On 2nd December Jill Insley wrote an article ( http://t.co/1Cx2wAzR ) in The Observer about Nic Hughes whose critical
illness claim has been turned down by Friends Life. A campaign has started to
get Friends Life to overturn their decision and backed by @stephenfry on twitter the
campaign is set to gain momentum.
We have decided to support the campaign and we want to
explain our reasons why.
As we have previously expressed, we have had concerns for some time that the way that life insurance companies currently work may be
leaving some customers exposed to the danger of a claim being turned down. When
it comes to critical illness and life insurance there can be nothing worse than
thinking you have done the right thing and protected your family with personal
insurance cover only to find out when its too late that the insurance
company has thrown out the claim due to ‘non disclosure’.
We accept that there are some occasions where due to
deliberate non disclosure an insurance company will be quite within their
rights to decline a claim.
However we believe there currently exists a grey area where
it is much less clear that a customer has deliberately non disclosed. Misunderstandings concerning disclosure can and do arise and in
the case of Nic Hughes it looks as though this might have been part of the
problem.
We believe that the current underwriting practices used by
most life insurance companies are adding to this problem. This is because most
life companies often deliberately make the decision not to write for further
medical information from the client’s GP at the application stage, even though
the client might have disclosed one or more medical conditions on the
application form. For medical disclosures such as heart disease and cancer, life
insurance companies will nearly always prefer to write out to the client’s GP
for further medical information. But there are many potentially ‘less serious’ conditions
where the insurance company may decide not to bother with this stage of the
process and to offer acceptance terms straight away. In fact life insurance companies adopt
this approach for the majority of applications.
The problem is that where there is no independent medical verification there can be an increased risk of misunderstanding and therefore
of a claim being declined, which is potentially catastrophic for the policy
holder.
Life insurance companies argue that if they were to write
out for medical evidence in a greater number of cases that this would add to
their costs and that it would delay customers obtaining cover. They say that
customers want cover quickly and that if they can’t get it quickly they will be put off taking out
insurance.
We disagree strongly and so do most of our clients. We think
that the argument that the ‘client needs a fast turnaround’ is a smoke screen and that there
may be other motivating factors.
Here @MoneysworthUK our clients tell us that the most important thing for them
is to know that their cover is valid. Getting the job done right is
much more important than getting a quick fix. In the main they positively
welcome a GP report as part of the underwriting process, because
it makes them feel safer that they haven’t accidentally left something out. That’s
probably not surprising when you consider that the majority of our clients already
have an existing health condition such as diabetes, heart disease, mental
health etc.
In the case of Nic Hughes, had the life insurance company
written out to the client’s GP for a report before making their underwriting
decision then the current situation could have been avoided. If they had
declined or postponed cover then Nic could have explored other avenues to see
if other options were available. Instead
of which the insurance company seems to have taken the easy route which has
turned out to be easy for them but very difficult for Nic and for his family.
In Nic’s case we think Friends Life should settle the claim. If you would like to sign the petition here is the link https://t.co/7KlFyuOL
Furthermore we think that Nic’s case illustrates the need for a reassessment of
underwriting procedures across all life insurance companies. One possible way of dealing
with this issue would be to make insurance companies fully liable for claims
arising after a limited initial period – that would change the way life
insurance companies approached their underwriting processes as they would not be able to rely on non disclosure at the claim stage. But it would leave
customers knowing where they stand.
In the meantime until life insurance companies change their ways we think that ‘grey’ cases should be
settled in favour of the applicants.Labels: #NicsFight, claim, critical illness, disclosure, Friends Life, GP, Jill Insley, life insurance, MoneysworthUK, Nic Hughes, non disclosure, stephenfry, twitter campaign, underwritriting