Over Insured.........CARDIF PINNACLE

marshallka

di3004 wrote: »

Hi Marshallka, I posted similar above, and like yourself I didn't know, no letters were sent in regards of this.
As far as we know when we first taken the cover out in 2003 it was known as Income Protection, and I am determined to find the keyfacts for this cover.
I note online it only states keyfacts for Mortgage protection.

So I'm still looking.

You won't find a key facts for it Di if its a helpupay policy as it was not (according to them) income protection but mortgage protection (although paid over the consumer in the same way).

They stated in my letters and final response all about having this Key Features document BUT when they sent information to FOS they said in 2004 they did not have ANY key features in place. As yours was 2003 then I doubt you would have had one either.

I was just annoyed how they used it in all my letters and in the final response to me and then said to FOS that they agreed, there was no key features.

Just strange how we BOTH thought we had "income protection"??

marshallka

magpiecottage wrote: »

It is true that you could claim on both at the same time. However, such a statement is, nevertheless misleading because, between them, they would restrict the total amount claimed.

It would therefore be a breach of the GISC Code whose subscribers promise to "make sure all the information we give you is clear, fair and not misleading"

That is what we thought and emailed them to ask. We were told (before and during the complaint/asking back of our over insurance) from TWO different advisors at Cardif that we could not insure for over 75% of our income otherwise one policy would reduce the other.... and and another mentioned 60% of gross income. We HAD NOT cancelled at this point..... on that advice we cancelled the policy as we were wasting money...

Then Mr V from Cardif got hold of the complaint and stated about our PHI the following


However, these schemes are not mortgage payment protection insurance
which are designed to protect secured loan repayments and not lost
income which may be applied to all categories of expenses. In view of
this, I do not concur that you had duplicate protection, were
over-insured or are eligible for a refund of all or any premiums. In my
opinion, you could have had the benefit of both policies at the same
time.

I don't know what to believe? The FOS have agreed with his statement also?

magpiecottage

marshallka wrote: »

these schemes are not mortgage payment protection insurance
which are designed to protect secured loan repayments and not lost
income which may be applied to all categories of expenses.

This is true.

In view of
this, I do not concur that you had duplicate protection, were
over-insured or are eligible for a refund of all or any premiums. In my
opinion, you could have had the benefit of both policies at the same
time.

It is possible that the Pinnacle policy would have paid out anyway but a personal PHI policy would almost certainly restrict the benefit payable unless the claim on the PPI went direct to the lender.

On the other hand, if the PHI was an employment benefit maintained by your employer, it would have paid out to the employer who could then have passed it on to you, less Income Tax and National Insurance.

However, dependent on the level of benefit, even then there might have been no NEED for cover.

di3004

Don't know if this is of any use but just came across it whilst browsing for info.
Difference between income protection and mortgage protection?



http://www.moneysupermarket.com/community/forums/p/46501/difference-between-income-protection-and-mortgage-194563.aspx

Difference between income protection and mortgage protection?


http://www.drewberryincomeprotection.co.uk/faq/25/difference-between-income-protection-mortgage-protection

Sorry not sure if I am allowed to post these on here, feel free to delete otherwise MSE team, cheers.

marshallka

magpiecottage wrote: »

Th[/FONT][/SIZE]is is true.



It is possible that the Pinnacle policy would have paid out anyway but a personal PHI policy would almost certainly restrict the benefit payable unless the claim on the PPI went direct to the lender.

On the other hand, if the PHI was an employment benefit maintained by your employer, it would have paid out to the employer who could then have passed it on to you, less Income Tax and National Insurance.

However, dependent on the level of benefit, even then there might have been no NEED for cover.

So do I have a complaint or not? Is it not wrong to tell me what they did in their first emails BEFORE cancelling the ASU upon making the complaint and was told that one would reduce the other if in fact what Mr V is saying in that they would both pay out anyway (conflicing advice when I asked)?

I know that BOTH are incomes and paid over to us.... be it called MPPI or Income protection? I have actually shown FOS here by three different people from Pinnacle saying three different things. Does that not go against "them"?

marshallka

I have just been reading this thread here

https://forums.moneysavingexpert.com/discussion/1556357

Post number 13 onwards in particular and it seems to me that these policies that pay claims over to the consumer have a lot of "legalisation problems" with everything..... its classed as "income" if a policy pays direct to you and not to the mortgage direct for all purposes. Something needs doing because those that think they are bettering themselves and looking after themselves are being penalised in the end.

