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Travel insurer not to blame for autopsy delays, AFCA finds

The financial services ombudsman has ruled out compensation for the family of a traveller who died overseas and says insurer Chubb handled the claim appropriately and offered a fair settlement.

The traveller, who held coverage through his credit card, died in May last year and his family claimed for their travel and cremation costs.  

Chubb held off making a settlement after a preliminary autopsy report gave an indeterminate cause of death. It said further testing was required to rule out the presence of toxins.  

The insurer said there was evidence the man had a “large amount of medication” on him, and video footage showed him entering a lift with “certain imbalance and instability when walking”.

In June this year, Chubb told the family it would pay the claim following a “delayed process with the final autopsy report”. It offered $9821 after accounting for policy limitations on return airfares and accommodation expenses.  

The family said the insurer’s response was unreasonably delayed; it failed to provide in-country support; and the terms of the coverage “forced” them to cremate the man.

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In its dispute ruling, the Australian Financial Complaints Authority acknowledges the family’s difficult situation but says it was reasonable for the insurer to require the final autopsy report.  

It says the policy “does not cover all contingencies” and some costs would fall on the policyholder’s family.  

“The outcome is fair, as the insurer has now accepted and settled the claim (in accordance with the remaining policy terms and conditions), given ongoing uncertainty about the availability of the outstanding information,” the authority said.  

“[The insurer] cannot be held responsible for delays outside its control, nor for other compensation when it has acted reasonably overall in its handling of this inherently difficult and upsetting matter.”  

See the ruling here.