Policyholders who were denied payouts or compensation by one of Britain’s biggest travel insurance providers are to have their cases reviewed after the company’s top doctor was suspended for medical misconduct.
The Financial Ombudsman Service said it had appointed a legal firm to review 20 cases where Miguel Nadal, the former medical director of Travel Insurance Facilities (TIF), provided evidence. TIF used to operate an emergency assistance service for popular brands including Boots and the Post Office.
In July Nadal was suspended from the medical profession for a year for “deplorable” misconduct after failing to pursue the evacuation of a desperately ill holidaymaker from an inadequate Turkish hospital and exaggerating the risks of air ambulances to the family of another critically ill policyholder in a Lanzarote hospital.
Many other customers who fell ill abroad and felt they had been mistreated by TIF or had their claims unfairly denied, complained to the ombudsman service about their experiences. However, in some cases, the ombudsman sided with the insurance company after taking into account evidence from Nadal that was submitted by TIF. It is these cases that the ombudsman will now review.
In a statement, the ombudsman service said: “When people who are travelling overseas become seriously unwell they can find themselves in an extremely vulnerable situation. It is imperative that insurers treat everyone with decency and fairness. Where there are concerns that this has not happened, firms must deal with consumers’ complaints effectively.
“We have commissioned a counsel-led independent review of the small number of cases where Dr Nadal’s medical advice was a factor. This independent review will identify any grounds for further action including, if appropriate, reopening investigations.”
The ombudsman has refused to confirm which cases are being reviewed. However, in one case seen by The Times, the ombudsman rejected a complaint from the family of a policyholder who was denied an air ambulance after falling seriously ill abroad.
• I’ve no duty to policyholders, claims travel insurance doctor Miguel Nadal after deaths
The family complained that their relative had been deemed “fit to fly” by the overseas treating doctor but the insurance company, which was advised by Dr Nadal and another doctor, had decided not to return the patient to the UK, describing the transfer as too risky.
The ombudsman’s ruling rejected the family’s argument that TIF should pay compensation for leaving their relative “alone abroad frustrated, distressed and upset” and unable to spend time with his loved ones before he died. Instead it concluded that the decision was reached fairly and on the advice of relevant medical expertise.
TIF says the main doctor in the case was not Nadal.
James Daley, the founder of Fairer Finance, said: “It’s great that the ombudsman is reviewing TIF cases where Dr Nadal’s evidence may have played a part in the decision. Too often we have seen the ombudsman rely on testimony from insurers without verifying the facts. That must change. And it’s clearly now time for the Financial Conduct Authority to create new rules around how insurers deal with emergency medical claims.”
The ombudsman said that its audit of cases involving Nadal was in progress so the number of complaints it could send to be reviewed may yet increase. It added that it was now establishing a wider technical panel to help advise on the use of evidence in complex medico-legal, fraud, and FinTech cases.
In a statement, TIF, which operates the brands HolidaySafe, Alpha, and albert & eddie, said: “We confirm that the Financial Ombudsman Service has contacted us for information about historic cases which involve a doctor who advised us. We have been co-operating fully with the requests for information and will assist the Ombudsman in any way we can whilst its review of any selected cases takes place.”
It added that other than the findings made by the medical tribunal, Nadal had an unblemished career having been involved in more than 1,000 medical assistance cases.
Nadal questioned whether the ombudsman’s investigation was appropriate.
“Recent cases of doctors who have been suspended for plagiarism or cheating London Transport have been found ‘impaired’,” Nadal said. “No one seeks to find fault with their patient management. It is similarly inappropriate to investigate Travel Insurance Facilities on the basis of the findings against me for breaches of good medical practice. It is neither alleged nor found that any policyholder has been harmed.”
He added that he had no recollection of the ombudsman case where the patient had been deemed unfit to fly.
