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Jo C.
Jo C., Barrister
Category: Law
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Experience:  Over 5 years in practice
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There, I have trouble with my travel insurance and I

Resolved Question:

Hi there,
I have trouble with my travel insurance and I would like to have your opinion on the situation please.
We have asked our insurer for some more detail about the policy, because I am pregnant.
The following information was given to us:
Your policy is not affected by being pregnant however it is important to note that cover is only given for claims arising from complications of pregnancy and childbirth as follows: toxaemia, gestational hypertension, pre-eclampsia, ectopic pregnancy, hydatidiform mole (molar pregnancy), post partum haemorrhage, retained placenta membrane, placental abruption, hyperemesis gravidarum, placenta praevia, stillbirths, miscarriage, medically necessary emergency Caesarean sections/medically necessary termination and any premature births more than 8 weeks (or 16 weeks in the case of a known multiple pregnancy) prior to the expected delivery date.
In my 20th week pregnant they found out that I am at high at risk of a miscarriage or stillbirth, due to the fact of my cervix decrease. They put stitches in the cervix and I have to bed rest for the rest of the pregnancy to prevent a miscarriage. In my opinion my complications are the risk of a miscarriage, which should be covered accordant to the policy.
Thanks for your help.
Regards
Su
Submitted: 1 year ago.
Category: Law
Expert:  Jo C. replied 1 year ago.
Hi.
Thank you for your question. My name is ***** ***** I will try to help with this.
Are you asking whether a court would agree with your view?
Customer: replied 1 year ago.

Hi Jo,

sorry for my delay, we have been on a long weekend trip.

I would like your help more on what I can write back to the insurance company in a more professional way.

Something like: that I don't accept their decision, because I am not fit to travel due to a risk of miscarriage which is cover under our policy.

Can you interpreted it like that out of their policy?

Thanks for your help.

Su

Expert:  Jo C. replied 1 year ago.
I'm not sure what you mean?
Customer: replied 1 year ago.

Could you please explain in more detail what you are not sure about?

Thank you.

Expert:  Jo C. replied 1 year ago.
Im sorry if I'm missing the point but I do not see your challenge.
They do not exclude pregnancy but they give a list of potential situations that do not include yours.
It might well be that you would prefer your situation to be covered but it is not. This isn't a test of fairness. It ia an issue of contract. Either your situation is covered or it is not and, on the face, of it your policy does not cover it.
In those circumstances I'm not sure what you are hoping to do about this?
You can always write back registering a complaint. That never does any harm. Sometimes they do cave in. However, if you are hoping to challenge in law on that basis then I'm afraid there is no scope under this policy of insurace to do that.
Can I clarify anything for you?
Jo
Customer: replied 1 year ago.

Hi Jo,

Thanks for your answer.

Yes you could. Thank you.

I think, I totally misunderstood this section of the policy. My understanding was that the prevention of a miscarriage is covered as well and not just a miscarriage.

Thanks again for your advice.

Su

Expert:  Jo C. replied 1 year ago.
Thanks.
Sorry if I'm missing the point but I'm not sure on what basis ? This condition is excluded on the policy above?
Customer: replied 1 year ago.

Hi Jo,

miscarriage is not excluded of the policy.

But it seems anything to prevent a miscarriage is excluded. That is where I got wrong, I think.

Thanks for your help again.

Su

Expert:  Jo C. replied 1 year ago.
No, but it not one of the listed conditions.
So it is not explicitly excluded but not included either which has the same effect?
Customer: replied 1 year ago.

Hi Jo,

please find hereunder part of the policy:

... cover is only given claims arising from complications of pregnancy and childbirth as follows: miscarriage

That means a miscarriage is included, but to prevent a miscarriage isn't. That is so confusing ;-)

Expert:  Jo C. replied 1 year ago.
Yes, but that is what I mean.
The specific condition is not covered. It might be unfair and you complain but that is not the test.
Jo C., Barrister
Category: Law
Satisfied Customers: 69786
Experience: Over 5 years in practice
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