevant or reasonable, but says there are no other hospital records,” an ombudsman said.

“I do not accept the hospital would have no clinical records regarding the complainant’s attendance and testing at the hospital.

“The complainant also says he has seen the same general practitioner for 30 years. However, he has not provided any information from this doctor, as requested by the insurer. 

“This does not assist the complainant in showing he had no awareness of the condition when he purchased the policy.”

The ombudsman says AFCA cannot reasonably determine whether the man was aware his circumstances would lead to a claim, but “I consider it is fair to draw an adverse inference regarding the complainant’s failure to provide information from his general practitioner and the hospital’s full records regarding his presentation on July 20 2023.  

“It would not be fair to require the insurer to pay the claim when the complainant has not provided records to confirm what he knew about his condition when he purchased the policy.”  

Click here for the ruling.