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Travel disputes keep AFCA busy

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Travel claims are the leading cause of general insurance disputes since October 1, when the Australian Financial Complaints Authority (AFCA) began naming companies in its rulings.

Complaints over rejected claims for travel-related losses led the way with six, followed by five each for motor vehicle and home and contents, according to an insuranceNEWS.com.au search of the AFCA website.

Half of the six travel cases involved policy exclusions for pre-existing medical conditions.

In one of the cases involving Zurich, AFCA ruled the insurer had no grounds to rely on non-disclosure of a previous episode of angina and high blood pressure medication to reject the claim for cancellation of trip costs.

The couple who took out the policy had to cancel the trip after one of them required a coronary artery bypass graft.

Zurich said it would not have provided the cover if the couple had disclosed the details. The insurer also argued the claim arose from a pre-existing condition for which no additional cover was correctly applied for.

But AFCA sees the matter differently, saying Zurich has not shown “it clearly informed the complainants of the general nature and effect of the duty of disclosure prior to the inception of the policy”.

AFCA further adds Zurich is not entitled to rely on the pre-existing condition exclusion as it “was on risk for any loss caused by cardiac failure, which broadly applies to the condition causing the claim”.

Zurich was ordered to pay the complainants $19,750 plus interest.

Meanwhile, the Australian Securities and Investments Commission has commenced “scoping a review” of travel insurance products with further work planned for next year, a spokesman told insuranceNEWS.com.au.

According to the Consumer Action Law Centre, travel insurance is an area where consumers are unfairly disadvantaged.

“People continue to face shocking outcomes at claims time when it comes to travel insurance,” Senior Policy Officer Cat Newton told insuranceNEWS.com.au.

“It’s time for insurers to look at their policies carefully…and to ensure that they are selling those policies appropriately for people who can benefit from them and understand what they are signing up to.”