Loan Insurnace refusing to payout

markwebster

In 2004 I was a drector of a company along with my parents and we took a loan out with a bank with a horse (not sure about the protocol of naming names here). We decided to take the PPI insurance in mine and my fathers name as we were the key workers (more fool us). Just before the loan was taken out (September) my father went for a scan concerning a hiatus hernia he had had for many years, this was a regular occurence, the manager of the bank who was filling in the forms knew us for several years and no questions were everasked re medical conditions etc and if they had they would have been answered honestly and fully. In November 2004 the scan results came back saying by father had developed a condition called Barretts Oesopahgus which is caused by constant irration of the Oesophagus through reflux (a side effect of the hernia), this conditon wasn't considered serious and in fact the decision was taken to just see him again in 2 years for another regular scan.
In April 2005 due to ongoing pain my father was admitted into hospital where it was discovered he had developed Cancer of the Oesophagus, needless say we put in a claim using the PPI and guess what, "sorry it is a pre-existing condition and we won't be paying out". We have the doctors, the consultants and even the Barretts Oesophagus Foundation telling the Insurance company that whilst Oesophageal Cancer has generally been preceded by Barretts Oesopagus in 95% of the cases the chances of Barretts turning cancerous are less than 1%. Unfortunately in October 2005 by Father died so we pushed again response "sorry it was a pre-existing condition and we won't be paying out". We have been arguing the case ever since whilst carrying on paying the loan - didn't want to default and give them more reasons to cry out.
In January 2008 unfortunately the business went into receivership but as myself and mother are guarantees on the loan and the payments stopped in January they are now asking for settlement. I am trying everythig to get them to see sense that a, the isurance was mis-sold in the first place and b, the conditons were so unfair and in fact illegal as it made it impossible for a claim to be made successfully.
I have tried the ombudsman and am at the pijt of threatening them with a small court claim for the loan payments we have made since the original claim.

Does anyone have any advice they could offer, sorry for the long post but there does seem to eb a short way of putting this.

Thanks

Mark

Rafter

Mark,

I think you need a solicitor to advise you on this one and may have to go to court to get the insurance company to pay out.

You certainly seem to have a misselling complaint if you didn't have to declare any existing medical conditions or this exclusion wasn't pointed out clearly to you at the point of sale (in writing or verball).

A 1% probablility of a treatable condition turning into cancer seems indefencinble to be on the part of the insurance company but they are in the business of defending claims at all costs. Watch 'The Incredibles'!

The insurance would probably only have paid out for 12 months, although critical illness or death cover might have written off the balance of the loan?

Good luck and keep pushing!

R.

milliemonster

This is precisely why these loans aren't worth the paper they are written on, most of them don't actually come into force until 3 months after you have taken them out anyway and because your dad had his first scan related to all this just before you took the loan out is why they are refusing to pay out.

In most cases, they will always find something in your medical records to say it was a related to a pre exisiting condition, irrespective of what your medical professionals say.

Unfortunately I don't think you will get them to pay out but you should be able to claim back the PPI on being missold it.

Really sorry about your dad, x

marshallka

Mark, sorry to hear your troubles here. Have you actually written to them about the misselling and sent them the template letter out. I don't know how you stand as if the PPI was in joint names with your father and he has passed away if you are allowed to make the claim for him?? You can certainly claim for yourself though...

I would now send out the misselling letter and give them 8 weeks to respond with a full and final response. Where you say you have tried the Ombudsman do you mean just called them or sent in a complaint and had it turned away??

I would otherwise make this a court matter but in all fairness you should not have to here. If you need any more help then join us on the PPI reclaiming discussion thread and lots would be able to advise you on there.

Good luck. This sort of thing maddens me and I really hope you get somewhere with this complaint.

di3004

markwebster wrote: »

In 2004 I was a drector of a company along with my parents and we took a loan out with a bank with a horse (not sure about the protocol of naming names here). We decided to take the PPI insurance in mine and my fathers name as we were the key workers (more fool us). Just before the loan was taken out (September) my father went for a scan concerning a hiatus hernia he had had for many years, this was a regular occurence, the manager of the bank who was filling in the forms knew us for several years and no questions were everasked re medical conditions etc and if they had they would have been answered honestly and fully. In November 2004 the scan results came back saying by father had developed a condition called Barretts Oesopahgus which is caused by constant irration of the Oesophagus through reflux (a side effect of the hernia), this conditon wasn't considered serious and in fact the decision was taken to just see him again in 2 years for another regular scan.
In April 2005 due to ongoing pain my father was admitted into hospital where it was discovered he had developed Cancer of the Oesophagus, needless say we put in a claim using the PPI and guess what, "sorry it is a pre-existing condition and we won't be paying out". We have the doctors, the consultants and even the Barretts Oesophagus Foundation telling the Insurance company that whilst Oesophageal Cancer has generally been preceded by Barretts Oesopagus in 95% of the cases the chances of Barretts turning cancerous are less than 1%. Unfortunately in October 2005 by Father died so we pushed again response "sorry it was a pre-existing condition and we won't be paying out". We have been arguing the case ever since whilst carrying on paying the loan - didn't want to default and give them more reasons to cry out.
In January 2008 unfortunately the business went into receivership but as myself and mother are guarantees on the loan and the payments stopped in January they are now asking for settlement. I am trying everythig to get them to see sense that a, the isurance was mis-sold in the first place and b, the conditons were so unfair and in fact illegal as it made it impossible for a claim to be made successfully.
I have tried the ombudsman and am at the pijt of threatening them with a small court claim for the loan payments we have made since the original claim.

Does anyone have any advice they could offer, sorry for the long post but there does seem to eb a short way of putting this.

Thanks

Mark

Hi Mark

Like everyone else here hun I am so sorry to hear of your dad and the problems now with this.

I echo everyone else here and feel you have excellent grounds for complaint.

So please do as advised hun and hopefully this will resolve in your favour in the end.

I wish you the very best of luck.

love to all.
Di.
x

markwebster

Thanks for the replies, when we have looked further into it the insurance company can look back 2 years over your medical history and draw info from there in there attempts to refuse the claim. The example I have heard from the Barretts Foundation is that if you have visited your doctor for a migraine headache or simillar and within 2 years you try and claim for a brain tumor then they can say "pre-exisiting", this is how likely Barretts is to turn to cancer yet using their terminology and conditions they say they would be within their rights to reject. The 12 months issue is not relevant in this case as we have never accepted their decision not to pay out and have been keeping the claim live through correspondence. I have spoken to a man who works in the legal side of the Insurance industry (normally on their side) and he is so p****d off with this he is considering helping (FOC) draft a particular of claims so we can try and sue the !!!!!!s.

I think the way he is talking we are going to try and claim that the insurance should have paid out when we originally claimed and we want that enacted as of that date and all of the loan payments paid since to be refunded, this amount is likely to be simillar to the amount now outstanding so we will see who flinches first.


Mark

countrygirl84

Have you gone through and read all your paperwork that you signed when you took out the loan? I work with loans myself and it is my responsibility to go through a 'duty of care checklist'. This explains the general ins and outs of the insurance poilcy and asks a few general questions about your current situation. If this was explained and signed by you, then it may be hard to file a lawsuit. BUT, you stated that no questions had been asked so that would be mis-selling.
I'm sorry to hear about your father and wish you luck in your claim. It sucks how the banks always seem to get themselves out of these situations.