Critical Illness cover

greenoak

I have just been looking at my endowment policy statments and noted that i also have critical illness cover with my policy.

The policy was originally with Scottish Amicable and this is now a Prudential policy

Now I had a minor heart attack last May which appears to qualify.

However the polict states I have to submit a claim within 6 months. My HA was 8 months ago.

Is there any hope I can still claim?

Thanks

FinAdv

Hi,

Sorry, this is probably what you dont want to hear but its the truth.

Insurance companies try their best to find a way not to pay the claim and if it states clearly in the T & Cs
that the claim should be submitted within 6 months, I dont see any chance.

But, you can try your luck by calling them and speaking to them.

Cheers

dunstonh

Most providers will not enforce the timescales as long as they are reasonable and you have a good reason. Your reason sounds fair enough. Even if they digged their heels in, I cannot for one minute think that the FOS would let them get away with such a short period over their limit.

The longer past the claimable event, the harder it can be for them to obtain the necessary proof or tests to satisfy claim requirements.

Gene_Hunt_2

You may also find your no longer covered on the policy.

pedro123456

greenoak, you say "Now I had a minor heart attack last May which appears to qualify", now as already said the IC "try their best to find a way not to pay the claim", even if they did not enforce the time scales, I am hard pushed to see them accepting your claim.

You have to meet the IC definition of an heart attack, and I suspect a "minor heart attack", that you and your GP may think amounts to a valid claim doesn't exist in their definition. ::think:

gook luck anyway.

FinAdv

I dont think its a good enough reason to not enforce the timescales.

Its just that Greenoak wasn't aware that he had CIC included in the endowment policy. I beleive its carelessness on his part as I'm sure he didn't go through the documents which would clearly state what he was covered for.

He probably needs much better reason to justify and convince the company why he didn't claim within the 6 months.

dunstonh

He probably needs much better reason to justify and convince the company why he didn't claim within the 6 months.

So, if they refuse and he then has to pursue a complaint to the FOS, then he should say that the shock and distress of the event on such a life changing issue meant that he didn't get a chance to claim within, what is a very small window, as his head was not in the right place.

See FOS publication 32

32/12
life assurance policy – request for waiver of premiums made "too late" – whether firm should reconsider granting the request

After suffering a heart attack, Mr F needed heart bypass surgery and he was seriously ill for some months. Nine months after his heart attack, Mr F contacted the firm to ask for a "waiver of premiums" for his life assurance policy (in other words to suspend his payments for a period). He was still not well enough to return to work, even part-time, and his earnings had been substantially reduced.

When the firm told him that it was unable to consider his request, Mr F came to us.

complaint settled
Under its policy conditions, there were certain circumstances in which the firm could allow policyholders to suspend payments temporarily. These circumstances included ill health, but the policyholder had to apply within six months of becoming ill. So the firm said Mr F had left it too late to apply.

Mr F and his wife told us that the months following his heart attack had been very traumatic and there had been some doubt as to whether he would survive. Mrs F said that her only concern during this period had been her husband’s health. It was only when his condition improved that they were able to start thinking about other matters, including their finances.

We accepted that the firm was not under any contractual obligation to agree to the couple’s request. However, we suggested that in view of the couple’s circumstances and the seriousness of Mr F’s illness, it should review its decision. The firm agreed to waive the premiums for a certain period.

greenoak

I have spoken to the life company and I am covered for CI, i did not even know endowments had CI as an option, i thoufght it was just life cover no more.

I meet the terms of a heart attack in the policy. Its a very old policy and wording is nothing as restrictive as new ones.

I have requested the claim form which can take a week to arrive.