Critical illness question

nw_man

Slightly off topic here, but relevant in general terms to this discussion is the fact that the insurers, in my opinion, should NOT expect either the agent ( IFA / broker etc ) NOR the client to give medical information as they are both prone to getting it wrong, accidently or otherwise. Memory fades over time.

If you ask me they should be forced to write to the clients GP to get the information at application stage.

That would sort out a lot of non disclosure problems.

pedro123456

They do sometimes nw_man, but refuting claims is how they make their money and non disclose will be a lucrative little loop hole for them...........any way this is part of joint BMA and ABI agreements..............

Insurance companies are finding that some doctors provide full printouts of all the computerheld
patient records instead of filling in the GPR and, for example, including as an attachment
a printout of details of relevant medical certificates that have been issued. Only relevant
information should be provided and it is ethically unacceptable to provide extraneous
information. Doctors must not send full medical records in lieu of medical reports and ABI
members should not accept these printouts. The full records are not necessary and will very
probably include information that is not relevant to the insurance being applied for. Insurance
companies are entitled only to information which is relevant to the policy, and disclosure or

other processing of irrelevant information is likely to breach the Data Protection Act 1998.

Pete

OshayAway

pedro123456 wrote: »

My point is this......Kev has been diagnised as having cancer, the insurance company are now lineing up for non disclosure by asking about Anxiety / Depression.....

What's Anxiety / Depression got to do with the price of fish?

Depression isn't linked to his diagnosis

It's relevant to the validity of the policy, not necessarily the condition being claimed for.

In other words the contract is based on the original disclosures, if the questions are not answered correctly, it could be that different terms or a higher premium would have been offered. In some cases a decline of terms altogether.

Think of it this way, if an alcoholic, HIV+, bungy-jumping, 35 stone steeplejack disclosed none of that on a application and died in a car accident... obviously his lifestyle / situaltion has nothing to do with his death but would it be unreasonable for the insurer not to pay out?

Going back to this specific case though, given that it was so long ago and if you've had no related problems since, I very much doubt 'cynical pete' will be proved right.

pedro123456

Oshayaway........cynical Pete?..........lol...Iv'e been descibed worse thing I suppose.........

"It's relevant to the validity of the policy"......why?, lets not try and dress this up by using "coined phrases", if they were interested in validity they would have asked for a GP report BEFORE they slipped their hands into Kevs pocket.

Would the Inurance have turned him down because of a possible depression episode....I doubt it because they wern't interested as he was signing on the dotted line, much about his PMH.............but surely enough they would be concerned about it when he claimed........because thats how insurance companies work.

And yes I am talking from "bitter experience" and yes cynical to a degree.

As for me being proved right..........I hope not

I hope all goes well for Kev......and that I am totally wrong.

Pete

dunstonh

if they were interested in validity they would have asked for a GP report BEFORE they slipped their hands into Kevs pocket.

And they may well have done if they had been made aware of the facts.

However, in Kev's case, its almost certainly not going to be an issue.

Would the Inurance have turned him down because of a possible depression episode

Possibly. I have seen cases refused on that basis. Although more common is a rating in premium. In Kevs place, if the insurer decides they would have rated the premium had they been aware they will just reduce the claim payout by that amount assuming the FOS guidelines are followed.

OshayAway

pedro123456 wrote: »

if they were interested in validity they would have asked for a GP report BEFORE they slipped their hands into Kevs pocket.

Requesting a GP report on every case would have certain disadvantages including:

Time - It often takes weeks, and sometimes months for doctors to complete and return reports as it is, not to mention having to write out a second time because it's illegible or because there's not enough information. Imagine how much longer it would take if every single case needed one! What about the would be claims that are not valid between application and on risk date?

Cost - It costs the best part of £100 for a GP report, payable by the insurer but that money will no doubt be funded from higher premiums.

Not only that but the most common disclosures are smoker status, BMI (height and weight) and symptoms not seen a doctor about. All of which would not necessarily be evidenced by a GP's report.

pedro123456 wrote: »

Would the Insurance have turned him down because of a possible depression episode ....I doubt it because they weren't interested as he was signing on the dotted line

Why would they ask the question then?

Anxiety, stress and depression are very common and taken very seriously by insurers. True, this is an area where insurers do vary on the stand they take with underwriting but because mental health can have a significant impact on physical health, yes non-standard terms and even declined applications are common place. [/QUOTE]

pedro123456

OA.........yes you are right of course........."Requesting a GP report on every case would have certain disadvantages including time & cost".........but..........

The time and costs become irrelevent once you make a claim........they have all the time in the world, and dont seem to have any cost restrictions.

And of course if the IC went to as much trouble before dipping into pockets to gain Full Medical History, it wouldn't be able to play its get out of jail non disclosure card.........and their profits would be affected.......sharks the lot of um!!

And as for your comments "mental health can have a significant impact on physical health"..........yes again you are right..........but..........

Just for your attention it's called "holistic" health and it generally refers to the ill health effects that a psychological problem can have on your physical well being....as indeed your socal,economical, relegious problems can have a negative effect on your physical well being.....

Anyway .sorry to digress............would the insurance pay out the slightly over weight fella who dranktoo much , and who was unfortunate enough to contract Aids through a blood transfusion, who had a sporting back ground?............My guess is ...no....... they wouldn't........but why not?..............was he drink driving ?.....no. .........was he driving while bungee jumping .....no..........had his HIV progressed while he was out driving to the chip shop....no..........

So why shouldn't they pay he died in a car accident ...............that may or may not have been his fault...........they should pay in full.......but guess what ?.............out comes the all singing all dancing non disclosure loop hole.......and Bob's your uncle (or aunty if he's a cross dresser).........they wont pay out.

Just too also point out I would be gob smacked if you, or anyone else could provide links to suggest that Aniety, depression or stress has an effect on someone being unfortunate enough to contract cancer.

I have no desire to comment any further on this as I think ive made my point.............we have different opinions............I'm right..your wrong...

So............good luck Kev, I hope all goes well for you mate...I have no magic words, but I really wish you well.

Pete

dunstonh

e time and costs become irrelevent once you make a claim........they have all the time in the world, and dont seem to have any cost restrictions.

Its a total waste of money and time though. GPs would be flooded and the cost would sky rocket. Most applications are clean so the majority of consumers would lose out. Claims for non disclosure only tend to hit less than 5% of claims. So, in the scheme of things it isnt worth it.

pedro123456

Dunstonh/Oshayaway. please lets not get carried away here.....this thread was opened by Kev........who asked "What should i expect?, i have a feeling they will decline it because of this 'non-disclosure".

Now Ive said (in effect).you do right to expect they will decline your claim Kev and they will try and get out of paying etc etc........Kev (i hope) will gether his thoughts and support as he see's best..I hope I am a million miles away from the truth, and the the IC will just pay out............

If you wish to enter into a discussion about who's right or wrong lets open a new thread and make our points for all to see.and let others address Kev's concerns if they wish too.



Pete

Kev2009_2

Seems i've started a bit of a debate here! lol, cheers for the advice and info guys, i've sent all the info off today so we will see what they come back with, i'm guessing it will be 6 to 8 weeks before i know or hear anything from them, give them time to do searches etc.
I will post back and let you know what happens

Cheers all

Kev