A traveller who fell ill and returned early from a trip abroad has lost a claims dispute after his insurer argued he was not medically required to end his holiday.

The elderly complainant was midway through a visit to Egypt when he suffered a sore throat, stomach cramps and diarrhoea last June 6. 

He consulted with a local doctor who recommended rest, but the man said it was difficult to recover outside the comfort of his own home. The claimant returned to Australia on June 17 and later confirmed the doctor had diagnosed gastroenteritis and a sore throat.

He wanted Nib Travel Services to cover expenses relating to accommodation, medical costs and flight changes, amounting to $4526.

The insurer said its policy would cover losses if the insured was “unable to start or finish the trip because of ... death, sudden serious illness or serious injury that occurs before or during the trip”.  

Nib declined the claim on the basis the man had not shown he was declared medically unfit to travel.  

The Australian Financial Complaints Authority agrees the complainant did not provide evidence he was required to cancel his trip early.

“While I empathise with the complainant’s situation, it is not enough that the complainant was ill and sought medical attention,” the authority’s dispute adjudicator said. “To trigger cover, he was required to be considered by the overseas treating doctor as medically unfit to travel.

“There is no evidence presented that the complainant was certified as medically unfit to travel or that it was necessary for the complainant to return home early.

“Further, the complainant’s own material shows he unilaterally decided not to continue the trip based on his preference to rest at home.”  

The authority considered whether the loss could be covered under the policy’s benefit for medical evacuation and repatriation but says this applies only in matters where it is “medically necessary”.

The authority declined to consider a separate issue raised by the claimant relating to a toe injury sustained on his flight when an attendant spilled a drink on him. It says this is a matter for the airline and is outside the insurer’s scope. 

Click here for the ruling.