Couple Faces £22,000 Loss as Insurer Rejects Wedding Cancellation Claim After Cancer Diagnosis
A devastating family medical emergency has left a London couple facing a staggering financial loss after their insurer refused to pay out for a cancelled wedding. The couple, who wish to remain anonymous, have lost £22,000 and now cannot afford to book a new date for their ceremony following the heartbreaking diagnosis.
Last-Minute Cancellation Due to Terminal Illness
Just two days before their planned wedding in May last year, the groom's 23-year-old brother received a terminal brain cancer diagnosis and underwent emergency surgery. The couple immediately cancelled their wedding arrangements and submitted a claim to The Insurance Emporium (TIE), from whom they had purchased cancellation cover 18 months previously.
The insurance company's response proved both unsympathetic and problematic from the outset. Staff showed little compassion before misplacing the original claim forms, forcing the couple to resubmit their documentation. They faced continual delays and had to chase repeatedly for updates on their case.
Claim Denied Based on Retrospective Diagnosis
Two months after submitting their claim, the couple received a denial from TIE. The insurer argued that the brother had experienced daytime drowsiness prior to the policy's commencement, which they retrospectively determined were symptoms of the tumour. This decision came despite medical professionals having found no cause for concern during previous consultations and making no diagnosis at the time.
In 2020 and 2022, the brother - a medical student - had consulted doctors about a drooping eyelid and recurring drowsiness. He was referred to a sleep clinic on both occasions and received advice about sleep hygiene, with medical letters confirming "no additional red flags" in 2022.
Insurance Policy Traps and Vague Wording
The insurance declaration form asked whether anyone critical to the wedding had any previous or existing medical conditions. The brother's undiagnosed fatigue didn't register as a concern for the couple, particularly as doctors had given him a clean bill of health. However, the policy's separate list of exclusions included any claim arising from a pre-existing condition, defined as any illness showing "clinical signs" before the policy commenced.
TIE acknowledges that it wasn't unreasonable for the couple to omit the brother's fatigue on the form, given the medical clearance he had received. Nevertheless, the company insists that his symptoms were retrospectively related to the tumour and that the exclusion therefore applies.
The policy's terms and conditions appear particularly problematic - they strike as vague, sweeping and confusingly worded. The exclusion seems to cover every symptom and previous or potential illness of the entire wedding party at any point in time. Furthermore, TIE's rejection letter implies that conditions don't need to have been formally diagnosed to disqualify a claim, essentially allowing retrospective diagnosis when claims are made.
Financial Ombudsman Service Perspective
The Financial Ombudsman Service, which investigates complaints about rejected insurance claims, considers whether customers should reasonably have been aware of an undiagnosed pre-existing condition that might lead to a claim. They note that symptoms must be considered in context - for instance, headaches don't necessarily indicate serious illness but could later turn out to be symptoms of a brain tumour.
When challenged about these issues, TIE stood by its pre-existing condition exclusion and its wording. "To remain fair and consistent to all customers, we are not able to alter or waive this requirement for individual cases," the company stated.
Partial Resolution and Policy Changes
Following the couple's complaints, TIE has rewritten its declaration form. Customers are now specifically asked about conditions awaiting test results, treatment, or any terminal diagnoses. The company initially offered £9,000 in October last year - five months after the claim - to reflect medical evidence uncertainty and sensitive circumstances, but withdrew the offer three weeks later.
After media intervention, TIE agreed to reinstate the £9,000 offer and has already paid £350 in recognition of service shortfalls. The couple have accepted this settlement to focus on supporting the brother through his illness, though the Financial Ombudsman Service might potentially have ordered a full payout had they pursued the complaint further.
This heartbreaking case highlights the significant traps that can lurk within insurance contracts, particularly regarding pre-existing condition exclusions and retrospective diagnosis practices. It serves as a stark warning to consumers about the importance of understanding policy wording and the potential limitations of cancellation cover during family medical emergencies.
