Critical Illness Advice pls?

quietheart

badger247 wrote: »

I wonder is a complaint to the Financial Ombudsman would result in your non-disclosure being deemed "innocent"?

Sorry I'm not sure what you mean.
Do you mean I could possibly get their additional 'back' clause overruled?
Don't mean to be dim....:o

dunstonh

The FOS published guidelines some time back on non-disclosure cases. Accidental/innocent non disclosures are treated differently to intentional. However, non-intentional non-disclosure can still result in no pay out or a reduced one.

quietheart

dunstonh wrote: »

The FOS published guidelines some time back on non-disclosure cases. Accidental/innocent non disclosures are treated differently to intentional. However, non-intentional non-disclosure can still result in no pay out or a reduced one.

Thanks. Do you think it would it be worth contesting Friends Provident's additional back clause or not?

starrystarry

There's nothing to contest quietheart. FP weren't advised about your previous back problem at the time you took the policy out. Whether that was your fault or your IFAs isn't really relevant. FP are entitled to revise their terms to those that they would have offered if they'd known about your back problem from the start.

quietheart

starrystarry wrote: »

Pedro, you're only partly correct there. The insurance company should not ask for quietheart's full medical records and I can guarantee that they won't have.

Well they have actually. I have a letter that states "I have written to your GP to ask for a copy of your full adult medical records".
If they aren't meant to do this should I complain, is there any point?
I would appreciate the views of those of you in the insurance industry, Friend's Provident have made me feel like a criminal during this process so if they have been negligent I would like something done about it.

pedro123456

Quietheart, print out the FULL guidelines, highlight SECTION 4, take them to your GP (I presume you mean they have written to the GP), and take a copy of the letter from the IC.

Ask your GP to consider the guidelines and request they send only medical records that are RELEVANT (in his/her opinion) to your claim for the stroke, in accordance with the joint ABI/BMA guidelines.

The GP is being paid for this by the IC, he/she may not be aware of these guidelines.

As for the IC asking for FMH, that aint surprising they think they are a law unto themselves, you know what they say “where there’s a fiddle, you’ll find an insurance company”

quietheart

pedro123456 wrote: »

Quietheart, print out the FULL guidelines, highlight SECTION 4, take them to your GP (I presume you mean they have written to the GP), and take a copy of the letter from the IC.

Ask your GP to consider the guidelines and request they send only medical records that are RELEVANT (in his/her opinion) to your claim for the stroke, in accordance with the joint ABI/BMA guidelines.

The GP is being paid for this by the IC, he/she may not be aware of these guidelines.

As for the IC asking for FMH, that aint surprising they think they are a law unto themselves, you know what they say “where there’s a fiddle, you’ll find an insurance company”

It's too late for that. The full medical records were sent and Friends Provident have accepted them and picked through them. They've now written to me accusing me of negligence (see earlier posts for detail). I will take it up with the GP but I'm more annoyed with the IC. I just wondered if there is a point to complaining to them about them not following the guidelines.

pedro123456

"They've now written to me accusing me of negligence" Could you explain this a little more quietheart?,

It would also be handy to know why you didn't meet their definition and who diagnosed your stroke etc GP/Neurologist?,

My initial thought is to consider complaining to the FOS, but first you have to have a final responce letter from the IC.

happypearl

Hi

Sorry to hear you have been having problems. We have just put a critical illness claim following my husband having a stroke. Would you mind telling me why they rejected yours? Was it that they queried the diagnosis or because they say you didn't disclose your full medical history. Thanks and good luck.

janetmarshall

I've read all the info with interest - I'm just about to send in a claim form and I had ticked the box to say that I didn't wish to see any medical report or records before they were sent to the insurance company. However, after reading this I think I'll change my mind and see everything before it's sent. Thanks again and good luck!