Another similar thread here and dmg24 is a regular poster on these type things so I would tend to listen
https://forums.moneysavingexpert.com/discussion/1821739

Helpucover (the new name for helpupay) say

• Paid direct to you in addition to any other benefits (i.e. Statutory Sick Pay)

magpiecottage

marshallka wrote: »

So do I have a complaint or not?

That would depend.

If somebody told you that you could claim on both you when you could not then yes. However, it was only this Mr V, after you had cancelled the policies that would not be grounds to uphold it, since his error did not cause you a loss.

By contrast, if you were told that you could claim on both at or around the time you took the policy out then you may well do.

marshallka

magpiecottage wrote: »

That would depend.

If somebody told you that you could claim on both you when you could not then yes. However, it was only this Mr V, after you had cancelled the policies that would not be grounds to uphold it, since his error did not cause you a loss.

By contrast, if you were told that you could claim on both at or around the time you took the policy out then you may well do.

So his "error" was in fact an "error" and he is a manager at Pinnalce. How can you trust them?

What about the other emails that state that it would actually be worthless TBH as we could not benefit from it to its full potential which is what we took it out for? It surely must go against them (the insurance company) that they can give so much conflicting advice when taking out insurance/during insurance.

One says one thing, one says another, someone says we were over insured and we would get a refund, a manager says we were over insured and would get a refund after receiving our works policy..... it was only when Mr Vane got hold of the complaint (after we had cancelled it and that is what I think they were wanting us to do and that is why the complaint took so long to answer) that he then stated DIFFERENT.... But, it was HIS OPINION and not fact.

If a consumer had said all these different things then they would then be a try it on.... the firm can say and do what they want so it seems. I am so annoyed that FOS say they are "unbiased". They have listened to Cardif and what they "would have done" all the time and not listened to us at all. How can that be unbiased? Why is it a firm with so many unconsistencies more credible than us? They have said so many things (the key facts documents which were not around at the time) that have turned out not to the case. We never spoke to them.......non advised.....I sent FOS all the evidence of this from the emails from Cardif. FOS listened to THEM without evidence.

We cancelled the insurance after receiving a couple of different emails stating that our works policy would be reduced by the Cardif one. Why could they not say that in the beginning when asked? In fact I actually did not comlpain at first, I just wanted their opinion that since them giving it turned out that our policy would be useless. It was then I started the complaint. I thought they were a great firm TBH and they did not argue we were over insured. They got back and said they would refund.....great.... could not fault them, but since Mr V got involved all the inconsistencies came along too. It just goes to show that they are no different than some of the firms we see massive complaints about on here daily. I really thought this was a different firm. It was only after all this that I looked up all their complaints on the internet and there are loads. I suppose I should not have judged unless we had to use the insurance. They are a sham of a firm in my eyes and perhaps the worst complaints procedure I have ever known. They do not know their !!!! from their elbow.

I just hope that FOS can help in this because I really cannot let go on it. In fact I hope we have highlighted a "problem" within the industry about policies that do not pay over to the "debts"......these policies that pay over to the consumer much the same as "income protection insurance".... I have left some threads up a couple of posts prior showing about legalisation in this area. Something needs doing. We are not the scum of the earth benefit scrounging try it onners, we are the ones that wanted to get ourselves "protected" so the state would not have to. Insurance should not be like putting your money on Paddy Power, it should be based on rules and fact and no-one seems to know for definate (even IFA's on here) of this area where the consumer has money paid over to them. A very Grey area, almost black in fact.

Just been reading through thorougly the Adjudicators decision and she says she is satisfied that Pinnacle did not give any advice EVEN if we had rang them... she states that even if we had mentioned an IPI (she calls it) of 75% income they had no need to state about one policy reducing the other..... I am so confused???? Is that NOT misleading? She also states that the MPPI was specific to the Mortgage...these type of MPPI polices (in fact we thought it was income protection) are paid DIRECT to the consumer so different rules. She says that if a consumer asks the question then Pinnacle were quite right to say that their policy and the IPI would pay out....? I call it misleading? God this is cracking me up now!!

