'Asia' not included in 'Australasia': Holidaymaker stung $28k after insurance invalid in India

A man who ended up in hospital with Covid-19 while on holiday in India had to pay $28,000 when his insurer denied its policy covered Asia because the word was part of Australasia. Photo / Getty Images

A Kiwi holidaymaker landed with a $28,000 hospital bill after contracting Covid-19 in India thought his insurance would cover him because "Asia" was in the word "Australasia".

But his insurer said the term Australasia was only broadly applicable to treatment in Australia and New Zealand.

"J", as he is referred to in a decision by the Insurance and Financial Services Ombudsman Scheme (IFSO), argued that because the word "Australasia" included "Asia" his health insurer should pay the medical bills in India - a country in Asia.

Ombudsman Karen Stevens declined the complaint.

The man was travelling in India when he contracted the virus and incurred the hefty medical bill.

He was shocked when his insurer informed him that his policy did not include broad worldwide cover and declined his claim, a summary of the decision on the insurance ombudsman's website said.

The unnamed insurer said the term "Australasia" meant medical cover was only broadly applicable to treatment in Australia and New Zealand, not Asia.

On top of this, the insurer said the policy excluded emergency treatment and J did not meet any of the requirements of the overseas treatment provisions.

In his complaint about the insurer, J said he changed from a previous insurance company because his financial adviser told him the new policy had worldwide cover, the summary said.

According to the summary, J believed the wording was misleading because he believed "Australasia", meant Asia and therefore included India.

Finally, J said that the brochure he was given before arranging the policy indicated the health cover applied worldwide.

But Stevens found the financial adviser was not the insurer's agent meaning the insurer was not responsible for any incorrect advice the adviser gave J.

And, when J arranged the insurance the insurer was not told the only reason he wanted to change was because of his understanding of the worldwide nature of the insurance.

Stevens found the brochure issued at the time reflected the actual policy wording and was not misleading.

She also found that the "Australasian Coverage" made it clear the benefit only extended to Australia and New Zealand.

She found the use of "Australasian" did not mean the health cover was extended to Asia or to India.

It meant the insurer did not misrepresent the cover to J and his complaint was not upheld by the IFSO Scheme.

"Never make assumptions about insurance policies," Stevens warned.

"If you are unsure about the extent of cover, ask about it, and make sure you read the policy so you know what you're insured for.

"If you leave it until you want to make a claim, it's too late."