Ombudsman says rejected claims are commonplace for holidaymakers who drink too much
Tourists are being warned that claims will most likely be rejected if the insurer thinks the incident occurred when they were drunk.
According to the Financial Ombudsman Service (FOS), most travel insurance policies include an alcohol exclusion. It also warns that if an insurer believes someone’s accident was due too them being too drunk, the claim might be rejected.
The FOS released its latest complaints figures for the last three months in 2017. In the report, it gave details of cases where people had their claims rejected because of excessive alcohol consumption.
One claim which was rejected involved a man who slipped and fell in a nightclub toilet while on holiday and hit his head. He admitted to drinking but said he was not drunk at the time of the accident.
Originally, the ombudsman told the insurer to pay up for the man’s medical costs but then decided that the evidence showed the incident was more likely than not caused by alcohol consumption.
Another claim which was rejected involved a woman who said her knee had come out of its joint. She needed to put her leg in a cast, and it even cut her holiday short.
But again, the insurer refused to pay out for her medical expenses, saying the injury would not have happened if she hadn’t been drinking.
According to the FOS, 21.9 million people from the UK went on summer holidays abroad in 2017.
It said, in total, there were around 3,000 complaints about travel insurance made last year. It also said that in almost 40% of the cases, the insurers had not treated their customers fairly.
Caroline Wayman, chief ombudsman and chief executive at the FOS, told the BBC: “Insurers may choose not to pay out if they believe someone’s been drinking excessively - although this doesn’t mean holidays need to be totally alcohol-free.
“In each case, we look at, we’ll carefully weigh up all the evidence to decide, on balance, whether the insurer has made the right call.”
A spokesperson at the Association of British Insurers (ABI) said: “Travel insurance is a lifeline for people who run into trouble overseas, with insurers paying out more than a million pounds every day. More than half of this funds emergency medical treatment for people who have been badly injured or have fallen seriously ill.
“As with any insurance, customers do have a responsibility not to behave recklessly. Insurers know people will likely want to drink alcohol while they’re on holiday and they don’t expect you to stay sober all the time, but there is a danger of invalidating your cover if you drink so much that it makes you act dangerously or means you are out of control.”