Life Insurance And Critical Illness

DW123_2

the definition of “terminally ill” in section 66(2) of the Social Security Contributions and Benefits Act 1992: a person is “terminally ill” at any time if at that time he or she suffers from a progressive disease and his or her death in consequence of that disease can reasonably be expected within 6 months.

And your point is????

It's no good quoting legislation at me. I don't believe this has any relevance to a Critical Illness policy unless it's with the government! You'll find most policies say a Terminal Illness is one where life expectancy is not expected to last more than 12 months.

Millions can & do recover from critical illness's,

If the insurance company expect you to recover why did say to my friend "people can and do recover" then go on to refuse to pay out????

As I said before IFA's will not deride critical illness policies no more than a 2nd hand car salesmen would describe his cars as "dodgy". After all it's a source of income. Don't take my word for it, others agree..... http://news.bbc.co.uk/1/hi/programmes/inside_money/6915329.stm

dunstonh

Again, you are mixing up terminal illness and critical illness.

DW123_2

Again, you are mixing up terminal illness and critical illness.

No I'm not. I was merely clarifying the post of feisty1. Let's put this in some sort of context shall we??

A terminal illness is generally one of the 30 or so critical illnesses, whatever that terminal illness might be. The terminal illness also has it's own criteria which generally is survival for not longer than 12 months, although the poster was implying it is 6 months. The previous post quoted legislation at me which has no relevance in a Critical Illness Policy just as a definition of disability has no bearing either. The fact that you are classified as Disabled by the state has no effect on whether the insurance company pays out under the TPD side of the policy.

feisty1

DW123

Yr friend who saw the chiropractor would have been refused on the grounds of non disclosure.

I think you would be in a better position to debate if you understood the difference between critical illness and terminal illness.

DW123_2

DW123

Yr friend who saw the chiropractor would have been refused on the grounds of non disclosure.

I think you would be in a better position to debate if you understood the difference between critical illness and terminal illness.Today 12:14 PM

I think your just trying to wind me up. Yes the question however was something like "have you seen a doctor/consultant within the last 12 months" or something like that. Since when is a chirpractor a doctor. Do they have a degree in medicine. Dunno if they are registred with the GMC though or whether this is actually relevant.

Go on then tell me.....what is the difference between CI and TI???? Do not refer to legislation because it is irrelevant. Are you saying that a Terminal Illness is not also a critical illness?? Read this and you might understand a bit better that a terminal illness is also a critical illness within the definitions of the policy.
http://www.abi.org.uk/Public/Consumer/Medical/5442_Critical_Illness_new.pdf

pheww...that was hard work!!

dunstonh

BTW, you said earlier that my comments on the complaints stats were complete tosh. Insurance companies publish stats on these things and are available. Here are those from one of the biggest, NU.

NU paid out on 94% of claims on CI policies in the first 6 months of 2008. That compares with 85% in the same period of 2007.

The number of claims declined for non-disclosure of medical information fell to 1.5% (to end June 2007: 6.7%).

Norwich Union paid out more than £58 million to policyholders who claimed on their critical illness policies over the last six months. Highlights include:

• Total payouts for policies increased to over £58 million, compared to over £52 million in the first half of 2007
• Cancer remains the most common cause of claims at 60.1%
• The number of children's claims paid increased to 42 from 15 during the first half of 2007
• In total, 813 claims were paid out and the average payout was just under £72,000
• The number of claims rejected for non-disclosure of medical facts at the policy's outset continued to fall to just 1.5% in 2008, from 6.8% at June 2007 and 4.17% for the full year

During the first half of 2008 claims by illness type were as follows:

• Cancer 60.1%
• Heart attack 7.7%
• Multiple sclerosis 6.6%
• Stroke 6.9%
• Total permanent disability 5.9%
• Heart surgery 5.1%
• Benign brain tumour 2.7%
• Other 5.0%

DW123_2

NU paid out on 94% of claims on CI policies in the first 6 months of 2008. That compares with 85% in the same period of 2007.

Thanks for plugging Norwich Union.

The industry average is about 80% success isn't it? 1 in 5 claims are rejected by the industry. I'm sure those people that were rejected will take comfort from your stats. Perhaps you think they submitted frivolous claims and shouldn't be entitled. Some will have, but not all of them.

It is worth noting that sales advisers (including IFA's I believe) receive commission worth 200 per cent of the annual premium for each critical illness policy sold. On an average policy this can net a £1,600 fee.

In conclusion..........You keep your view. I'll keep mine.

feisty1

quote=DW123;17219985]quote:I think your just trying to wind me up.
Yr winding yrself up as yr sadly misinformed regarding so many things as your posts are increasingly proving.

Quote: Since when is a chiropractor a doctor. Do they have a degree in medicine. Dunno if they are registred with the GMC though or whether this is actually relevant.
Chiropractors as the word suggests are Doctors of Chiropractic Medicine. I am presuming yr comparison is to that of a Dr of Conventional Medicine.

Chiropractors are primary healthcare professionals and are subject to statutory regulation by the General Chiropractic Council (GCC).

Quote: Go on then tell me.....what is the difference between CI and TI???? Illness is not also a critical illness??
Terminal Illness Cover and Critical Illness Cover are NOT the same thing!

