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When can travel insurers reject your claims relating to holiday curtailment, rail strikes, pre-existing medical conditions, theft, damaged baggage and European breakdowns? Here are real-life examples.

Travel insurance is a complicated insurance. There are many terms and exclusions, and lots of areas to consider from baggage to illness to winter sports, and more. Many claims are therefore rejected. Here are some real-life examples of customers' fight for a pay out.

Overseas rail strikes

It's almost unheard of, but there was a workers' strike in France. This affected the journey of Mr C, who was travelling by train from London to Milan, staying overnight in Paris. When in Paris, he learned the delay meant he'd miss his connection, so he booked a flight from Paris to Milan. He claimed this back from his insurer, who refused, saying the delay didn't occur in the UK – at 'the final point of international departure' – as per the insurance policy.

The Financial Ombudsman Service considered that phrase to be ambiguous even though it was supported in the small print by a reference to the UK. It's well-established legal practice in these cases to interpret contracts in the way most favourable to the consumer, so the FOS said the insurer must reimburse Mr C.

Holiday cut short by injury

Miss H badly injured her ankle on a cruise ship. She was due the next day to stay a week in Cyprus. She called her insurer for help getting home. The insurer said it would pay for medical treatment abroad only; it didn't believe she needed to come home early. Miss H came home anyway and claimed for the cost of cancelling her week's holiday at the hotel in Cyprus and the cost of her journey back, including flight and taxis. Furthermore, she wanted compensation for time off work for physiotherapy and for the inconvenience caused by the insurer.

The insurer refused and Miss H complained to the Financial Ombudsman Service. The cruise ship's doctor confirmed he'd recommended complete immobilisation for 10-14 days and returning home. The hotel couldn't provide the assistance she would have needed. The FOS ordered the insurer to repay the costs incurred in cancelling the hotel and travelling home, plus £250 in compensation. However, it agreed the travel policy didn't cover time off work.

Pre-existing medical conditions

Mr D spent a few days in hospital overseas with pleurisy, a painful inflammation near the lungs. He made a claim, but the insurer said he'd been already diagnosed with asthma and had experienced 'previous episodes of pneumonia, bronchitis and pleurisy'. Mr D accepted he'd had breathing problems in the past, but not that they related to a pre-existing condition he should have declared. They'd all been, he said, one-off infections.

Mr D also complained about 'a number of repeated and unnecessary' phone calls whilst he was in hospital suffering from extreme breathing difficulties, which created 'additional stress at an already difficult and worrying time'. The insurer claimed this was just their nurses calling out of concern. The insurer rejected both Mr D's complaints.

Mr D complained to the FOS. His doctor said 'asthma' had been written on Mr D's record for data purposes, but Mr D had never actually been given this diagnosis. The FOS noted there was no evidence linking the previous problems, and that the insurer's records said 'pleurisy did not arise directly or indirectly from asthma'. The FOS found inconsistencies in the insurer's records of the phone calls made to Mr D and what they'd told him when he complained about them. The FOS upheld Mr D's complaint, requiring the insurer to pay the medical expenses plus interest, plus £250 compensation for distress and inconvenience.

Property damaged and missing after flight

Mr A and his family flew to South Africa. On arrival in Johannesburg he noted that his hold luggage had been damaged. He reported it to airport staff, who advised him to inform the police and his insurer. Before he could do this or check the luggage, they needed to catch an internal flight to their final destination.

On his arrival, he found items missing and some damaged, including a video camera. He filed a report with the police. His insurer rejected his claim, because he hadn't obtained a 'property irregularity report' from his airline when in Johannesburg. It also said it didn't cover valuables kept in hold baggage, even though he couldn't carry the video camera and care for his two children simultaneously.

Mr A hadn't strictly followed the terms of his travel policy by not obtaining a property irregularity report, but he'd followed the advice of the airline staff and had written evidence from the police, which the FOS thought reasonable considering he was juggling a connecting flight and two small children.

The airline's report would, in any case, have provided no more evidence than the police report. Moreover, the insurance document says claims should be reported to the 'carrier or the local police'. It told the insurer to pay up, but agreed the video camera wasn't covered under the policy terms.

Breakdown in Europe

Mr K's motor-home broke down in France. The insurer arranged for it to be towed to a garage, which said the engine needed to be replaced at a cost of £6,000. Mr K told his insurer he didn't believe them, and wanted the insurer to tow the vehicle back to England to be repaired by a local garage.

The insurer said it would do that if the French garage couldn't complete the repairs before he was due to return only, but the garage said it could. Mr K made his own arrangements to bring the vehicle back, costing £1,136. The problem was a blocked air filter, costing £46 to replace. The insurer refused to reimburse him.

The FOS noted that Mr K's policy covered travel expenses that would allow him either to continue his journey or to travel home if the repairs couldn't be completed inside 12 hours. As it seemed likely the repairs would take longer, it considered Mr K's claim valid. It told the insurer to pay the cost of returning the vehicle to the UK (£1,136), plus interest.

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