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Insurance claim, delaying tactics

Posted: July 10th, 2018, 4:16 pm
by MyNameIsUrl
I’m trying to claim a refund for the cost of tickets to a sporting event, and the insurer are just stalling.

I should say at the outset that they say it’s not insurance. It is ‘Booking Refund Protection. …will provide you with a refund for any unused booking if you are unable to attend the booked event due to any of the circumstances set out below. It is not an insurance policy.’

I was unable to attend because of the death of a family member. The clause I am relying on says: ‘We will refund the cost of your booking if you are unable to attend a booked event due to the death, accident, or illness happening to you, a member of your immediate family or any person(s) in the group due to attend the booked event with you.’

The insurer is relying on another clause which contradicts the one above. My legal question is, if there are two contradictory clauses, how do we resolve it?

Secondly, there is no clear process: they asked for a form to be completed, which we did; they asked for a death certificate, which we sent; they are now asking for a form to be completed by a GP. It seems to me that if we complete that form, they will send another to be completed by a specialist, or three specialists, or who knows what else until we give up. My practical question is, how do we get round a seemingly endless process which has costs for us and appears to be simply a delaying tactic by the insurer?

Re: Insurance claim, delaying tactics

Posted: July 10th, 2018, 6:15 pm
by staffordian
Not a legal answer, but a pragmatic response.

Can you not contact the company, tell them you want the claim resolving within a reasonable timescale, and to that end ask them for an itemised list of what they require in order to satisfy their requirements so you can get it all and send them together?

It might also help others here if you give details of the contradictory clause.

Re: Insurance claim, delaying tactics

Posted: July 11th, 2018, 3:38 pm
by DrBunsenHoneydew
I've come across this before - it's a standard term that they won't cover a death due to a pre-existing condition, and they will always need a doctor's report to confirm this (for which you will almost certainly have to pay).
And 'exclusion clauses' trump 'what's covered'.