Insurance companies and non disclosure.

Atermis

however in all seriousness, had one the other day, without going into any detail obviously.

Requested GP notes for a claimant, Sent the necessary forms to the claimant, which was filled in and returned, sent the cheque to the GP's etc etc.

A week later a file 200 pages long came in, with everything in it dated from the early 90's. some relating to v.personal details, illnesses etc.

Didnt even look at it, just pulled out the 2-3 releveant pages and chucked the rest in the confidential waste bin.

Im sure the claimant wouldnt be best pleased knowing that every single piece of info/notes was sent to us!

pedro123456

Bingo..............Atermist............thats my point,

Only relevent information should asked for and supplied.......end of story

it should not be allowed it should be addressed, if it isn't it ought to be illegal.

Ta Pete

OshayAway

Anything that goes to the accuracy of the completed application is relevant as it establishes if there are any non-disclosure issues.

pedro123456

Oshay.............that sounds very much like a law, if it is it should be challenged.

The Medical professoins should be in charge of relevent past medical History as they are fully qualified and trained. and obviously know "how" someone PMH can effect their present claim

If the Insurance are in charge.....well mice and cheese spring to mind.

Ta Pete

FH_Brit

pedro - the wording "obtain medical history from all doctors who have attended you" and your consent signature makes it legal because you agreed. Perhaps we (customers) should insist on the word RELEVANT or the words PERTAINING TO THE CONDITION THAT IS BEING CLAIMED FOR may clarify the situation and then you would only agree to relevant med history instead of FMH in a release consent. The bottom line is your declaration of consent does not limit the information that you are consenting to being given. They are legal (as they have your signed consent) and your doctors are covered as you gave your consent to the release of information.

Bearing in mind insurance companies are not interested in every time you went to your GP and they do not have the time to sort through a persons FMH to look for relevant info, in fact I would presume that after you signed the declaration of consent, the request to your doctors was probably only asking for information medically related to the condition/illness that you are claiming for.

You contradict above, saying "relevant history" yet earlier you "quote" your declaration as saying ).............."to enable us to deal with your claim it will be necessary for us to obtain medical history from all doctors who have attended you" - either it did or did not say "relevant" in the declaration (not policy or schedule).

Also you mention that;
the question is asked "have you ever suffered depression".....and you say no.........the IC will check through your FMH and if it's found that you had in fact suffered for a few week off depression...........
Well here, if you did say no and you had "a few week off depression" then you withheld information/missguided/lied and that means you are in breach of contract - you should have declared "few week off"!

FH_Brit

To be DEvils Advocate, bear these points in mind;

Ins Co's are in business to make profit - if they can get out of paying your claim (legally) they will!

If you owned the Ins Company and could find a legal way of not paying a claim and make some money - you would.

These insurance co's can afford much better lawyers than their customers and in most cases their policies (legal contracts) are watertight.

I deal a lot with these sort of claims and the bottyom line is that few people actually read (or if they do fail to understand) exactly what they are agreeing to.

There's an old saying - Never sign until you have read! If only people would do this!

OshayAway

pedro123456 wrote: »

Oshay.............that sounds very much like a law, if it is it should be challenged.

The Medical professoins should be in charge of relevent past medical History as they are fully qualified and trained. and obviously know "how" someone PMH can effect their present claim

No really, it's common sense. The insurers make very clear what information they use to asses an individual's risk by the questions they ask on the application form. None of said questions are misleading or 'trick-questions' they are spelled out in plain English. It's hardly unreasonable to check medical records to see if an individual misinformed or blatantly lied to an insurer in the form that is the basis of the contract.

pedro123456

FH...........presume away

"I would presume that after you signed the declaration of consent, the request to your doctors was probably only asking for information medically related to the condition/illness that you are claiming for"

ok.....the words "relevent" aint in.......but neither is "full"............the IC ask for full medical history and they shouldn't..................end of story.

as for the depression quote...........It may be relevent in some claims and that is for the doctor to decide, but he isnt aware of ABI/BMA guidelines and sends what he's asked...........FMH.

Ta Pete.

OshayAway

pedro123456 wrote: »

as for the depression quote...........It may be relevent in some claims and that is for the doctor to decide

By definition the doctors that hold your medical records are General Practitioners not specialists. It's not in their job description to be responsible and make decisions on whether (potentially) hundreds of thousands of pounds be paid out or not.

Imagine the potential for fraud if the GP 'forgot' to include certain notes on a report at claim stage? I'm sure plenty of people could exploit that, especially any who were 'inventive' when filling out their application form in the first place. It's naive to think that an insurance company do anything other than asses claims in-house.

At any rate, any GP will tell you that mental health can have far reaching effects on physical health... and they are learning more all the time.

pedro123456

hehe.....you are begining to impresss now Oshay........not only are you well informed about finance, but you now know the job description of a GP.....

Who mentioned them being responsible for thousands of pounds, they are (or should) be responsible for assessing the relevance of PMH to a particular condition.

And........have you any idea Who/where medical records are held............because I know how /where they are kept..........but you obviously dont.

And as for Mental health affecting owt else,physical or otherwise .... I think ive mentioned this before.
Its called Holistic care............I

f you understand it and are knowledgeable about it...........please quote it............if you dont please refrain from talking about it.

unless of course you want to know everthing about it.........in the case ask me....

Ta Pete