I am a fit 31-year-old who unfortunately suffered a sudden cardiac arrest while on holiday in the US last year.
When I went to make a claim on my travel insurance for the medical treatment I received, it was declined because I hadn’t declared a visit to my doctor over an earache 18 months before.
I am worried sick I’ll be on the hook for a six-figure sum. Please help.
A.B., Canterbury, Kent.
Sally Hamilton replies: When I called you to hear more about this frightening episode you sounded upbeat. This is because you are feeling fit again and are under the care of cardiac specialists in the UK via your private medical insurance.
However, your experience one week into a fortnight’s holiday to the Grand Canyon last October still haunts you – compounded by the worry that your finances would suffer a canyon-sized dent if you had to meet the ensuing dizzying medical bills.
Denied: A travel insurer rejected a claim from a customer who had suffered a cardiac arrest on holiday over a trip to the doctors they had made for an earache
After you had fallen asleep in your campervan at a site near the famous Horse Shoe Bend, your wife was woken to the sound of you having a seizure and your heart appeared to have stopped. Having learnt first aid in her role as a teacher, she performed CPR while phoning emergency services.
They arrived within a few minutes and used a defibrillator several times to bring you back to life. You were driven to a local hospital where it was decided to airlift you for specialist cardiac care in a larger hospital one hour’s helicopter ride away.
Your wife drove the campervan three hours through the night to join you, not knowing whether you would survive.
But you came through and were fitted with a cardioverter-defibrillator, designed to correct an irregular heartbeat, should things go wrong again. You have not had another episode to date, are making a great recovery and back at work part-time.
Most people know medical care in the US is costly.
You estimate your bills will total $100,000 (£77,000) or more, though AXA wouldn’t confirm the figures as it is waiting until all the bills are in.
But the implant device you received cost $50,000 (£39,000) and on average air ambulances are priced from $50,000.
The bill for the first hospital you were in came to $9,000. Then there are all the other elements, from the operation to treatments. You said the anaesthetist bill alone was $3,700.
You didn’t worry as you trusted your annual travel policy with Coverwise (underwritten by AXA Partners). You have held and renewed it each year since 2019.
But your new defibrillator was put to the test when you got the sudden and shocking news on November 2 your claim had been refused.
The letter pointed to policy stating cover is valid for a policyholder ‘who has not suffered a medical condition nor required prescribed medication, surgery, treatment, tests or investigations within the two years leading up to the purchase date’.
It turned out you failed to declare an earache requiring drops for seven days 18 months before your policy renewed. A consultation over toenail fungus was also not touched on. You were horrified these minor ailments would invalidate your claim.
It is an oversight not to mention GP visits – and I urge all policy buyers to double check they have declared all medical issues to their insurers, however minor.
Many will still issue cover anyway for the same price or perhaps a slightly higher premium. It is better to be safely covered than sorry.
But forgetting to mention minor health issues is easily done – and I’d argue an oversight is more readily made when a policy is being renewed automatically, like yours.
You told me you’d read the initial wording: ‘If you’re happy with your renewal quote and the details of your new policy, you don’t need to do anything.’
Had you read on, you would have seen the requirement to declare medical issues over the past two years.
However, I felt AXA has been overzealous regarding the minor ailments completely unrelated to your cardiac arrest.
In practice, many insurers will often overlook one or two minor medical issues and still pay a claim – although it is risky not to mention them when purchasing a policy.
I asked AXA Partners to reconsider your case and a few days later, it came back with the momentous news that it would meet the claim, plus pay you £500 compensation.
A spokesman for AXA Partners, says: ‘We are sorry for the issues A.B. experienced during his claim.
Upon further review, we have now settled his claim in full. We have notified him of this and will also be providing compensation in recognition of the issues he faced.’
Help I can’t access my betting account balance
William Hill closed its telephone betting in April 2024, and in July I phoned to request it return the £530 balance on my account.
I have not received it even though it has the account details where from which it previously took debits. I am worried it may have been credited to someone else.
M.P., Coulsdon, Surrey.
Sally Hamilton replies: You told me you didn’t have the technical knowhow to upload a bank statement to their customer service chat system – which is the only way customers can contact William Hill these days – so you posted a copy of your bank statement as evidence of your account in the hope it would release your money.
However, nothing happened. Despite numerous attempts to get hold of someone at William Hill to discuss your problem you got nowhere. When about six months had passed without success, you came to me.
Once I got in touch with William Hill, it quickly emerged that it had tried to return your money, but failed because the card linked to your account had expired.
It said it couldn’t trace the letter or bank statement you had posted and asked if you could resend them, which you did.
When we caught up recently you confirmed that your £530 was now safely in your account.
You thanked me for my help but also made the urgent point that the delay could have been avoided if William Hill had taken phone enquiries, as they used to.
Sadly, it’s a sure-fire bet more and more firms will going the way of William Hill, with customers the losers.
Scam watch
iPhone and Mac users should beware a scam email being used to impersonate Apple, consumer website Which? warns.
The tricksters claim you violated Apple’s policy and terms of service and that you must verify your ID as your account has been disabled. The email threatens if you do not verify within 48 hours then your account will be terminated.
The link in the email leads to a phishing website designed to steal your personal and financial details.
Do not click on it – instead forward the email to report@phishing.gov.uk.
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