Total, Permanent Disability

somewhatnew

pedro123456 wrote: »

I would imagine only the worse case scenarios are covered under TPD, and that there are many loopholes for the IC

The fist part of the statement I agree with, the second part not so much.

A lot of the TPD problems arise because you have to be TOTALLY (i.e if own occupation, not be able to do any part of your occupation such as take phone calls), and PERMENANTLY (i.e. never, ever have hope of recovery) disabled. You pretty much have to be a vegetable before it pays out. It's not a great part to an insurance policy, but it is what it is and thats why the RDR are looking to to change it at the moment. All we can do as brokers is to try to ensure that we provide the most comprehensive plans!

mikey boy - with regards to the Own Occupation I dont this you will be able to get TPD with own occupation given your business milage (if anyone knows any difference please let me know).

Regarding the index option I am a fan of Scottish Equitable as, if the RPI is 3%, then the premium will rise at 3% along with the level of cover. But most companies will increase the premium at 1.4*the RPI but keep the cover increase at 1*the RPI, hence the longer you keep the cover the more expensive it becomes.

I'll leave it with you to check out Bright Greys indexation options but if bright grey are 1:1 rather than 1.4:1 then go with them.

pedro123456

“A few weeks ago there was a thread started by someone who was enquiring about whether to claim for ulcerative colitis. Incredibly, some on this forum encouraged them to put a claim in”

I recall the thread about UC, I can’t recall anyone suggesting it was a TPD though, or anyone “incredibly” encouraging the OP to put a claim in.

Other than severe brain/head injuries/illnesses, and spinal cord injuries, it’s hard to imagine what other conditions/injuries would constitute being covered under a TPD claim.

As somewhat says, “You pretty much have to be a vegetable before it pays out”

somewhatnew

pedro123456 wrote: »

I recall the thread about UC, I can’t recall anyone suggesting it was a TPD though, or anyone “incredibly” encouraging the OP to put a claim in.

Funnily enough Pedro it was you that suggested it. Please see the last paragraph nicely highlighted in red. Taken from http://forums.moneysavingexpert.com/showthread.html?t=1726625&highlight=colitis


With all these non-TPD claims going in, I wonder is this another reason why TPD has such a bad reputation?

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pedro123456
MoneySaving Stalwart


Join Date: Mar 2009
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Let me see if I understand this correctly, Suzanne.
You have CI with Legal & General, Ulcerative colitis is not a CI with them,
However UC is a CI with Prudential, therefore you wish you had arranged cover with them.

1-You ask for advice because your Hubbies Consultant said he had suffered a critical illness UC but in actual fact you IC don’t cover UC as a Critical illness.
2-You wish to know if UC could be covered under Total & Permanent Disability clause because L&G do not have it as a core condition

1-If your Insurance cover does not list UC as a Critical Illness then you cant make a claim for it
2-If the UC is such that it meets the definition of the L&G you can claim, however this definition of the IC (Total & Permanent Disability) I would have though caters for only the extreme cases Injuries/Illnesses.
In my opinion the IC would not have any of it, I may be wrong and hope I am, but I don’t think so.

People buy CI on the understanding that “if” they get diagnosed with a “condition” by their Doctor/GP/consultant and that this condition is alisted as a CI, that they are "covered"and in reality that isn’t the case.as a medical definition differs from a IC's definition.
Lets take UC, as you have some experience and knowledge of it.

Your husband has UC, diagnosed by his Surgical Consultant, he will have been on medication to address this condition for a while, he will have had all tests to confirm UC.
A Colonoscopy, History, blood results, possible histology, would have been enough for the diagnosis to be made.

However lets look at the IC’s definition.

Ulcerative Colitis shall mean acute Fulminant Ulcerative Colitis with life threatening electrolyte disturbances usually associated with intestinal distention and a risk of intestinal rupture, involving the entire colon with severe bloody diarrhea. Diagnosis must be based on histopathological features and surgery in the form of colectomy and ileostomy should form part of the treatment.

In this definition.

Abnormal blood results aren’t enough, they have to be “life threatening”
The abnormal results also have to be associated with “abdominal dissention with risk of intestinal rupture”
It has to affect the “entire colon”
“Surgery has to be formed as part of the treatment, and result in a ileostomy”

So in other words thousands and thousands of people have been diagnosed by their Surgical Consultants, as having UC, but the diagnosis is only accepted by the Insurance Companies if you meet “THE INSURANCE COMPANIES OWN DEFINITION IS MET.

There isn’t a medical definition that of any of the CI core definitions that are adopted by the ABI, and IC’s, without added embellishments.

Steph “
Have you actually made a claim yet? Regardless of what you were told on the phone you should put a claim in and then the insurer will have access to the full medical records surrounding the illness, and not just your description over the phone

littlemermaid_2

As per the above posts and TPD, when I was training at the insurance company I worked for the phrase "you have to be a vegetable" to claim under tasks definition TPD did actually come up. (I didn't work in claims, for the record). It's just not designed to cover accident and illness, it's different and this is where people go wrong. .. PTD really is for what it says on the tin!

I saw enough claims in my time that were turned down only because they did not meet the criteria. Ultimately, you sign up to the company and the criteria, if you simply don't meet it there is no right of appeal. I even saw people put claims in when they'd already been told there was no way they would meet the criteria just because they wanted to - of course increasing the number of claims that get turned down. A lot of people I dealt with seemed to get mixed up and think that critical illness is the same as an income protection policy - it pays out if you get ill. Don't work like that!

OshayAway

Very well said somewhatnew! your post really highlights the point very well (and the chump factor from a certain poster.)
I bet pedro will still try to argue black is white though. I am almost tempted to take him off my ignore list to see... maybe not!

pedro123456

Ello tweedle dumb, has been joined by tweedle dummer :rotfl::rotfl::rotfl:

mikeyboy

Evening All!

Thanks for all of your advice so far... much appreciated.

I have been trawling over the KFDs again tonight, and am still perplexed!

I like the Skandia policy, it offers a lot of cover ie: £10k/20% of insured benefit for low grade prostate cancer and angioplasty along with £50k of serious accident cover (which wouldnt affect the insured amount) which would basically pay out if hospitalised for 28 days (serious car accident etc.) The cost is £40 per month.

I can get Bright Grey cover for £23 a month, but they don't offer the 'nice to haves' that the Skandia cover provides. Are Bright Grey a big player? good level of cover overall?

Struggling to get my head round which to go for! I need to employ a DR to look at the condition definitions, as I think that this is where all the differences must be!!

Should I just stomach the extra cost and go for the Skandia?

As always... any advice would help!!!!

Mikeyboy