Insurance Co wont pay and closed my policy

baileyp_2

I took a insurance policy in 2000 to cover me for critical illness, to pay a lump sum if i sufferd accident or illeness that prevented me from working. In Nov 06 i had a work accident that has left unable to work, and now in serious finacial problems.
The insurance company have said they recognise that i am disabled but i am not disabled enough to the claim the payment of the policy, i have been to the ombudsman service and they have just copied the answer of the insurance co. No solicitor will take on the case without me paying upfront. and i dont have that sort of money, can you please give any advice.
I have been registered as fully disabled and unabel to work or seek work, and to add insult to injury the Ins Co have now closed my policy as i can no longer make the premiums.
:mad: Thanks Paul

dunstonh

No solicitor will take on the case without me paying upfront.

Which indicates little or no chance of success.

I have been registered as fully disabled and unabel to work or seek work, and to add insult to injury the Ins Co have now closed my policy as i can no longer make the premiums.

Critical illness plans are not income protection plans. They pay out on diagnosis of a range of specified critical illnesses.

You say you have an accident that has left you disabled. However, most CI plans require total disablement. Indeed, the common phrase is "'total and permanent disability". The definition of which is quite clear. If you dont meet that definition then they wont pay out.

If you had an permanent health insurance policy or even right down to a budget income protection plan rather than a CI policy then its quite possible, even probable, that it would pay out as disability (and different levels of) if you are signed off by a doctor as unable to work. However, it seems you are possibly trying to claim for something under a policy which you dont meet the criteria for.

pedro123456

I agree with Dunstonh on this one in part anyway, CI is not a Income Protection, it's a list of illness or conditions that you have to have and as he say'y total & permanent disability is part of most if not all CI..........but

"You say you have an accident that has left you disabled. However, most CI plans require total disablement. Indeed, the common phrase is "'total and permanent disability". The definition of which is quite clear. If you dont meet that definition then they wont pay out".

Dunstonh what is your take on "total and permanent disability?", because i just cant gets to grips with it........except obvious extreem cases etc.

Pete

dunstonh

Dunstonh what is your take on "total and permanent disability?", because i just cant gets to grips with it........except obvious extreem cases etc.

With looking up exactly what the insurance companies class it as word for word, I would refer to it as a disability that prevents you permanantly from working any form of occupation for the rest of your life. In simple language you are really looking at pretty severe disabilities. The insurers should have a published definition of what they consider to be T&PD as it does vary with different providers. Also, budget, standard and comprehensive plans (terms which are not generally used in marketing of the product but need to be considered when buying) will have an impact on the definitions. A Skandia plan, for example, may be more expensive than most but its also far more likely to have a claimable event and likely to have less hoops to jump through to claim.