Heartbreak Before a Wedding

Just two days before our wedding last May, my 23-year-old brother was diagnosed with a terminal brain tumor, and he had to have emergency surgery.

I had taken out cancellation cover about 18 months prior. Unfortunately, we had to cancel our wedding and immediately filed a claim with Insurance Emporium.

The staff, however, were not very sympathetic. They even misplaced my bill and told me to submit it again. I had to keep chasing them for updates.

Two months later, my claim was denied. The reasoning? My brother had experienced daytime sleepiness before the insurance policy started. The doctors found no cause for concern at the time, and there was no formal diagnosis. However, the insurance company chose to interpret these symptoms as indicative of a tumor.

In October, roughly five months after I filed my complaint, the company offered to pay £9,000. They based this on the uncertain medical evidence and the sensitive nature of the situation. Yet, just three weeks later, they withdrew the offer. In total, we lost £22,000, and now we’re left without enough time to plan a new wedding date.

This situation is truly heartbreaking and underscores the pitfalls present in many insurance policies.

You noted that in 2020 and 2022, my brother had seen a doctor about his drooping eyelids and recurring sleepiness. He was referred to a sleep clinic both times and received advice on better sleep habits. The reports indicated “no further red flags.”

We secured our insurance in December 2023. The application asked if anyone important to the wedding, such as flower girls or grandparents, had any pre-existing medical conditions. At the time, my brother’s unexplained fatigue didn’t even cross my mind. There was also a list of exclusions covering any claims due to pre-existing conditions, defined as illnesses showing “clinical signs” before the policy began.

Insurance Emporium acknowledged that it wasn’t unreasonable to leave out my brother’s fatigue from the form, given that the doctor provided a medical certificate for him. Yet, they argued that looking back, those symptoms were linked to the tumor, thus applying the exclusion.

This terminology struck me as rather vague, broad, and confusing. It seemed to cover any potential symptoms or prior conditions that could affect the entire wedding party, even if those were minor.

Furthermore, the denial letter from the company suggested that a formal diagnosis wasn’t necessary to reject a claim. This enables them to utilize hindsight when addressing complaints. The Financial Ombudsman Service, which reviews complaints about denied claims, is currently examining if customers should reasonably be aware of undiagnosed conditions that could impact a claim, especially when symptoms are mild.

I raised these observations with Insurance Emporium. They stood by their exclusion and its wording, stating, “To ensure fairness and consistency for all customers, we cannot alter or waive this requirement for individual cases.”

Despite this, the company has revised its declaration process. Now, customers must explicitly answer questions about pending tests or treatments, including terminal diagnoses.

When I inquired about the retraction of the £9,000 offer, the company agreed to reinstate it. I already incurred a cost of £350 for what I perceived as inadequate service. The Financial Ombudsman Service might accept my claim and require the full payment.

Yet, since my brother had to undergo several medical consultations before we were eligible for coverage, the decision by the insurer may be deemed reasonable. Consequently, the benefits might be reduced or not paid at all. That being said, I accepted the offer so I could focus on supporting him during this tough time.