Life Decreasing Assurance

jas65_2

Hi there. More than 2 years ago my wife was diagnosed with M.S, and after looking at our decreasing life assurance policy, with critical illness cover, discovered that She was covered on the policy. We sent in a claims form to the Insurance company. Only for them to find a way out of not paying up, and cancelling our life assurance cover, also paying back into our bank account, all the funds that We had paid in from 2003 to 2007 which is when my wife was diagnosed with M.S.

We have since been to a solicitor who has taken on our case, and has been dealing with it for the last 2 years. The case was put forward to the Courts in July of this year, and has to be sorted out within four months of that date. So hopefully we will have an answer one way or the other by the middle of November. I will keep you updated as to what happens, and will go into more detail once the case is over with. I will also mention the Companies involved, which are two well known companies.

stephenni1971

Only for them to find a way out of not paying up

Or the possibility that you had no cover under the terms of the policy?

lso paying back into our bank account, all the funds that We had paid in from 2003 to 2007 which is when my wife was diagnosed with M.S

If they have taken this step its likely that they found something important enough that they never would have given you the cover in the first place had they known.

It sounds like an issue with disclosure at the time of application.

We have since been to a solicitor who has taken on our case, and has been dealing with it for the last 2 years

Thats quite a while. Did you follow the insurers complaints procedure first?

I will also mention the Companies involved, which are two well known companies

Did you take the policies out yourself direct, or did you use an intermediary such as an IFA or bank?

starrystarry

jas65 wrote: »

Only for them to find a way out of not paying up, and cancelling our life assurance cover, also paying back into our bank account, all the funds that We had paid in from 2003 to 2007 which is when my wife was diagnosed with M.S.

That's got non-disclosure written all over it.

I'm getting fed up of hearing people say insurance companies will do anything to avoid paying out. I'm going to start countering with "applicants for insurance will do anything to avoid giving honest answers to direct questions".

*MF*

FWIW ... earlier post from OP elsewhere on MSE provides some more details:

http://forums.moneysavingexpert.com/showpost.html?p=10076695&postcount=2888

dunstonh

Only for them to find a way out of not paying up, and cancelling our life assurance cover, also paying back into our bank account

That is the typical outcome when there is non-disclosure on a material fact that would have meant they would not have offered cover from the start had they known.

The FOS has clear guidelines on non-disclosure issues and these are published.

If it is a non-disclosure issue, then I'm surprised a solicitor has taken it on board. Especially assuming that you have already exhausted the normal complaints process which is free of charge to use.

sandsy

Based on your other post, this is clear non-disclosure. Ultimately, you sign the proposal form to say that all the information on it is correct, even if someone else filled it in for you.

ACG

Some companies are stricter than others with non disclosure.

Friends Provident for example has a proportionate benefit system built in so if they find something you did not mention preuming its not related they will pay out a percentage depending on what the premiums were that they would have charged.

But i think some people are correct in that it is definate non disclosure, whether or not it is linked or something stupid that theyre using to wriggle out is a totally different debate but it does look like you have missed something out. Might be worth checking if they requested a medical or GPR as then you have the argument they had the info but missed it?

dunstonh

Since the FOS publication on non-disclosure, things have been a lot better. Insurance companies know exactly how the FOS are going to look at any complaint. So, they dont have a lot of room to wriggle.

I'm not sure how taking the insurer to court is going to help though as they have done nothing wrong. They didnt fill the forms in and they only acted on what they were told. The liability is with the consumer and the person that filled out the forms.

starrystarry

dunstonh wrote: »

I'm not sure how taking the insurer to court is going to help though as they have done nothing wrong. They didnt fill the forms in and they only acted on what they were told. The liability is with the consumer and the person that filled out the forms.

That's true if it was an IFA. If it was an AR then the insurance company might be liable, since the AR was acting as their agent rather than the consumer's.

Either way, I personally don't think there's any excuse for signing the form without reading what answers the selling agent had written down.

jas65_2

Hi there, and thanks for all your replies. Although most of them seem negative. They are refusing to pay out for none disclosure. However We answered all the questions that were asked of us, knowing that if We answered incorrectly, this would be picked up when they requested the medical notes.
The Bank asked us if We had Life Insurance, to which We replied no, but We were looking, so they said they would send out an advisor, which they did.
He never offered for us to fill out the form. He just sat there, asked the questions, and We answered the best We could. We were both a bit naive as far as Insurance is concerned, so We thought Him being an expert, He would offer the best advice, and He knew what He was doing. He never offered us any other policies, other than the one We took out, yet according to the Bank, He was able to sell any policy with any company, but when we checked the back of His business card, only a couple of weeks ago, it said He could only sell (the company we ended up with policy's). As We are both smokers, obviously the premiums were very high, so We just told him to insure myself being the main earner. He asked us both to check our names, and Birth dates were correct, then sign. One of the questions He asked was. Has my wife ever been off work with depression. She said yes. I'm off at the moment, and will be back to work next week. He even wrote the medication that she was on down on the form. However, when he sent it in He had ticked no to her having time off work, but there was an exclusion for any mental disorders on the policy anyway, but they still picked up on that when we put a claim in, stating that she had had 4 months off work with depression, and not declared it, and if they had known that, they would have deffered the policy for 12 months.
Untill the insurance form came through, We didn't even think that She had been insured, because He had told us it would be £78 a month for the both of us, thats when we said just insure me for now, but they insured both of us for £33 a month??? and only when the policy came through did We realise who We were insured through, untill then We thought it was the banks own policy.
According to the Guy that visited us from the Bank. He made 2 visits to the house. The second time to do a fact finding form. He never, He only came the once. An indipendant underwriter has said that if he was the underwiter for the insurance firm. He would have requested to see further medical evidence from the Hospital due to the fact that my Wife had, had depression, so would have noticed that she had been off work.
He also finds it amazing that the insurance company had put on a disclosure for mental illness, but not for smoking, as an Asthmatic smoker.

dunstonh

An indipendant underwriter has said that if he was the underwiter for the insurance firm. He would have requested to see further medical evidence from the Hospital due to the fact that my Wife had, had depression, so would have noticed that she had been off work.
He also finds it amazing that the insurance company had put on a disclosure for mental illness, but not for smoking, as an Asthmatic smoker.

I have had cases with depression go through without requiring further medical evidence.

Can you clarify what you mean by disclosure for mental illness but not for smoking. Both things are covered in life assurance application forms. Is that what you mean? Or do you mean when the policy was set up they put in a clause about mental illness?