You said here

Quote:
I was told by the advisor that it would be fine to claim on both policies at the same time (even when knowing that our other policy was for 75% income)
It is true that you could claim on both at the same time. However, such a statement is, nevertheless misleading because, between them, they would restrict the total amount claimed.

It would therefore be a breach of the GISC Code whose subscribers promise to "make sure all the information we give you is clear, fair and not misleading"


BUT Mr Vane is still misleading whereby he states you can claim on both policies at the same time..... even after knowing, seeing and reading our works policies..... he is "misleading to this day".. does that not account for anything?????

In fact I am going to SAR them. I should have done this long ago although they say they do not hold records... we complained within 6 years. They say they do not have records of our applying and can only generate what "we would have seen".....

In fact I want to get to the bottom of this so much and will be making another complaint that on advice of their advisors (two fo them) we have now cancelled the policy IF it was that we could have used both to FULL potential which is what we purchased it for. That was the point of "asking" before complaining.

I just enquired IF we were over insured

This is one of the replies I got before we cancelled

Dear ,

Thank you for your recent e-mail.

Thank you for clarifying the situation.(we had to send them a copy of what we had about our PHI) I have discussed this with my manager, and she has agreed that you have had duplicate cover since 7th September***** with Friends Provident and in March ***** you had Accident and Sickness Cover with Marsh Financial Services Ltd.

We had always since having THEIR insurance been covered for the Accident, Sickness part... granted the unemployment was not covered as PHI does not cover unemployment.

Now we have cancelled because of this and another person who stated the same.

Before this email we had a reply that we were over insured IF our income was insured for more than 65% against sickness, accident (which it was) and they said we then had duplicate insurance.

Mr V's final response was based on the fact that he said we were not over insured so I feel it is relevent to the complaint IF what he said was misleading regardless of when we cancelled



However, these schemes are not mortgage payment protection insurance
which are designed to protect secured loan repayments and not lost
income which may be applied to all categories of expenses. In view of
this, I do not concur that you had duplicate protection, were
over-insured or are eligible for a refund of all or any premiums. In my
opinion, you could have had the benefit of both policies at the same
time.

magpiecottage

Sorry - I am getting confused here. Let me state my understanding of the situation

1)I have only just picked up on the fact that it was employer provided but the PHI policy is owned by your employer, not you. If you were too ill to work, it would pay a sum each month to your employer who would pay some of it to HRMC as National Insurance and Income Tax and the rest to you.

That should NOT be affected by any insurances you might have because the contract of insurance is between your employer and the insurer.

This is different to a personally held PHI policy.

2) You have MPPI. This would pay, subject to its terms and conditions, if you could not work through illness, disability or unemployment.

The first question therefore seems to be "Would this policy pay benefits simply if you were too ill to work or only if your employer stopped paying an income to you if you were too ill to work?"

If it is the former, then you do seem to be entitled to a duplication of benefit. If so, the next question is "Where you simply told you could have both benefits or did the firm actually make comment about the merits of doing this?" If the former, it is simply a statement of fact and there is no need to consider suitability.

If the latter, it is advice which may be relevant but even then may not cause a complaint to be upheld as it could have been part of a comment that you were paying for an incapacity benefit which was not strictly necessary but would also receive an unemployment benefit which your employer would not provide.

If, on the other hand, the policy only paid benefits if the employer stopped paying an income, the next question is whether the firm commented on the merits of paying a premium when the employer would continue to pay an income if you were ill or disabled anyway. Again, this would amount to advice but it might still not lead to a complaint being upheld if the value of the unemployment benefit, which the employer could not provide, had been explained to you.

marshallka

magpiecottage wrote: »

Sorry - I am getting confused here. Let me state my understanding of the situation

1)I have only just picked up on the fact that it was employer provided but the PHI policy is owned by your employer, not you. If you were too ill to work, it would pay a sum each month to your employer who would pay some of it to HRMC as National Insurance and Income Tax and the rest to you.

That should NOT be affected by any insurances you might have because the contract of insurance is between your employer and the insurer.

This is different to a personally held PHI policy.

