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.”
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.
QBE and Blue Zebra have extended their motor underwriting partnership, with Blue Zebra confirming a new multi-year agreement after the previous arrangement expired. QBE has been underwriting Blue Zebra’s commercial and private motor products since July last year, following the end of the agency’s earlier arrangement with Youi. - read more
A new Australian Financial Complaints Authority decision has put income protection claims under the spotlight, with useful lessons for tradies who rely on their own capacity to work. The dispute involved a delivery driver who had received weekly income protection benefits after a serious arm-related medical condition prevented him from working. The insurer later tried to recover more than $31,000 in paid benefits, arguing it had information suggesting he could have returned to work earlier. - read more
CHU Underwriting Agencies has launched its inaugural Green Grant Program, distributing $50,000 across seven strata communities on 16 July 2026. The initiative is modest in scale, with grants capped at $10,000 per successful application, but it points to a larger change in the way strata insurance risk is being discussed. Instead of focusing only on premium increases after extreme weather or building losses, insurers are increasingly looking at practical ways to reduce risk before claims occur. - read more
Marsh Risk has appointed Justin Gillingham as its new head of strata, in a move that reflects how quickly the Australian strata insurance market is becoming more specialised. Announced on 20 July 2026, the appointment brings a senior insurance and risk professional into a role focused on buildings, owners corporations and communities dealing with increasingly complicated cover, compliance and claims issues. - read more
When it comes to navigating the complex waters of insurance, understanding public liability insurance claims is crucial for businesses and individuals alike. Public liability insurance serves as a safeguard, protecting against the financial repercussions that arise from accidents or injuries that occur on your premises or through your operations. In this introductory section, we will delve into the essence of public liability insurance and underline its significance. - read more
In the ever-evolving landscape of Australian commerce, business insurance stands as a crucial bulwark, safeguarding enterprises against unforeseen financial perils. Recognizing this, our in-depth exploration begins with an overview of the monumental role business insurance plays for Australian companies, both large and small. It's a cornerstone for risk management, providing business owners with peace of mind as they navigate the intricacies of their industries. - read more
As a small business owner, understanding the intricacies of liability insurance is pivotal to safeguarding the fruit of your hard work. Insurances such as professional indemnity and public liability are not just safety nets; they are vital components that can mean the difference between bouncing back and closing down following unforeseen legal hurdles. - read more
Public liability insurance is a crucial safety net for both businesses and individuals, providing protection against the financial fallout from claims of injury or damage that your business operations might cause to third parties. This type of insurance is designed to cover legal and compensation costs, safeguarding you from unexpected financial burdens. - read more
Start Here !
Knowledgebase
Actuary: A professional who analyzes the financial costs of risk and uncertainty using mathematics, statistics, and financial theory.
No comments yet. Be the first to share your thoughts.