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Insurance Claim Rejected


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As discussed on another thread, APT Travelmarvel cancelled our European River Cruise scheduled for this September. They kept a massive $4500 of our $23k as non recoverable expenses, but that's another story.

 

We have claimed the $4500 from our insurers Budget Direct, and felt confident that this was a reasonable claim having confirmed that we are insured for a pandemic.

 

The claim has been rejected on the basis that we are required to minimise any loss, and they contend that we should have taken the the credit for the full amount which was offered by APT, and therefore have not suffered a loss.

 

We have gone to dispute contending that a future credit did not suit us and we are entitled to a refund. Has anybody had any experience of this, do we have a reasonable case?

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What were you supposed to do if you took the credit for a future cruise but it turned out that you were unable to use it in the future? Would they have met your claim in two years' time if that turned out to be the case for you? I doubt that they would. This would be a likely scenario for many people when it is likely to be a year or two before travel as we know starts to become available. It could be longer. For many people, this would be too long - they would not feel physically capable of undertaking a major trip.

 

I do recall that the Aust ACCC (I think that is correct) said that people who cancel because of the pandemic are entitled to a refund or a credit for future travel. That might sound good to someone in the prime of their life, but it isn't the case for older people.

 

My situation - I had an extensive trip from the UK booked (time in London, then a cruise through Norway, Iceland to NYC). I was confident I was capable of doing this trip this year, but I am not confident I could do it in a couple of years' time. Luckily I got all my money back.

 

 

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44 minutes ago, ozblue_7 said:

As discussed on another thread, APT Travelmarvel cancelled our European River Cruise scheduled for this September. They kept a massive $4500 of our $23k as non recoverable expenses, but that's another story.

 

We have claimed the $4500 from our insurers Budget Direct, and felt confident that this was a reasonable claim having confirmed that we are insured for a pandemic.

 

The claim has been rejected on the basis that we are required to minimise any loss, and they contend that we should have taken the the credit for the full amount which was offered by APT, and therefore have not suffered a loss.

 

We have gone to dispute contending that a future credit did not suit us and we are entitled to a refund. Has anybody had any experience of this, do we have a reasonable case?

To a reasonable person, yes. Have you taken your case re $4500 non recoverable expenses by APT Travelmarvel and rejection of your claim for this $4500 from Budget Direct to ACCC?

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1 hour ago, MMDown Under said:

To a reasonable person, yes. Have you taken your case re $4500 non recoverable expenses by APT Travelmarvel and rejection of your claim for this $4500 from Budget Direct to ACCC?

Or refer it to the Insurance Ombudsman? Good luck with it all.

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Or refer it to the Insurance Ombudsman? Good luck with it all.


Hi Les

I haven’t posted on here for quite awhile after losing Kay nearly 5 years ago and I’m sorry to hear you lost your wife too

I moved from Cootamundra 2 years ago and I’m in Wauchope now

Getting back to the post but we had a good outcome with our travel insurance with NRMA with a full refund


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27 minutes ago, rkmw said:

 


Hi Les

I haven’t posted on here for quite awhile after losing Kay nearly 5 years ago and I’m sorry to hear you lost your wife too

I moved from Cootamundra 2 years ago and I’m in Wauchope now

Getting back to the post but we had a good outcome with our travel insurance with NRMA with a full refund


Sent from my iPad using Forums

 

Hello again, Bob, nice to hear from you. I knew about your wife passing and thanks for your thoughts re Mary. I still remember our meet at Coota. All the best to you in Wauchope. Les

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10 hours ago, Aus Traveller said:

I do recall that the Aust ACCC (I think that is correct) said that people who cancel because of the pandemic are entitled to a refund or a credit for future travel

 

 

 

That was in reference to a supplier's response, in line with their terms. They encourage both parties to come to their own solution though, not saying that a credit is necessarily sufficient. i.e. they don't want to enforce it on suppliers as it will likely bankrupt them if forced to provide for everyone, but equally it's not sufficient to blanket wide not give refunds, so basically comes down to individual negotiation.

 

I can't agree that a credit is equivalent to a refund so don't agree it qualifies as minimising a loss. Again it depends on wording as it obviously minimises loss to insurer - but is quite a valid argument that it doesn't minimise loss to yourself if for example you can't use the credit at all. If the wording specifically says "minimise loss to the insurer" though, then you may have lost out on this deal.

 

If it doesn't specify that, I agree with nswp, this is one to take to the Insurance Ombudsman.

 

Nice to see Budget Direct haven't changed...

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Thanks for your responses. The clause they are quoting is,

 

2. You must take all reasonable steps to avoid or reduce any loss which may mean that you have to make a claim under this insurance.

 

My claim has been escalated to Budget Directs internal Disputes Resolution Team which will take a couple more weeks. The next step they say if I'm still not happy is AFCA being the Australian Financial Complaints Authority. I'll have to check how this fits with either the ACCC or Ombudsman. Either way I'm sure I'm sure its a valid claim and I'll take it to them all if necessary.

 

Both APT Travelmarvel and Budget Direct have behaved badly in my view and are rightly being hammered in Product Review.

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If it comes down to a dispute where you represent yourself, the keyword in that clause for your argument is "reasonable". If getting a credit would not be suitable and hence reasonable to your situation then your claim for a refund was the correct thing to do.

 

AFCA has replaced the Insurance ombudsman, so is the correct authority.

 

ACCC don't get involved in specific individual consumer complaints. You can log a complaint but that will just inform their own activities if they feel there is a general issue they want to take action on. They won't intervene on your behalf, and will only give you their own general commentary, which is what is on their web site.

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  • 3 months later...

Thought I'd get back to this thread now that its all settled, and let people know what happened.

 

The Budget Direct Internal Disputes team also rejected the claim, and escalation to their 2nd level Disputes team had the same result. So three times Budget Direct denied our claim on the grounds that we had not taken reasonable steps to minimise the loss.

 

We complained to AFCA. The process was all on line and very easy to do. In the first instance AFCA forwarded a copy of our complaint to BD. Within a week  BD had a rethink, and whilst standing by their interpretation of the clause, accepted our claim and paid out in full!

 

Thanks to all those who offered advice, and a special thank you to The Big M, for pointing out that the key word in the clause BD were using to deny our claim was `reasonable'. We hammered this word in our complaint, listing the reasons why BD were being unreasonable in their expection of what we should do to minimise the/their loss.  

 

 

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2 hours ago, bazzaw said:

Their name isn't "Budget Direct" for no reason! 

They paid me out 20k in 2010 when coeliac disease hit me with massive medical issues and we could not travel, air, land, cruises to Europe. Paid out in a month after all the paperwork submitted of course.

 

At the end of the day not much between them Barry.

Edited by NSWP
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11 hours ago, MMDown Under said:

Well Done!  An excellent example of why passengers should pursue their claims until they are resolved in their favour. 

 

There's not a lot of point pursuing something if you're not covered, as you'll just waste your own time and energy. But in this case, the policy wording allowed for coverage in this instance, which is what counts.

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