Dump the critical illness?

Percybridge

pedro123456 wrote: »

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 (www.abi.org.uk and 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

We never send anything to them without the express consent of the patient. We also sent the information to the patient before it is sent off to the insurers to make sure that they are happy.

pedro123456

I appreciate that percy, but are you aware of these BMA/ABI guidelines if not why not?

http://www.bma.org.uk/ethics/health_records/MedicalInfoInsurance.jsp

Also does the IC ask for "relevant PMH", when a patient makes a claim, does your surgery send "relevant PMH, or does the IC ask for FMH, and does your surgery send FMH?

ellie43

That is all very well Pedro - but in my experience IC's tell claimants that they need to see all their medical records and if they refuse to consent their claim maybe jepordised and/or any ongoing payments stopped. This is what the IC said:

If you do not provide the information we have requested during the review process we can stop your benefits being paid

and on the consent form

You do not need to give your permission but if you do not we may not be able to go ahead with your claim

They were seeking permission to obtain:
1. A copy of all my medical records
2. Information from past employers, DWP, HMRC and any other third party source deemed relevant by the IC
3. Info regarding any other insurances applied for

To be valid during my lifetime and after my death (not just during the lifetime of the policy)

As you will see from my earlier posts my claim went on over 5 years and the consent forms became increasingly wide in scope.

I am not surprised by Percybridge's comments, my GP too has been horrified by my experience.

pedro123456 wrote: »

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 (www.abi.org.uk and 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

pedro123456

Well that is my point ellie, according to these "joint guidelines" the IC have no right to ask for full medical notes and the GP has no right sending them.

These are guidelines agreed by both the medical profession (BMA)and the Insurance profession (ABI).

ps call me skeptical, but it is my belief the GP has no idea about these "guidelines" , but the IC do, and they choose to ignore the guidelines as they see fit.

pps http://www.abi.org.uk/Publications/49193.pdf

http://www.abi.org.uk/Media/Releases/2009/11/ABI_proposes_changes_to_critical_illness_insurance_definitions_to_ensure_clarity_for_consumers.aspx

shelly42

pedro123456 wrote: »

Well that is my point ellie, according to these "joint guidelines" the IC have no right to ask for full medical notes and the GP has no right sending them.

Perhaps you'd be so kind as to confirm exactly what information contained in a claimant's medical history would not be considered relevant when assessing a life or critical illness claim?

OshayAway

AlisonHarrison wrote: »

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.

Oh dear, Let me clarify. TPD is being looked at and changes implemented in the near future. However, the term TPD that is "Total and Permanent Disability" is not changing. Along with the changes to the cover itself, there was a proposal to change the name to "irreversible Life-Changing Disability" but this was abandoned at the end of last year following poor customer feedback.

You said in post 23 you thought the ABI had decided in December not to change the TPD definitions and then asked if you were wrong. I'm sorry if you only wanted an answer from Dunstonh on this public forum but what I stated is not contradictory but factually correct.

Is that a little clearer?

(I'm tempted to make a comment about not reading the (not so) small print but will resist... oops))

OshayAway

shelly42 wrote: »

Perhaps you'd be so kind as to confirm exactly what information contained in a claimant's medical history would not be considered relevant when assessing a life or critical illness claim?

Now you've done it! Not enjoyed the Pedro forum experience before have you!

pedro123456

Certainly Shelly.

Whatever the Medical professional deemed "relevant" as per joint BMA/ABI guidelines of course.

pedro123456

Grow up oshayaway and stop your bullying

ellie43

Thanks for the links pedro - very interesting. And from a personal view the classification of ME/CFS as a mental health illness (despite World Health Organisation and DofH classifications of neurological). Back in the 1990's Unum recognised that claims as a result of ME/CFS were soaring which probably is a factor in exclusion.

The problem with 'guidelines' is that IC routinely ignore them, as Alison's has said:

At one stage they tried to stop my IP and indicated that I was fit for work. When I made a SAR from them it was clear that they had no evidence to support this. They knew that they had no evidence but the file notes that I received said "......we could say that....."

In info I obtained via a SAR my insurer noted that my consultant was retiring so would not be available to support my claim.

Claimants should not have to go to the FOS or solicitors to get fair treatment.

It may well be that some GP surgeries are not aware of the new rules, which they should be. The main problem though is with the IC tactic's - and the wide range of info they seek to obtain.

I was pleased to see in Percybridge's post that his surgery lets claimants check info before it is sent out to insurers. This is good practice.

Thanks for bringing the ABI research to my attention - I had not seen the detail.:)

pedro123456 wrote: »

Well that is my point ellie, according to these "joint guidelines" the IC have no right to ask for full medical notes and the GP has no right sending them.

These are guidelines agreed by both the medical profession (BMA)and the Insurance profession (ABI).

ps call me skeptical, but it is my belief the GP has no idea about these "guidelines" , but the IC do, and they choose to ignore the guidelines as they see fit.

pps http://www.abi.org.uk/Publications/49193.pdf

http://www.abi.org.uk/Media/Releases/2009/11/ABI_proposes_changes_to_critical_illness_insurance_definitions_to_ensure_clarity_for_consumers.aspx