boonyed

Thanks both for your intuative comments. I have responded to the ombudsman asking for the case to be reconsidered, though I have not yet recieved a reply. In my opinion the treatment that my wife recieved may have been a little over the top. She had a brain scan and head x-ray which obviously increased the costs. We are only claiming for the hospital bill, the ambulance transfer to hospital and the taxi fare back to the hotel. I have argued the point that my wife was in no fit state to contact the advisor at the time of the accident and that her friend has no responsibility to do so, on her bahalf, as they are not related. I have also mentioned that the hospital may have contacted the advisory service on her behalf and that a copy of the MES may indicate whether this was the case in this instance. Basically I am just trying to keep the case open.....by not challenging it, I would simply be capitulating and allowing the insurance company to get away with it. Thanks for your input, I will let you know what the ombudsman says when I hear. Andy

Thanks for the reply ScarletPimpernel The accident happened in Playa de las Americas, Tenerife. As I mentioned above, my Wife did not have details of the medical assistance company, but I have managed to find a reference to them in one of the many correnspondences I have had with White Horse Ireland Insurance Ltd. They are Axa Assistance 0044 (0) 845610 1429. Do you think they are likely to respond if I call them for information? Cheers in advance Andy

Haydn Thanks for your reply. However, I think I would rather try to appeal before going straight for the throat!!! Andy

Hi I have received excellent advice from this site in the past and was successfull in my claim against Barclays bank for unlawful bank charges because of that advice, so I thought I'd come back in the hope that someone may be able to help with a holiday insurance claim that the ombudsman have refused to investigate on my wife's behalf. She purchased a holiday, via Going Places in May this year and at the same time purchased holiday insurance which was underwritten by a company called White Horse. She had a reciept at the time of booking and later received an insurance certificate/schedule. Whilst mid way through the holiday she had a severe rection to something she ate in the hotel and on here way out of the restaurant collapsed and banged her head on the floor. An off-duty nurse attended her and as she had been unconscious for more than 5 minutes advised that she should attend hospital. A doctor and an ambulance were called and she was whisked off to hospital for tests. Her friend contacted the holday rep whilst waiting for the ambulance using the emergency number at the hotel and has her mobile telephone bill which confirms this. She asked the rep what documentation she would need to take with her. The rep said that she should just take their insurance certificate and my wifes passport. This she did. The total bill for my wifes treatment was about 900euros, which of course we would like to claim. She wrote to White Horse on her return, filled out a claim form and attached all of the evidence and bills. White Horse replied to say that they would not pay the claim as my wife or her friend did not contact their Medical Assistance Company before agreeing to treatment. They qoute their terms and conditions; in the event of death, incurring expenses in excess of £250, or your being involved in an accident, being admitted to hospital, or curtailing for medical reasons, the Assistance Company must be advised as soon as possible and liability shall only attach for expenses agreed by them. Failure to notify the Assistance Company will prejudice the Insurer and will result in the insurer's non-acceptance of liability in such claims. What you are not covered for: In addition to the General Exclusions of the policy, the insurer shall not be responsible for; 11. claims arising out of your failure to contact the Assistance Company. Pretty straight forward, I hear you say, well here's the rub; as you can appreciate my wife was in no fit state to contact the Assistance Company at the time; my wife's companion contacted the Going Places rep who advised that they did not need to contact anyone else; no documentation provided by Going Places at time that the holiday was purchased, when the insurance and tickets arrived, or since, contain the terms and conditions of the insurance or the details/telephone number of the Assistance company as stated above. White Horse have sent copies of the insurance terms and conditions (which do state the conditions above) and therefore the ombudsman will not investigate further. I have a week to appeal and don't know where I stand. Can anyone offer advice? Many thanks in advance Andy