The information on this website is general in nature and does not take into account your objectives, financial situation, or needs. Consider seeking personal advice from a licensed adviser before acting on any information.
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.â€
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.
Please Note: We do not endorse any specific products or companies. Some content is sourced from third parties, including press releases, and may not be independently verified for accuracy or completeness.
The Australian Financial Complaints Authority’s latest annual review has put income protection insurance back in focus, with the product again attracting the highest number of life insurance complaints in 2025-26. The figures are a useful reminder that the real value of cover is tested not at purchase, but when illness or injury interrupts a person’s capacity to earn. - read more
A recent Australian Financial Complaints Authority determination involving a flooded farmhouse has put claims handling back under the microscope for rural policyholders, after the insurer was ordered to pay almost $432,000 across building repairs, additional temporary accommodation, professional costs and compensation for non-financial loss. The decision, dated 27 August 2026 and reported by Insurance News on 15 October 2026, is a useful reminder that the practical aftermath of a farm flood can extend well beyond the first clean-up. - read more
A recent Australian Financial Complaints Authority decision involving a vandalised Hino truck is a useful reminder that disclosure disputes in commercial motor insurance turn on evidence, not assumptions. Reported by insuranceNEWS.com.au on 15 October 2026, the matter ended with Suncorp being ordered to reinstate the policy and reassess the claim after AFCA found the insurer had not proved that undisclosed driving history would have justified refusing the risk. - read more
Australia's construction sector remains under pressure, with recent insolvency figures continuing to show building and construction as one of the most exposed parts of the economy. Higher material costs, tight margins, labour shortages, delayed payments and fixed-price contract stress have all contributed to a tougher operating environment for builders, subcontractors and project owners. - read more
Small businesses face risks that can affect their premises, equipment, stock, cash flow and reputation. Insurance helps transfer some of the financial impact of unexpected events to an insurer, so a single incident is less likely to derail day-to-day operations. - read more
Professional indemnity and public liability insurance protect small businesses against different types of claims. Understanding the difference can help you assess whether your risks relate mainly to advice and professional services, physical injury and property damage, or both. - read more
Freelancers can face liability risks when providing services, visiting client sites or working with client property. Liability insurance can help manage the financial impact of certain claims, but the right cover depends on the type of work you do, your contracts and your risk exposure. - read more
Liability insurance helps Australian small businesses manage the financial impact of legal claims involving injury, property damage, negligent services or products connected with business activities. Understanding the main types of cover, policy limits, exclusions and claims processes can help business owners make more informed risk management decisions. - read more
Start Here !
Knowledgebase
Term Life Insurance: A life insurance that provides a cover for a specific period of time - usually one to five years or until the insured reaches age 65 or 70.
No comments yet. Be the first to share your thoughts.