Dump the critical illness?

dunstonh

It was due to issues on "old" cases that led to the requirement of clear cut published definitions and the FOS laying out some ground rules to the insurers. Since then the payout rates have risen from around 65-75% to 90-95%.

It also interesting to note that both of you mention the same company. It is one that is known to be a bit harder on claims. Claims information & quality of cover is one of the things that IFAs should consider when giving advice. FAs don't have to as they only have their tied company to offer and people who DIY typically go by price and buy the cheapest (and that is potentially an issue just waiting to go wrong).

AlisonHarrison

dunstonh wrote: »

It also interesting to note that both of you mention the same company. It is one that is known to be a bit harder on claims.).

My IC is not Scottish Provident. It was a different insurer.
It is interesting what you said in another post that there had been changes to the TPD definitions. I thought that ABI had decided in December not to change them. Am I wrong here?

OshayAway

AlisonHarrison wrote: »

Anyway, I hope everyone else reading the post is able to understand that and take heed from negative experiences we have both had.

I hope that people consider that 4% - 7% of claims (in 2009) are not paid due to not meeting the policy condition and don't view that as a reason not to take out the cover. Rather, I hope that it has the effect of encouraging them to understand the cover properly, how they vary between providers and ideally take decent advice.

OshayAway

AlisonHarrison wrote: »

My IC is not Scottish Provident. It was a different insurer.
It is interesting what you said in another post that there had been changes to the TPD definitions. I thought that ABI had decided in December not to change them. Am I wrong here?

Yes, you are wrong. They decided not to change the term 'TPD' a mistake IMO.

Burridge60

MM seems to be a lot of heavy metal swinging around in this post better used to roof churches.

I was at meeting recently where an Insurance Company Claims Manager was speaking. He happened to mention as a comical aside that the only department in his company that were entitled to log on to Facebook everyday despite their companies usage policy was their Claims Department.

As a result they declined amongst others the claim of the lady who managed 18 holes of golf three times a week but was claiming to be unable to work due to chronic back pain.

Now I am no athlete but I ache less after going to work than I do after 18 holes of golf!

What amazed me more was in the indignation amongst an audience of IFAs that they should stoop so low as to use peoples' Facebook postings against them!

Do people lie to Facebook and Insurers?

Percybridge

I am not sure where you get your figures of 4-7% of people who do not meet the terms of the policy. However, assuming you are right that is nearly half of people who do meet the terms of a TPD policy being denied the payout. This does not surprise me. I am a GP and often get involved in cases and have seen some appalling practices by insurance companies when dealing with both TPD and income protection cases. It is more difficult for them to wriggle out of paying for other aspects of the critical illness policy as the medical diagnosis is so clear. But there is far more scope for them to do so with TPD.

OshayAway wrote: »

Yes, you are wrong. They decided not to change the term 'TPD' a mistake IMO.

She is not wrong. What are you talking about? She said she thought that they had decided NOT to change the definition, but was asking DunstonH whether this was correct as he appeared to have other information. You really should read posts properly before responding, which makes me question your stats.
People definitely should be aware of the behaviour of insurance companies before taking out the policies, and also, as DuntonH says, it may be a good practice for IFAs to warn consumers about how harse individual companies are.

Percybridge

Burridge60 wrote: »

MM seems to be a lot of heavy metal swinging around in this post better used to roof churches.

And you know this how???? I am a GP and I cannot tell from this thread. You must be a genius.

OshayAway

Percybridge wrote: »

I am not sure where you get your figures of 4-7% of people who do not meet the terms of the policy. However, assuming you are right that is nearly half of people who do meet the terms of a TPD policy being denied the payout. This does not surprise me. I am a GP and often get involved in cases and have seen some appalling practices by insurance companies when dealing with both TPD and income protection cases. It is more difficult for them to wriggle out of paying for other aspects of the critical illness policy as the medical diagnosis is so clear. But there is far more scope for them to do so with TPD.

She is not wrong. What are you talking about? She said she thought that they had decided NOT to change the definition, but was asking DunstonH whether this was correct as he appeared to have other information. You really should read posts properly before responding, which makes me question your stats.
People definitely should be aware of the behaviour of insurance companies before taking out the policies, and also, as DuntonH says, it may be a good practice for IFAs to warn consumers about how harse individual companies are.

Erm... no, what I said is correct. Perhaps you should re-read the posts.

As for the claim stats, they are also correct and in the public domain. There is a thread on this forum somewhere so do a search or google it. I'm sure a clever old GP like yourself can manage that.

pedro123456

Percybridge, as you say you are a GP, can I ask if you are aware of this document.

http://www.bma.org.uk/images/medicalinfoandinsurancemarch2010_tcm41-195140.pdf

and its directives of a GP providing only relevant information to the IC,

4. General practitioner reports
The ABI and BMA have developed a standard GPR form, which is available on the ABI and BMA
websites (https://www.abi.org.uk and https://www.bma.org.uk) and is widely used.
Only relevant information should be provided and it is ethically unacceptable to provide extraneous
information. Doctors must not send originals, photocopies or printouts of full medical records in lieu
of medical reports and ABI members should not accept them. The full records are not necessary and
will very probably include information that is not relevant to the insurance being applied for. Insurance
companies only need information that is relevant to the policy. Disclosure or other processing of
information that is released without the consent of the applicant or insured person is likely to breach
the Data Protection Act 1998, and may compromise a doctor’s registration.

or is it common practice at your surgery to just send all PMH to the Insurance company, because the IC request it? :undecided

AlisonHarrison

OshayAway wrote: »

Erm... no, what I said is correct. Perhaps you should re-read the posts.

No it is not correct. Read post 25.

If you note from my previous posts I said that I was under the impression that the TPD definition had NOT been changed. However, DunstonH said that it had.

I responded by asking him if I was wrong in making my assumption.

You then jumped in and said I was wrong and it had NOT been changed.

If you look at post 25 you will see that you are contradicting yourself.

Anyway, I hope that DunstonH tells me that it has been changed and I was wrong after all as it would make things a lot better for claimants who are being mistreated on this part of the policy.