A traveller who called off his holiday to be with his dying father will not be covered for his losses after a dispute body accepted that his insurer had fairly applied exclusions.  

The complainant cancelled the trip on October 14 2022, shortly before his intended travel date, after he was informed his father was terminally ill and had only a few days to live. He lodged a claim with NIB Travel Services (Australia) for $18,976 in cancellation expenses for non-refundable tours.  

The insurer declined the claim, saying the cause of the death was a previously diagnosed metastatic melanoma, which had been a known and existing medical condition to the complainant.  

The policy excludes cover for “any existing medical condition of you, a member of the travelling party, a non-travelling close relative or business partner”, as well as any death from a metastatic or terminal prognosis.   

The insured says he had been unaware that his father’s melanoma had become metastatic when he took out the policy in August 2022 and argues that it would have been unreasonable for him to ask family members about their health before taking out travel insurance.   

The claimant also notes that the father’s death certificate detailed “Cellulitis, Pulmonary oedema, Aspiration pneumonia,” as contributory reasons for the death and says these were the “cause of his rapid demise”.   

The Australian Financial Complaints Authority noted that the claimant’s father’s GP record showed that he had been undergoing immunotherapy for metastatic melanoma in January 2022. During this time, the man had been prescribed several medications, attended follow-up appointments, and undergone hospital admissions for other medical conditions.   

The authority accepted that the primary cause of the father’s death had been his diagnosed metastatic melanoma and that the policyholder had been aware of the condition at the time that he had taken out the policy.  

“Whilst the complainant may not have been aware of the severity of his father’s illness, on their own admissions ... the complainant and his wife were aware the complainant’s father had a metastatic condition (melanoma) and was receiving periodic immunotherapy for several years prior to them purchasing the policy,” the authority said.  

It agreed that the insurer had clearly established that the policy excluded losses caused by an existing medical condition or a metastatic or terminal prognosis and it was entitled to deny the claim.

“While I appreciate the complainant is disappointed his cancellation expenses are not covered under the policy, I am satisfied the insurer has established general exclusions 5 and 6 apply and it can deny cover for the cancellation expenses,” the authority said.  

The decision found that the insurer had unreasonably delayed its claim assessment and required it to compensate the claimant $2000 for stress and inconvenience.   

Click here for the ruling.