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The ill-fated trip in question encompassed a journey to Europe and Bali. The couple's holiday commenced on September 2 and was originally envisaged to conclude on October 2 of the previous year. Nevertheless, an unforeseen medical emergency involving the man's wife necessitated their early return from Bali to their Melbourne home, disrupting their travel plans.
Subsequently, the policyholder filed a claim with Tokio Marine & Nichido Fire Insurance to cover the medical costs incurred as well as the emergency travel expenses back to Australia. The insurance provider, however, declined the claim, asserting that the policy's effective coverage had terminated upon the couple's initial return to Australia from Europe, prior to their Bali visit.
The disappointed claimant contested that he was under the impression he had a multi-trip policy and that he would have opted for such had he been aware of his actual coverage. He argued that his insurer should have clarified the limitations of his single-trip policy during a phone call to modify his policy in January last year, a conversation used as evidence in the dispute.
The inquiry into the claim revealed otherwise, with the Australian Financial Complaints Authority determining that the travel insurance provider had communicated clearly regarding the policy's scope. The policyholder had twice confirmed the travel dates, reflecting an understanding that the coverage was for a single trip extending from September 2 to October 2.
Scrutiny over the conversation and the website interaction by the authority suggested that Tokio Marine & Nichido Fire Insurance had provided clear distinctions between the single-trip and multi-trip options available. Hence, it became incumbent upon the traveler to ensure his selected policy aligned with his travel needs. Furthermore, opportunities for clarification about policy details had been ample before embarking on the journey to Europe, evidenced by the discussions had and policy documents made available prior to travel.
The adjudicator from the authority concluded that the insurer was rightful in rejecting the claim based on the clear stipulation in the single-trip policy that coverage ceases once the insured party returns to their home. With the Europe trip concluded and the couple back in Australia before they left for Bali, the authority found that the Bali excursion constituted an entirely separate journey.
Published:Friday, 5th Apr 2024
Source: Paige Estritori
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