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Alcohol and travel insurance: what’s the right mix?

Paloma Kubiak
Written By:
Paloma Kubiak
Posted:
Updated:
31/01/2018

Holidays provide an opportunity to relax and sink back a few cocktails by the pool. But with many travel insurers refusing to pay out if they suspect excessive drinking led to a claim, can the two ever mix?

The Financial Ombudsman Service (FOS) dealt with around 3,000 travel insurance complaints last year and in the final quarter of 2017, it looked at nearly 900.

Most of the complaints centred on claims, with some relating to an insurer deciding someone’s drinking was a factor which led to an accident or injury they had on holiday. As such, they won’t pay out.

The FOS said it wouldn’t just assume that a claimant had been drinking to excess or that a claim resulted from intoxication. It also said that it’s up to insurers to show that any exclusions apply, rather than for the customer to show that it doesn’t.

In one case handled by the FOS a man in his 20s had been on a beach holiday and had been drinking when he slipped in the toilets of a nightclub and hit his head. He was fine in the evening but he awoke with a headache and dizziness. After contacting his insurer, he was advised to go to hospital where he had tests and medication.

When he claimed the costs from his insurer, they refused to pay on the grounds that he had been drinking. He didn’t dispute that he had some alcohol but he insisted he hadn’t been drunk at the time, having had a couple of drinks but nothing excessive. A look at the insurer’s terms revealed that it didn’t expect policyholders to avoid alcohol on holiday but where they were so drunk that their judgement was affected, a claim wouldn’t be upheld.

Medical records revealed the holidaymaker’s scan and blood tests were normal and back at home, his GP said he was probably concussed. The insurer said the alcohol content could have faded as he only went to hospital the following day.

FOS said the evidence didn’t suggest he had been drinking excessively and as such, it said it wasn’t fair or reasonable for the insurer to turn down the claim. It had to pay out for the customer’s costs and interest of 8%.

Definition of ‘excessive’ drinking

In another similar case seen by FOS, a man had fallen and hit his head but his insurer rejected his claim as it didn’t cover claims arising from excessive alcohol consumption. The holidaymaker said the insurer didn’t define “excessive”, adding that he’d tripped in his room which could have happened to anyone, whether or not they had been drinking.

However, his medical records showed he had alcohol poisoning and he wasn’t able to sign a form when he arrived in hospital. Other reports from the ambulance suggested he had been drinking all night.

Based on these reports, the FOS believed the accident was caused by his excessive alcohol consumption and that it wouldn’t have happened if he were sober.

Caroline Wayman, chief ombudsman and chief executive at the Financial Ombudsman Service, said:

“In general, holidays go to plan – and for most people, the types of problems insurance is there to cover, won’t be brought to life. However, each year people contact us when they’ve had trouble on holiday – and haven’t had the help from their travel insurer that they expected. And most of the time, these disputes centre on what’s covered and what’s not.

“Insurers may choose not to pay out if they believe someone’s been drinking excessively – although this doesn’t mean holidays need to be totally alcohol-free. In each case we look at, we’ll carefully weigh up all the evidence to decide, on balance, whether the insurer has made the right call.”

FOS added that alcohol exclusions are a common feature of travel insurance so it’s important for holidaymakers to bear in mind that claims could be turned out where someone is found to have drunk excessively.