Travel Insurance Online :: News

Share this news item!

AFCA Upholds Insurer’s Decision in Breast Cancer Claim Case

The information on this website is general in nature and does not take into account your objectives, financial situation, or needs. Consider seeking personal advice from a licensed adviser before acting on any information.

A recent ruling by the Australian Financial Complaints Authority (AFCA) has affected a woman’s critical illness claims, as her diagnosis came within mere days of her policy's eligibility period drawing to an end.

The woman was diagnosed with cancer in her right breast on October 5 of last year, followed by the discovery of cancer in her left breast eight days later. She filed claims under her critical illness policy that she had obtained on July 17.

However, TAL Life, her insurance provider, rejected the claims based on the policy's three-month qualifying period for cancer coverage.

In its ruling, AFCA noted that the policy had provisions to potentially waive the qualifying period if the policyholder could prove they were insured either under a previous TAL policy or by another insurer for the same events, right before their new coverage commenced.

The claimant contended that she had cancer coverage through an insurance policy provided by her husband's employer. She presented a letter from the employer affirming that she was covered under a "life, accident, critical illness, and medical insurance" scheme from August 2020 until June last year. Additionally, she showed documentation indicating her husband’s policy did include critical illness coverage for spouses, encompassing cancer.

While AFCA accepted the availability of this cancer coverage, it was not convinced that she held such coverage "immediately before the current policy began." It also noted she had failed to disclose her previous insurance when applying for the new policy with TAL Life.

"There is no information before me about the extent of the critical illness cover the complainant had, if any, through her husband's employer’s insurance arrangements," AFCA’s ombudsman stated.

"Furthermore, it appears that any cover she might have had ceased about a month before the new policy started. I am not convinced there was 'continuity of cover' as suggested by the complainant."

The ombudsman expressed AFCA’s sympathy towards the claimant, especially given that the diagnoses occurred "very close to the end of the qualifying period." Nonetheless, he emphasized that there was no valid reason for the qualifying period to be dismissed.

"The qualifying period is reasonably short and its existence is not unjust. These terms are part of all insurance policies and they draw necessary boundaries. The enforcement of these terms is not inherently unfair," the ombudsman elaborated.

For a more detailed account of the ruling, refer to the original report by AFCA.

Published:Wednesday, 4th Sep 2024
Source: Paige Estritori

Please Note: If this information affects you, seek advice from a licensed professional.

Share this news item:

Insurance News

Allianz Partners Highlights Risks of Travelling Uninsured

12 Nov 2025: Paige Estritori

Recent research conducted by the Insurance Council of Australia (ICA) and the Department of Foreign Affairs and Trade (DFAT) has unveiled a concerning trend: approximately 14% of Australian travellers embark on international journeys without any form of travel insurance. This statistic has prompted Allianz Partners to urge Australians to reconsider the importance of securing adequate coverage before travelling abroad. - read more

Unveiling Hidden Exclusions in Travel Insurance Policies

12 Nov 2025: Paige Estritori

Australian travellers are being urged to carefully review their travel insurance policies to identify potential exclusions that could affect their coverage. Legal expert Peter Carter from Carter Capner Law highlights that certain activities, such as riding motorbikes or jet skis and consuming alcohol, are often classified as high-risk by insurers. Incidents occurring during these activities may lead to claim rejections. - read more

Qantas Travel Insurance Honoured with Mozo Experts Choice Award 2024

04 Nov 2025: Paige Estritori

Qantas Travel Insurance has been recognised in the 2024 Mozo Experts Choice Awards for Travel Insurance, showcasing its exceptional value for their Annual Multi Trip Travel Insurance policy. - read more

SCTI Highlights Top 10 Costliest Travel Insurance Claims of 2024

04 Nov 2025: Paige Estritori

Southern Cross Travel Insurance (SCTI) has unveiled its top 10 most expensive international travel claims made by Australian travellers in 2024, shedding light on the significant financial risks associated with unforeseen incidents abroad. - read more

Allianz Partners Highlights the Risks of Travelling Uninsured

27 Oct 2025: Paige Estritori

Recent research conducted by the Insurance Council of Australia (ICA) and the Department of Foreign Affairs and Trade (DFAT) has revealed a concerning trend: one in seven Australian travellers embark on overseas trips without any form of travel insurance. This statistic has prompted Allianz Partners to urge Australians to reconsider the importance of securing adequate coverage before travelling abroad. - read more

Click for more Insurance News

Travel Insurance Articles

How to Avoid Common Pitfalls When Filing a Travel Insurance Claim

Travelling is an exciting adventure, but it comes with its own set of uncertainties. That's where travel insurance steps in, offering peace of mind by covering unforeseen expenses and emergencies. However, filing a travel insurance claim can sometimes be a daunting process. - read more

Cut Costs, Not Experiences: How to Plan a Budget-Friendly Australian Road Trip

Australian landscapes are a canvas of breathtaking vistas, and road tripping offers an intimate brush with this vast, picturesque continent. The allure of the open road, the freedom to explore quirky roadside attractions, and the opportunity to discover secluded spots creates an excitement unique to this mode of travel. - read more

The Savvy Traveller's Checklist for Affordable Travel Insurance

Travel insurance is an indispensable component for any savvy traveller from Australia, playing a protective role in a myriad of situations that may occur away from home. Whether it's encountering flight delays, requiring medical assistance, or facing luggage theft, having a solid travel insurance policy can convert potential nightmares into manageable inconveniences. Yet, despite its importance, the process of finding a policy that won't break the bank is increasingly challenging. - read more

Travel Troubles: How Travel Insurance Protects You from Unexpected Events Abroad

For many Australian travellers, setting off on a global adventure is an exciting prospect. Yet, amidst this excitement, it's crucial to acknowledge the unexpected twists and turns that could arise. That's where travel insurance steps in. Not just a safety net, it serves as a vital component of travel planning, providing peace of mind as you explore the world. - read more

Maximising Your Travel Budget: Tips for Australian Families

Travel plays a significant role in family bonding. There's nothing quite like exploring new places together, creating lasting memories, and experiencing adventures that will be talked about for years to come. - read more

Knowledgebase

Rider:
An optional provision added to an insurance policy that provides additional benefits or coverage.

This website is owned and operated by Clark Family Pty Ltd (ACN 010 281 008) as Trustee for the Clark Family Trust (ABN 35 957 893 714), 43 Larch Street Tallebudgera QLD 4228. Clark Family Pty Ltd is an Authorised Representative (AR 1298860) of Unique Group Broker Services Pty Ltd (AFSL 509434) for financial product referrals and an Authorised Credit Representative (ACR 401491) of Saccasan Pty Ltd (ACL 386297). Check our licensing details on the ASIC registers: Clark Family Pty Ltd ACR, Clark Family Pty Ltd AR, Saccasan Pty Ltd, Unique Group Broker Services.

IMPORTANT: We do not provide financial product advice or credit assistance. We act solely as an introducer and refer enquiries to licensed third-party intermediaries, insurers, and lenders - with whom you can then deal directly. We may receive a fee or commission from these third parties in consideration for the referral. Before any action is taken to obtain a product or service referred to by this website, advice should be obtained (from either the third party to whom we refer you or from another qualified intermediary) as to the appropriateness of obtaining those products having regard to your objectives, financial situation and needs. Whilst we have our own process for validating the legitimacy of our referral partners, you should always verify the credentials of your financial adviser before proceeding with recommendations that they may present. Visit the ASIC website for further information.