Policyholders who were denied payouts or compensation by one of the UK’s biggest travel insurers 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 law firm to review 20 cases involving Miguel Nadal, the former medical director of Travel Insurance Facilities (TIF). TIF used to run an emergency assistance service for high street 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 seriously 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 rejected complained to the Ombudsman about their experiences. In some cases, however, the ombudsman sided with the insurance company after considering evidence from Nadal submitted by TIF. It is these cases that the Ombudsman will now review.
In a statement, the Ombudsman said: “When people travelling abroad become seriously unwell, they can find themselves in an extremely vulnerable situation. It is essential that insurers treat everyone with decency and fairness. Where there are concerns that this has not happened, companies must deal effectively with consumers’ complaints.
“We have commissioned a lawyer-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 reopening investigations where appropriate.”
The Ombudsman has refused to confirm which cases will be 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.
The family complained that their relative had been deemed “fit to fly” by the treating doctor abroad, but the insurance company, on the advice of Dr Nadal and another doctor, had decided not to return the patient to the UK because the transfer was 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, he concluded that the decision was made fairly and on the advice of relevant medical expertise.
TIF says the main doctor in the case was not Nadal.
James Daley, founder of Fairer Finance, said: “It’s great to see the Ombudsman 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 insurers’ statements without verifying the facts. This must change. And it’s clearly time for the Financial Conduct Authority to create new rules on how insurers deal with emergency medical claims.
The ombudsman said its review of cases involving Nadal was ongoing, so the number of complaints it could send for consideration could increase. It added that it was now setting up a wider technical panel to advise on the use of evidence in complex medico-legal, fraud and fintech cases.
In a statement, TIF, which operates the HolidaySafe, Alpha and albert & eddie brands, said: “We confirm that the Financial Ombudsman Service has contacted us for information about historical cases involving a doctor who advised us. We have co-operated fully with the requests for information and will assist the Ombudsman in any way we can during his review of selected cases”.
She added that, apart from the findings of the medical tribunal, Nadal had an unblemished career, having been involved in more than 1,000 medical assistance cases.
Nadal questioned the appropriateness of the Ombudsman’s investigation.
“Recent cases of doctors suspended for plagiarism or defrauding London Transport have been found to be ‘impaired’,” Nadal said. “No one is trying to find fault with their management of patients. It is equally inappropriate to investigate travel insurance companies on the basis of 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 was deemed unfit to fly.