Terminal Illness Cover is a benefit included with Life Insurance policies which will pay out if you are told by a doctor that you have a condition that will die from within the next 6 (for children) 12/18 months. This is the only time it will payout and will not pay if you suffer from an illness which is not terminal. Critical Illness Cover on the other hand will payout for any of the specified conditions. An example of this is increasing testicular cancer in young men, a terminal illness policy would not pay out on this.
Quote: Read this and you might understand a bit better !!
Believe me, I DO understand, that is the difference between you & me.

dunstonh

Thanks for plugging Norwich Union.

NU are a market leader so it makes sense to use them. However, another popular one is Scottish Provident. 87.3% if claims submitted were paid in Jan-June 08.

Average age of claiment - 44
Average life of policy before claim - 73 months
Average payout - £73,423
largest payout - £552,487
Total amount paid £51,616,715

102 claims were not paid out on (12.7%). 87 of these because the illness did not meet criteria (10.8%) and 15 due to material non disclosure (1.9%). Those 15 had their premiums refunded (material non disclosure means it was intentional. Accidental non disclosure tends to result in payouts nowadays although with adjustments).

Cancer - 54%
Heart Attack 12%
Stroke 9%
Children benefit - 6%
MS -5%
Brain Tumour - 3%
Other - 11% (coronary artery by-pass, Heart valve replacement, Parkinsons, Angioplasty, Motor Neurone Disease, Aorta Graft, Coma, Kidney Failure, Paralysis/Paraplegia, blindness, major organ transplant and renal failure).

With heart attacks, 87% of those were men. With Cancer women accounted for 56% Stroke was 69% for men. MS had 70% women (more than double the number of men).

Two examples of rejections:

A claim was submitted by a 59-year old male, under the ‘angioplasty’ definition. Our definition states “angio must be carried out on two or more coronary arteries”. Medical reports confirmed that angio took place on only one renal artery, therefore this claim did not meet
our definition.

A claim was received from a 42-year-old female claiming for malignant melanoma under the ‘cancer’ definition. Medical investigation however revealed that the mole on her nose was not invasive and could be removed under local anesthetic, therefore this claim did
not meet our critical illness definition.

The industry average is about 80% success isn't it

85% for 2007 is a fair average although most companies seem to be heading into 90% for 2008.

As mentioned higher up. Of the 15% rejected, 5% is due to non-disclosure and 10% for claims on things the policy doesnt cover.

I'm sure those people that were rejected will take comfort from your stats.

It doesnt matter. Either they told lies on the application or they are trying to claim for something they are not entitled to claim for.

It is worth noting that sales advisers (including IFA's I believe) receive commission worth 200 per cent of the annual premium for each critical illness policy sold. On an average policy this can net a £1,600 fee.

My goodness. Are you saying that advisers get paid for doing a job? How disgraceful. Who would ever believe that people get paid for doing things. I thought people worked for love.

I'm fee based anyway, so I dont care.

DW123_2

feisty1 wrote: »

Terminal Illness Cover and Critical Illness Cover are NOT the same thing!
Terminal Illness Cover is a benefit included with Life Insurance policies which will pay out if you are told by a doctor that you have a condition that will die from within the next 6 (for children) 12/18 months. This is the only time it will payout and will not pay if you suffer from an illness which is not terminal. Critical Illness Cover on the other hand will payout for any of the specified conditions. An example of this is increasing testicular cancer in young men, a terminal illness policy would not pay out on this.

Tell me have you ever visited the Planet Earth??
I'm talking about the illnesses specific to a typical Critical Illness policy, what are you talking about??

Here is a list of CI's from a typical CI policy that I got off the net. I have highlighted the term Terminal Illness in RED. I do hope you're not colourblind too. The defintion of terminal illness wasn't given but I'm sure there would be precluding illnesses.

Alzheimer's Disease - resulting in permanent symptoms
Aorta Graft Surgery - requiring surgical replacement
Aplastic Anaemia - with permanent bone marrow failure
Bacterial Meningitis - resulting in permanent symptoms
Benign Brain Tumour - resulting in permanent symptoms
Blindness - permanent and irreversible
Cancer - excluding less advanced cases
Cardiomyopathy - of specified severity
Coma - resulting in permanent symptoms
Coronary Artery By-Pass Grafts - with surgery to divide the breastbone
Creutzfeldt-Jakob Disease (CJD) - resulting in permanent symptoms
Deafness - permanent and irreversible
Dementia - resulting in permanent symptoms
Encephalitis - resulting in permanent symptoms
Heart Attack - of specified severity
Heart Valve Replacement or Repair - with surgery to divide the breastbone
HIV infection - caught from a blood transfusion, physical assault or accident at work

Kidney failure -requiring dialysis
Liver failure - of advanced stage
Loss of hands or feet - permanent physical severance
Loss of Speech - permanent and irreversible
Major Organ Transplant
Motor Neurone Disease - resulting in permanent symptoms
Multiple Sclerosis - with persisting symptoms
Paralysis of limbs - total and irreversible
Parkinson's Disease - resulting in permanent symptoms
Primary Pulmonary Hypertension - of specified severity
Progressive Supranuclear Palsy - resulting in permanent symptoms
Respiratory failure - of advanced stage
Stroke - resulting in permanent symptoms
Systemic Lupus Erythematosus - with severe complications
Terminal Illness
Third Degree Burns - covering 20% of the body's surface area
Total and Permanent Disability
Traumatic head injury - resulting in permanent symptoms