Chubb European Group · DRN-6281500

The complaint Mr D complains that Chubb European Group SE haven’t settled a claim he made on a travel insurance policy. What happened Mr D claimed for medical expenses. Chubb asked for more information in support of the claim. This mainly focused on Mr D’s travel itinerary and information about his medical history, including a previous recent claim on his travel insurance policy. Mr D didn’t think this was fair and also complained to Chubb about the customer service he received. Chubb looked into what happened and said that they’d reasonably asked for more information in support of the claim. However, they offered £200 compensation for poor service, including a lack of updates and poor communication. Unhappy, Mr D complained to the Financial Ombudsman Service. Our investigator looked into what happened and didn’t uphold the complaint. She thought that Chubb had reasonably asked for more information about the claim. However, she thought that Chubb should increase the compensation for the poor service by £100. Mr D accepted the investigator’s recommendation but Chubb didn’t agree the compensation was fair. So, the complaint was referred to an ombudsman. Chubb then contacted the investigator to say they now accepted the recommendation to pay further compensation. However, Mr D then said he still wanted an ombudsman to review the complaint but gave no further reasons for not accepting the increased compensation. What I’ve decided – and why I’ve considered all the available evidence and arguments to decide what’s fair and reasonable in the circumstances of this complaint. The relevant rules and industry guidelines say that Chubb has a responsibility to handle claims promptly and fairly. And they shouldn’t reject a claim unreasonably. The policy terms and conditions The relevant policy terms and conditions say there is no cover for pre-existing conditions. The terms say: “What you need to know before you go – Pre-existing conditions Any health condition that was diagnosed, treated, or required hospital care in the 12 months before you booked your trip (or at the start of the insurance period), counts as a pre-existing condition that won’t be covered, we will not cover any medical conditions that are directly related to your pre-existing medical condition.” Furthermore, the terms say:

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We will not cover any holiday: “Which involves you travelling specifically to obtain medical, dental or cosmetic treatment” The policy also has an eligibility criteria which says: Your trip must commence and terminate at your primary residence in the UK, which is your regular place of residence. Did Chubb fairly ask for further information in support of the claim? I’m satisfied Chubb acted fairly when asking Mr D for more information in support of the claim. I say that because: • Mr D made a claim for a separate medical issue shortly before he made the claim that’s the subject of this complaint. Given the proximity of the claims in time, and the terms I’ve outlined above, I think it was reasonable for Chubb to want to review further medical evidence. That’s because the further evidence Chubb wants to review is directly relevant to whether there is cover available under the policy – that includes whether the exclusions relating to pre-existing medical conditions and travelling to obtain treatment apply. • Chubb also queried some of the documentation Mr D had provided in support of his return to the UK between trips (and the claims). Chubb did make Mr D aware of those concerns and I think, based on the evidence available, they are entitled to request more information. Chubb is entitled to validate the claim, and that includes requiring Mr D to show that his trip was eligible by demonstrating that it started and ended in the UK. • Mr D initially accepted our investigator’s recommendation. And, whilst he’s asked for a final decision, he hasn’t provided any further evidence or compelling arguments which address the issues Chubb identified during the claims process. So, I’m satisfied Chubb has reasonably asked for additional information in support of the claim. Did Mr D receive a good level of customer service? Chubb accepts that there were failings in the service Mr D received. That includes a lack of proactive and clear communication about the reasons the claim wasn’t being settled. I think £300 fairly reflects the impact on Mr D. I say that because it would have been frustrating and worrying for him not to receive clear information about the reasons the claim wasn’t being settled and why further evidence was required. It caused Mr D more frustration and annoyance than I think could reasonably be expected. So, I think the total of £300 is fair and reasonable. Putting things right I’m directing Chubb to pay Mr D a total of £300 compensation. That’s inclusive of the £200 compensation they have already offered in their final response letter and which I understand has already been paid to Mr D.

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My final decision I’m partly upholding Mr D’s complaint and direct Chubb European Group SE to put things right in the way I’ve outlined above. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr D to accept or reject my decision before 21 May 2026. Anna Wilshaw Ombudsman

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