2) You have MPPI. This would pay, subject to its terms and conditions, if you could not work through illness, disability or unemployment.

The first question therefore seems to be "Would this policy pay benefits simply if you were too ill to work or only if your employer stopped paying an income to you if you were too ill to work?"

If it is the former, then you do seem to be entitled to a duplication of benefit. If so, the next question is "Where you simply told you could have both benefits or did the firm actually make comment about the merits of doing this?" If the former, it is simply a statement of fact and there is no need to consider suitability.

If the latter, it is advice which may be relevant but even then may not cause a complaint to be upheld as it could have been part of a comment that you were paying for an incapacity benefit which was not strictly necessary but would also receive an unemployment benefit which your employer would not provide.

If, on the other hand, the policy only paid benefits if the employer stopped paying an income, the next question is whether the firm commented on the merits of paying a premium when the employer would continue to pay an income if you were ill or disabled anyway. Again, this would amount to advice but it might still not lead to a complaint being upheld if the value of the unemployment benefit, which the employer could not provide, had been explained to you.

Cardif did say that they would pay out regardless and the PHI would be reduced by their amount (which it IS as its "income" regardless)..... they then said they would refund as we were over insured. They gave this advice after "enquiring", before actually complaining and in an email AFTER they received details of our WORKS PHI.... on that advice (from two different employees and having been passed by Management too) we cancelled the policy. (who wouldn't).

The details they had to this point was of the works PHI was only that it was employers/works PHI and it was 75% of gross income deferred whilst receiving company sick pay (full) and deferred for 26 weeks. It covered sickness, accident and disability and paid out until retirement. All insurers KNOW (we did not though!!!) that 75% is the maximum amount you can insure yourself for as you cannot make yourself better off by being ill. As Pinnacle said that we were over insured IF we had more than 65% of our income insured (which we had already).

Group PHI is not any different to PHI in the way that you state above. Group PHI is still insurance that is insurance for a "member". The "member" being the "employee" and not the "employer" who takes out the policy. This is in regards to ALL group income protection policies. Take a look online at the technical guides on PHI insurance.

I have since found out that IF a policy pays out to ""you" direct then it is classed as "other income/insurance". If a policy pays straight to a loan/mortgage (which is what older type policies did before including "other" expenditure which they can now) then this would probably not be taken into account when claiming on "other insurance". it is still debatable (and obviously a RISK which insurance should not be) as to other policies not being taken into account that are paid direct to the lender. (again MOST people have no idea of this but do find out when they come to claim).

I did not know all this but surely an insurer would have to know of a 75% maximum gross income insurance..... I even asked in an email to the ABI and they stated that there is maximum combined insurance.

There is a big difference in the legalities on MPPI that pays direct to you (even if it is to pay the mortgage AFTER) and upon trying to claim JSA/benefits this often crops up. These legalities seem to always crop up when people come to claim. These rules need to be clear, fair and not misleading as people are being penalised for trying to help themselves.

Cardif pinnacles policy terms and conditions actually make no mention of "other income" whilst claiming, "other insurance" whilst claiming or HOW the money is paid over to you. Apparently we had things explained in the key facts.... which we never had. There was no mention in their "policy summary" either. They do however now mention a percentage of income that you can insure for and also other firms do also. They also mention that they pay their insurance DIRECT to the consumer. It also mentions that you can claim as well as receiving statutory sick pay BUT does not make any mention of "employers full sick pay"... doesn't anyone think that these things need highlighting?????

It is OK saying to read your terms and conditions BUT sometimes terms and conditions are not enough because they do not cover these important things about sick pay and other insurance when policies pay direct to the consumer. I know that ALL income protections had to have a key features documents because of these issues and also polices whereby they were Expenditure related (e.g mortgage) protection plans. This would make things so much easier.

I don't know if this applied to short term insurance income protection's also about the rules that the ABI Statement of best practice stated about Key Features but surely it would be better they did.

I will just have to wait for the outcome of my complaint and going by what you have said above it looks like you think I have no chance whatsoever but in all fairness we have been messed about and now we have cancelled on THEIR advice that we WERE over insured. I shall make another complaint IF we had good insurance that we could have used to full potential (which is what we took it out for).