Crusader: Hikers' £890 uphill struggle after insurance claim
A COUPLE were relieved to come through a health scare after a bout of altitude sickness during a summer hiking holiday in the Alps.
But Debra and Clifford Brown faced another uphill struggle back home when they claimed on their travel insurance for £890 of hospital and other expenses it cost them when their trip took a turn for the worse.
While the Browns' provider, Cigna Insurance Services, asked repeatedly for medical evidence, Debra considered she had supplied everything she could to support the claim.
After almost four months of automated responses to her emails, Debra decided it was time to contact Crusader.
"This stone-walling is very frustrating," she said.
"We even paid the premium for being at altitude. The evidence surely shows our claim is genuine."
Travel insurance includes an assistance service phone number that customers should call if they need any medical assistance while they're on their holiday
The couple consulted a doctor in the Italian mountain resort of Courmayeur when Clifford became ill while he and Debra were taking a Mont Blanc tour in July.
After an examination, the doctor sent Clifford and Debra by ambulance to a nearby hospital for tests. A few days later, in a lower altitude town, Clifford slowly recovered.
On their return Debra sent Cigna medical receipts, the cancellation invoice from the tour operator for the part of the holiday the Browns had missed, and the bill for the hospital tests.
That is when the Browns, from Sussex, came up against a problem Crusader has reported on before.
This concerns the gulf between what people can reasonably expect to obtain during a real life situation in a foreign country and the abstract formulated demands of an insurance policy.
Cigna kept asking for the first doctor's report. But in emergencies like this a GP acts more like an intermediary, referring the patient to hospital for diagnosis and treatment.
It never crossed the Browns' mind to ask the GP for a report because it was clear he was unsure of Clifford's illness, otherwise he would not have sent him to hospital.
The hospital supplied the key evidence. Debra sent this and their own GP's report but this could confirm only Clifford's recovery.
When Cigna kept asking for a certificate from the first doctor, Debra spent weeks chasing one but to no avail.
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When we put the issue to Cigna, it agreed enough was enough. It apologised for the difficulties Debra and Clifford had experienced and said: "We are satisfied we have sufficient evidence and are now settling the claim in full."
Cigna also advised: "Travel insurance includes an assistance service phone number that customers should call if they need any medical assistance while they're on their holiday."
Excess worry
A TRICKY matter of excess almost marred the Browns' relief when their claim was honoured.
Excess is the amount deducted from a successful claim. In the Browns' case, this was £250 (£125 each for the joint cover).
But the Browns understood that the excess would be waived because they had a European Health Insurance Card.
Crusader asked leading UK insurer Direct Line for clarity.
"In relation to EHIC, any part of a policyholder's medical expenses is covered," said a spokeswoman. "Direct Line would pay the remaining balance.
"If the policy was to claim for medical expenses dealt with on the spot, it would be only one excess.
"If the medical treatment meant the policyholder and their spouse had to stay longer it would still only be one excess as it comes under the medical expenses section for which one person is claiming."
Cigna has confirmed it will refund both excess deductions.
