They blamed your medical history.
You can’t declare what nobody asked about.
Screening questions are short, vague and answered in a hurry — whether it is a holiday booking, a health policy or a new pet. The refusal that follows is none of those things. Here is what has to be true before a pre-existing condition defeats your claim.
Who's behind thisSteve Smart Helped people recover £25M+ from rejected claimsRe: Your claim
Dear ,
We have now completed our review of your claim.
Your claim relates to a pre-existing medical condition which was not declared when the policy was purchased.Had we been aware of your medical history, cover for this condition would have been excluded.The condition you have claimed for is linked to a condition which existed before the policy started.You did not complete a medical screening for this condition.
We therefore regret that we are unable to meet your claim on this occasion.
Yours sincerely,
Claims Department
What they mean
Travel policies price on health. Insurers either ask you to declare existing conditions and then rate, exclude or accept them, or they apply a blanket exclusion for anything connected to a condition you already had.
When something goes wrong abroad and the claim is large, the medical file gets read carefully. If anything in it predates the policy, that is where the refusal starts.
Where it overreaches
The word doing all the work is "linked". A refusal will connect the thing that happened to you to something in your history, and treat the connection as settled. Often it is nothing of the kind — a previous back problem is not a reason to refuse a chest infection, and insurers reach for the link far more readily than the medical evidence supports.
Then there is what you were actually asked. Screening is usually a handful of broad questions at the end of a booking journey, and the law for consumers asks whether you took reasonable care answering the questions put to you — not whether you volunteered a full history nobody requested.
And you cannot misrepresent something you did not know. Conditions that were undiagnosed, or that you had no reason to consider relevant, are not things you failed to declare.
The counter-arguments
These are the points that put the burden back where it belongs. Not every one will apply to your case — the letter we write picks the ones that do.
The refusal rests on a medical connection between your claim and your history. That is a clinical question, and it needs clinical evidence — not an assumption drawn from a date order.
Ask them to set out precisely how the condition claimed for is connected to the condition they say you should have declared. Your own consultant’s view carries real weight here, and it frequently contradicts the insurer’s reading of the file.
Your duty is to take reasonable care not to misrepresent when answering the insurer’s questions. If the screening never asked about this, or asked in terms so broad that a reasonable person would not have thought it caught your situation, their position weakens sharply.
Ask for the questions exactly as they appeared at the point of sale. What was actually on screen is often much vaguer than the refusal letter now implies.
CIDRA 2012, s.2Undiagnosed is not undeclared. If you had no diagnosis, no symptoms, or no reason to connect something to your health at the time you bought the policy, there was nothing to misrepresent.
This matters most where a condition is discovered during or after the trip and the insurer then reads it backwards into your history.
Even where something was genuinely missed, an honest mistake is careless, not deliberate, and carelessness is presumed unless the insurer proves otherwise. The remedy then has to match what they would have done had they known: excluded that condition, charged more, or declined — not automatically refuse everything.
They also have to show it would actually have changed their decision. Not every omission would have.
CIDRA 2012, ss.4–5 & Sch 1Sources: Consumer Insurance (Disclosure and Representations) Act 2012
How it works
You do not have to make these arguments yourself. That is what we are for.
Describe in plain English what happened and your current concern. Takes 60 seconds. We'll give you clear guidance on whether we can help and what to do next - completely free. You can start right now, even if you don't have your refusal letter with you.
Drop your refusal letter and insurance policy. Takes 2 minutes. No account needed.
Our system identifies the legal flaws in the refusal and writes a professional rebuttal with citations.
Send the letter to your insurer. Most reverse their decision. If not, escalate to the Ombudsman.
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Questions
Only if the position stands up. They generally need to show you were asked a clear question, that you did not take reasonable care answering it, that they would have acted differently, and that the condition is genuinely connected to what you claimed for.
Each of those is arguable, and the medical link is the one that most often fails.
Not necessarily. An honest oversight is treated as careless rather than deliberate, and the remedy has to be proportionate to what the insurer would have done had they known.
If they would simply have excluded that condition, that is very different from refusing an unrelated claim outright.
Strongly, generally. You cannot fail to declare something you did not know about. If there was no diagnosis and no symptoms you had reason to connect to your health, there was nothing to disclose.
Yes, and it is often the weakest part of the refusal. A link is a medical question requiring medical evidence, not an inference from chronology.
Ask them to explain the connection, and put your treating clinician’s view alongside it.
No. smarterclaims publishes legal information and writes letters you can send yourself — like a digital version of a published legal guide. We are not a law firm and we do not give advice.
If your case needs professional representation, we will tell you, and we can introduce you to the right people if you ask us to.
Checking whether you have a case is free. You see the analysis and the arguments before you pay anything.
The rebuttal letter is £49.99. It comes with an explanation of where you stand and a step-by-step plan.
There is a no-questions-asked money-back guarantee. If the pack is not useful, tell us within 14 days and we refund you in full.
It should not, and firms are required to handle complaints fairly. Insurers deal with complaints as routine business — a well-argued letter tends to be taken more seriously than an angry phone call, not less.
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Meet Steve Who's behind this
Forty years inside the insurance industry, in both senior legal and commercial roles. Former UK General Counsel at AIG. Current Chairman of Lancashire Insurance UK. Regular voice on LBC radio. Steve has watched the same disputes come up again and again — and built the library of arguments that smarterclaims runs on, based on his decades of experience.
“I've spent forty years on the inside of insurance. The same excuses come up again and again, and most consumers don't know how to overcome them. This is the tool I wish my clients had before they called me.”Steve SmartMore about Steve
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