Couple win holiday insurance payout after two-year battle

Terry and Pauline Fuller have won a two-year battle with their travel insurance company. Picture: Ross Parry Agency
Terry and Pauline Fuller have won a two-year battle with their travel insurance company. Picture: Ross Parry Agency
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A WOMAN has two a two-year fight with her holiday insurance company after they refused to pay out because of a medical condition she didn’t know she had.

When holidaymaker Pauline Fuller fell ill in Majorca and had to go into hospital for tests and treatment.

Her husband Terry had to pay out about £12,000 before the Muro Hospital on the island would sign a release so she could fly home.

But they were hit with a huge blow when their insurance company told them they would not refund the medical bill because Mrs Fuller had chronic obstructive pulmonary disease (COPD) and hadn’t told them about it.

Mrs Fuller was not aware she had the condition because her doctor had not told her.

Now the couple, both aged 74, of Netherton, Huddersfield, are celebrating after winning their two-year battle with insurers to get back their money.

They have now urged others to check closely with their own doctors before taking out medical insurance.

Mr Fuller said: “Pauline had an operation for a stomach problem in May 2006, and they made a comment on her report that a mild case of COPD was evident.

“It wasn’t relevant to her condition at the time so our doctor said he didn’t bother to inform her of it.”

In fact, Mrs Fuller’s condition in Majorca had nothing to do with COPD.

She was taken ill in Puerto Pollensa in the north of Majorca, while staying at the Hotel Pollensa Park.

Mr Fuller said: “No checks were carried out at the Muro Hospital for COPD. Different checks were carried out and they diagnosed polyps on the trachea.”

But Spanish insurance underwriters Mapfre refused to honour their insurance agreement because she hadn’t told them she had the condition.

Mrs Fuller learned she had COPD from the insurers, who acquired the information from her medical records from the couple’s doctor in Huddersfield.

Mr Fuller said: “How can we put down a medical condition if we didn’t even know about it?

“The first question on the insurance application asked ‘are you aware’ of any underlying medical problem, to which we said ‘no’ because we were not aware of it.”

The couple appealed to the Financial Services Ombudsman and, after two years, have won the case.

Mapfre have been forced to recompense the full amount with interest.

But Mr Fuller believes other people going on holiday should be warned that they may fall into a similar trap with insurance companies looking for ‘get out’ clauses.

He added: “People should ask to see their medical records before applying for travel insurance.”

He added: “How many more people have been caught by this ‘get out’ obscure condition?”

A spokesman for the Association of British Insurers said: “Travel insurance is an essential purchase for anyone holidaying abroad. It protects customers against the cost of emergency medical treatment, which can amount to thousands of pounds, especially if medical repatriation is necessary.

“Cover is usually available to people who have a health condition or illness, or have had one in past, although some customers may need help to find the best policy for their needs.

The top three things that the ABI advises customers to think about when purchasing travel insurance are:

• The cheapest policy is not always the best. Customers should shop around and ensure the policy they purchase covers their individual needs.

• Travellers must ensure they disclose their medical conditions to insurers so that they know exactly what they are and are not covered for.

• Travellers should take necessary precautions to remain safe and not take unnecessary risks. Drink or drug-related incidents and leaving possessions unattended, particularly valuable items, could invalidate a claim.