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Insurance Claim Rejected After Flight Crew Timing Violation

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A traveler who faced a canceled flight due to the flight crew reaching their legal working hour limits will only receive partial reimbursement for his expenses.

This ruling came from an official complaints authority.

The frustrated passenger incurred additional costs when his flight from Palermo to London was unexpectedly stopped because the crew had worked the maximum hours allowed by law. He expected full coverage for these expenses under his travel insurance policy.

However, Lloyd’s Australia, the insurer, denied the claim, stating that the travel policy’s clause on additional expenses and disruption coverage only applies to events such as strikes, riots, hijacks, civil unrest, adverse weather conditions, or accidents involving the mode of transport.

The claimant argued otherwise, insisting that the crew reaching its working hours limit was akin to industrial action such as strikes, implying that the insurer had a too narrow interpretation of the policy's disruption cover. He stated that the restriction on working hours is a precaution to prevent accidents, which aligns with the "spirit of the policy".

Yet, The Australian Financial Complaints Authority (AFCA) did not accept this reasoning.

AFCA pointed out the scant information provided by the claimant which linked the flight cancellation directly to crew working hours being exceeded. They reinforced that this situation is distinct from a strike.

“A strike constitutes a deliberate refusal to work, whereas regulatory limits on work hours are a constraint and not a chosen action,” noted the AFCA's ombudsman. “Additionally, equating flight crew timing regulations with an accident scenario is not fitting, since the clause in question applies to actual incidents happening, not cancellations meant to forestall potential accidents.”

However, AFCA acknowledged a part of the travel policy which offers coverage for scenarios where a flight is delayed over six hours due to uncontrollable circumstances.

Under this provision, the insurer is required to compensate the complainant with the policy’s cap of $2000.

“Although the insurer claims that these circumstances are specifically excluded by the policy, they failed to indicate which exclusion they are relying on and provide justification for triggering it. Therefore, it is unconvincing that the insurer has adequately clarified its entitlement to decline or reduce the claim under this section,” AFCA concluded.

This case was originally reported by Insurance News Australia.

Published:Monday, 9th Sep 2024
Source: Paige Estritori

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

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Knowledgebase

Incontestability Clause:
A provision in a life insurance policy that prevents the insurer from voiding coverage due to a misstatement by the insured after a certain period.

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