Belfast Telegraph

Insurance small print can leave a hell of a hangover

By Simon Read

Insurers are using the small print to wrongly turn down claims from holidaymakers who have had an accident.

Companies include terms such as "alcohol abuse" and "alcoholic" in their exclusions, but then refuse claims from people who may only have had a drink or two.

The Financial Ombudsman Service said the policy was wrong and revealed it upheld 53% of cases against travel insurers last year.

Its figures suggest the problem is getting worse after climbing from 42% of cases upheld in 2011.

"In some cases, we find that terms describing alcohol consumption aren't clearly defined in the policy or have been unfairly applied by the insurer to reject a claim," the Ombudsman reported.

It highlighted the story of a Mr J, who was forced to turn to the Ombudsman after his insurer refused to pay out for medical bills incurred when he fell down stairs in a bar in Sydney. He broke a leg and suffered severe head trauma and was taken to a hospital for emergency surgery to remove a dangerous blood clot.

Despite this, his insurer said it had evidence that he had consumed an excessive amount of alcohol and blamed his fall on this.

But the Ombudsman ruled the insurer did not have enough evidence to back up its rejection of Mr J's claim, and told the firm to pay up, with interest.

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