A travel policyholder has won a payout after arguing a doctor’s declaration that he could not go overseas was a claimable event, rather than the earlier onset of illness.

The insured fell ill with “flu-like symptoms” and visited a GP during his travel cover’s 72-hour post-purchase waiting period.

Insurer HDI Global Specialty later cited the waiting period when rejecting the man’s trip cancellation claim.

But a diagnosis of severe narrowing of an artery and certification as being unfit to travel came during another doctor’s visit several weeks after the first one, and the Australian Financial Complaints Authority has found the policy must respond to this.

“The ... policy says the complainant must be unable to travel because of an injury, illness or medical condition which needs immediate treatment from a medical adviser who certifies the complainant as unfit to travel,” the ombudsman said.

“The complainant was not diagnosed with a medical condition which needed immediate treatment ... or certified as unfit to travel during the [initial] doctor’s visit. Attending a doctor is, by itself, not sufficient to trigger the cancellation cover under the policy.”

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HDI Global Specialty told AFCA: “Had the complainant not had symptoms, and not sought medical care, it seems likely they would have continued with their plans. However, due to the symptoms and subsequent medical treatment, they did cancel.

“Therefore, we maintain that this is the event, and it clearly occurred within the 72-hour waiting period.”

But AFCA’s adjudicator has expressed doubt that the first visit to the doctor related to the illness that scuppered the claimant’s trip abroad.

“No independent medical opinion has been provided and I am not satisfied the medical information clearly shows the symptoms present on June 18 2025 were caused by the severe narrowing of an artery supplying blood to the heart.

“I am satisfied the claimable event and the cause of the cancellation of the journey is the diagnosis and certification of being unfit to travel on August 11 2025.”

The insurer has been told to settle the claim for fees and deposits lost due to the trip being cancelled.

See the decision here.

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