Recent news reports have shown that more UK holiday makers than ever before are submitting fake insurance claims for sickness following their holidays. With the number of compensation claims for holiday sickness rising a massive 500% since 2013, travel insurance companies are sure to be even more vigilant when it comes to assessing a claim’s validity.
This has left many people with genuine insurance claims having their integrity questioned and, in some cases, their claim rejected. Nicole Rogers, solicitor at DAS Law, explains what you need to know…
If I fall ill on holiday, what steps should I take to prove or document this so I can claim on my travel insurance?
You should ensure that you:
- Take your travel insurance documents with you and that you have your insurer’s telephone number in a safe place;
- Know what you are and are not covered for and make sure you are aware of any relevant time limits for making a claim;
- Arrange any required vaccinations before you travel;
- Provide accurate information to your insurer to avoid disputes regarding cover and possible claims;
- Where possible, contact your insurer and obtain agreement for treatment. This will not always be possible in an emergency. Many European countries give free urgent/A&E treatment if you have a European Health Insurance Card (EHIC). If it is not possible to obtain agreement, keep any receipts and medical certificates safe
Can I take legal action against a resort/hotel/tour operator if I fall ill on holiday?
Taking legal action should be a last resort but any action you take will depend upon how the holiday was booked. If you have arranged the holiday yourself, you will have different contracts with separate parties. You would need to seek specialist advice as the governing law would be that of the country you have visited but, in the first instance, you should write to the hotel with your complaint.
If you have booked your holiday through an agent or tour operator, you should send a letter of complaint, along with copies of any evidence you have. If you do not receive a satisfactory response, you should check if the agent is registered with the Association of British Travel Agents (ABTA). If so, you should register your complaint with ABTA and await a response. For a fee, ABTA are able to mediate between you and the travel agent but if you are still unable to reach an amicable resolution, you would need to issue proceedings against the agent in the county court. This can be a very time consuming and costly process and you should consider whether it is a proportionate course of action.
If I fall ill on holiday can I claim back medical expenses, such as trips to the doctor and medication?
Firstly, you should ensure that you have the appropriate level of travel insurance and check the small print so that you are aware of the terms of your policy. For emergency assistance, you may receive free A&E assistance if you have a European Health Insurance Card. It is important that you consider using this as your insurer may refuse to repay your medical fees if you have an EHIC but did not use it.
Where possible, you should obtain agreement from your insurer before receiving treatment. Alternatively, you may need to pay for the treatment yourself and claim your expenses back from your insurer. You must ensure that you keep evidence of receipts and medical certificates as your insurer will usually request these.
Can I claim the entire amount of my trip if I fall ill abroad?
You would need to check the terms of your travel insurance. It is unlikely, however, that you would be able to claim for the entire amount of your trip.
My insurer declined my holiday sickness claim as being fraudulent, but it isn’t. How can I prove this?
There has been a significant increase in fraudulent claims on travel insurance policies but it would be very distressing to be wrongly accused of making such a claim. In the event that your insurer alleges fraud, seek legal advice immediately. You should ask your insurer for full reasons as to why they consider fraud is present. If you have not already done so, you should submit all copies of evidence for your claim. If you are dissatisfied with their response, you can consider making an internal complaint before escalating the matter to the Financial Conduct Authority.
If my holiday companion put in a false holiday sickness claim to their insurer and received a pay out, would I also be liable, even if I didn’t claim myself?
It is unlikely that you would be held liable for the wrong-doing of another party. However, if you have been complicit in fraud i.e. provided evidence which you know to be false in order to help your friend, you too may also become a subject within a fraud investigation.