Veronica purchased travel insurance cover online for her holiday to Brisbane. On her journey home, Veronica lost her dentures.
Veronica needed her dentures to eat and made a claim for a replacement set under the “emergency dental treatment” section of her travel insurance policy.
The insurer declined her claim as the policy excluded cover for loss, theft or damage of dentures.
Veronica complained to FSCL that the insurer was incorrect in declining her travel insurance claim to cover her lost dentures under the emergency dental section of her policy. Veronica said she did not receive her full policy from the insurer and was unaware she could not get cover for dentures. She only received a copy of her certificate of insurance and policy schedule.
We noted Veronica’s insurance policy expressly excluded cover for dentures and only provided for emergency dental treatment up to $552 for the immediate relief of pain.
We also found that the insurer had send Veronica an auto-generated email containing the policy wording by email. As Veronica had not retained a copy of the email sent to her, we were unable to verify whether she received the policy wording.
We attached the evidence received from the insurer and invited Veronica to withdraw her complaint. Veronica did not contact us again.
Insights for the participant and the complainant
The insurance policy forms the contractual basis between parties. The onus is on the insured to read and understand their policy wording. If the insured does not receive a copy, they should contact their travel insurer for a copy of their policy wording.