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Travel
policies tend to be fairly complex because they cover a wider
range of risks than any other type of insurance – from cancellation
to loss of luggage, hospitalisation and death claims. If cover
were not described broadly, it might never be understood. So exclusions
play an important role in defining the cover provided. For example,
broadly speaking, cancellation-cover specifically excludes anything
predictable.
Most
holidaymakers understand that no policy offers them unlimited
cover, either for what they may claim for or for how much they
will be paid. But if an insurer wishes to rely on a provision
which significantly reduces what the policy says it provides,
it will have to show that this provision was drawn to the customer’s
attention before the policy was sold. Relevant evidence here might
include explanatory literature given to the customer before sale
or a statement from the person selling the policy. It is clear,
however, that the extended sales chain for these policies (many
of which are sold directly by travel companies or high street
travel agents) can give rise to justifiable concerns from customers
about the sales process.
In
general, our approach is to determine whether the exclusion is
an important reduction to the cover marketed by the insurer. If
it is, we may well conclude that it would not be fair for the
insurer to rely on it to reject an otherwise valid claim.
This
approach is not the same, however, as assessing the importance
of the exclusion by reference to the policyholder’s particular
situation. Unless the circumstances were such that the policyholder
requested cover against a specific contingency, we are unlikely
to conclude that the exclusion should be judged on the basis of
how its operation has affected the policyholder.
case
studies - travel insurance
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