Inter Partner Assistance SA · DRN-6151166

The complaint Mr and Mrs S are unhappy with the way Inter Partner Assistance SA (‘IPA’) handled and settled their claim. What happened Mr and Mrs S booked a trip and bought travel insurance, underwritten by IPA. All reference to IPA includes any agents acting on its behalf. They went abroad but unfortunately Mr S became unwell and was hospitalised for part of his trip and confined to his cabin for the remainder. So they were unable to partake in the activities they had planned as part of a tour. They made a claim which IPA settled but it didn’t pay the costs for the unused parts of the trip on the basis that there wasn’t any evidence from the tour operator to confirm that parts of the trip were missed. Mr S wanted IPA to cover all their unused costs and the costs associated with his confinement. Mr S complained and unhappy with IPA’s response, referred the complaint to the Financial Ombudsman Service. Our investigator looked into the complaint and found that although IPA was entitled to ask for evidence, there was some evidence that certain parts of the holiday were missed as Mr S was hospitalised and IPA should have considered this. She recommended IPA consider those costs and set out any clear and specific requests for information. She also recommended £150 compensation for customer service problems in the claim. IPA accepted the investigator’s recommendation but Mr and Mrs S have not and have asked for an Ombudsman’s decision. And so the case has been passed to me. 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. Having done so, I agree with what the investigator has recommended. I’ll explain why. But firstly, I'd like to say I am really sorry to hear of Mr S’ illness and the circumstances which led to this claim. • The relevant rules and industry guidelines say an insurer should handle claims promptly and fairly. And shouldn't unreasonably reject a claim. • The background to this matter has been set out in quite some detail by the investigator. And I have carefully considered everything both parties have said even

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if I don’t explicitly address every point in my decision. I won’t repeat the facts here again. Instead I will focus on what I consider to be the crux of the complaint and what is key to my conclusions. • The starting point is the policy terms and conditions which make up the contract of insurance between Mr and Mrs S and IPA. For cutting their trip short, it says: “We will pay you up to the amount shown in the Table of Benefits for your proportion only of your unused travel and accommodation costs and other pre-paid charges together with any reasonable additional travel and expenses if you have to cut short your trip…” and: “Claims will be calculated on the number of nights of your trip you missed due to your early return or the number of nights which you were hospitalised, quarantined or confined to your accommodation”. • Under ‘what is not covered’ it says: “Any claim where you have been unable to evidence your loss, please refer to the claims evidence section.” Under the ‘claims evidence’ section, it says: “A letter from your tour operator’s representation, hotel or accommodation provider where appropriate” and “Confirmation from your ship’s medical officer that you were confined to your cabin and confirming the length of your confinement.”. • In summary, IPA covered the medical expenses and some costs for Mrs S’ confinement. It said it would consider covering additional costs if it received evidence from the cruise company or travel provider to confirm that Mr and Mrs S were unable to attend the planned events and activities. • The policy excludes claims where you are unable to evidence your loss. The sort of evidence IPA needed was evidence that Mr and Mrs S were confined to their cabin and for how long. As well as evidence of the activities that Mr and Mrs S missed due to ill health. • Our investigator said IPA should assess and pay benefit for some of the dates using the information available to it. She said it should use the dates of Mr S’ hospitalisation and match these up with the itinerary which will show that Mr and Mrs S couldn’t have attended certain planned activities on specific days as they were in a different location. IPA has agreed to do this and I also think this is fair and reasonable. • Our investigator has said that if IPA needs any further information, it should make a new, clear and specific request for Mr S so he knows what he needs and what to ask his travel company for. IPA has also agreed to do this and I think this is fair too. • Mr and Mrs S are unhappy that IPA hasn’t paid for the full cost of missing all the planned activities for the whole trip. Mr S has explained that he was unwell and hoping to get better but couldn’t attend any of the booked excursions. But IPA has asked for evidence from the travel company to confirm the activities Mr and Mrs S missed. I think this is fair and reasonable as Mr and Mrs S need to evidence their loss. • Mr S says he didn’t want to tell the travel company about how unwell he was as he was concerned about being effectively stranded. But I don’t think IPA’s request to verify the claim and benefit payable is unreasonable especially since the medical evidence from the time of his trip doesn’t go into any detail about whether Mr S should be confined to his cabin after being discharged from hospital. • I have carefully considered Mr S’ testimony and his description of how unwell he was

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during and after his trip and I am really sorry to hear this. I appreciate he will be disappointed with my decision but I can’t fairly ask IPA to pay the full costs of the unused elements of his trip without further evidence of the activities that were missed and the need for confinement. • In relation to the customer service provided to Mr S after he submitted his claim, there was a delay between August 2024 and February 2025 where Mr S asked for a call but didn’t receive one. Mr S then complained in 2025. I agree that IPA should pay £150 compensation to recognise the impact of the stress caused to Mr S by not arranging a call as he requested. I note Mr S didn’t chase in the meantime and had he done so, he may have received a response sooner. But IPA should have contacted him and so I consider £150 compensation is sufficient as IPA did clarify its position when it wrote to Mr S. • In response to the investigator’s view, Mr S has said he was suffering from severe ill health and shouldn’t be made responsible for complicated paperwork. He says the hospital secretary was in contact with the insurers and the missed elements of the claim can easily be costed as some tours were run by different companies. • I note and appreciate what Mr S says but the onus is on Mr and Mrs S to prove their claim. The terms of the policy are clear about the evidence required under the claims section and I don’t think it’s unreasonable for IPA to ask for more information from the travel company to prove that Mr and Mrs S were unable to take part in their planned activities. If Mr and Mrs S have information IPA hasn’t seen including the cost of the tours by different companies, they should forward this information to IPA so it can consider this in its reassessment. My final decision For the reasons set out above, I direct Inter Partner Assistance SA to: • Pay Mr and Mrs S a total of £150 compensation • Reassess the benefit due to Mr and Mrs S for the dates Mr S was hospitalised (making clear and specific requests for any information it needs). Under the rules of the Financial Ombudsman Service, I’m required to ask Mrs S and Mr S to accept or reject my decision before 3 April 2026. Shamaila Hussain Ombudsman

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