Dump the critical illness?

OshayAway

AlisonHarrison wrote: »

Nice attempt at wriggling out of previous comments but not quite good enough.

Where's the "wriggling"? All I have done is point out your mistake quoting from mine and your comments. When you're wrong you're wrong, if you're to proud to admit that, that's up to you.

kingstreet

mamaq wrote: »

Hello,

I'm hoping to get some observations on my situation and perhaps people's own experiences and choices.

Both my wife and I have had CI policies to cover the mortgage payments for over 10 years, spending around 100GBP per month. So I think we've paid out a fair old whack of cash which could have gone straight onto the mortgage by now. These policies are from a reputable insurer (Scottish Provident), bought through an IFA but still have plenty of exclusions and potential get-outs, I think.

The motivation for this is concerns that my employer doesn't have very good provision for sickness pay. With money getting tighter all the time, I'm considering whether these policies remain desirable or whether the money might be better used on some for of income protection. My thinking is to cancel the CIs, take out IP, save money and get a more practical cover.

Does anyone have any thoughts/observations? Anyone made a similar decision?

Thanks in advance

mamaq

If you have stand-alone critical illness cover, you might want to think about changing it for "death or earlier critical illness cover" which might reduce the cost of both your life cover and critical illness cover, although you would then get only one payout.

You could consider changing from level to decreasing cover if you are using it to protect a mortgage. You could also get comparative quotes to see if another provider might be cheaper. Reviewable rates may be a cheaper option if you have a guaranteed policy now.

Replacing critical illness cover with income protection cover is a very subjective issue and one you should consider carefully and only with advice from an IFA. If possible, reduce the cost of your CI and use the saving to fund income protection on top, not instead of.

As a small defence of Scottish Provident, notwithstanding other individual members experiences, the ability to claim for certain conditions (Coronary Artery Bypass Grafts, Heart Valve Replacement) without a sternotomy being necessary is potentially a valuable difference to alternative providers' products.

Finally, picking up on what was said earlier about TPD. I'd like to see it removed altogether. It is a benefit which can give unrealistic expectations and has the potential to further undermine the public's (lack of) confidence in the protection sector.

pedro123456

kingstreet, lack of customer confidence will not be addressed by removing TPD from CI cover, neither will clarification of TPD by the ABI.although yes lack of public confidence is rife.

The ABI are there to look after the interests of the IC's, definitions of their conditions are far removed from a medical definitions, these definitions of theirs have to "have bells on".

Definitions by the IC's for the IC's..........it that simple, and thats just 1 problem

Percybridge

pedro123456 wrote: »

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?

Yes I am aware of the guidelines.
More often than not the IC ask for copies of the notes when a person makes the claim.
Some, but not all, ICs ask for notes when a person takes out the policy. I generally tell the patient to cooperate fully at that point to avoid any issue of non disclosure at a later stage.
Generally, patients will tell us to send the notes regardless. Often they are intimidated by the ICs and are mistakenly lead to believe that a refusal at that point will jeopardise their benefits.
It is a disgrace sometimes how the ICs behave, often towards seriously ill and often terminally ill patients.
When a patient takes out a policy the ICs are very keen for us to offer opinions. However, it is very often the case that when a patient tries to make a claim, our opinion is not good enough. Particularly when they do not like it.

OshayAway

Percybridge wrote: »

Some, but not all, ICs ask for notes when a person takes out the policy.

If you are stating that Insurers request full medical notes (pre on-risk) rather than specific questions including date ranges, I would have to say that I very much doubt that.

pedro123456

Thanks Percy, its good to know you are aware of these guidelines, however I suspect many GP,s, Doctors/Consultants are not.

There ought to be a way of highlighting these guidelines to the medical profession, as it may even the playing field up for the consumer, and remove some of the power held by the IC over the policy payer.

IMO it’s the fault of the BMA not bringing these guidelines to the attention of their profession. They do however bring “fee’s” jointly agreed by the BMA/ABI, how strange?
As for your disgust of the IC’s, I and many others (IMO) would have to agree.

There is a lot of money involved in insurance, and it is in the interest of the IC to sell their wares at any price. As indeed its in the interest of IFA’s to peddle them and defend them, just look at the amount of IFA’s in this forum day in day out, why do they spend time on a “consumer forum”?, is it to offer advise for free?
That isn’t to tar everyone with the same brush, as there are many on this insurance forum that are very helpful/knowledgeable

Marketing products as “Top of the range, cant live without products”, and yet when the time comes to claim they become “useless pieces of paper, filled with a massive amount of “get out clauses”., that they call their Terms &Conditions .
As a GP, you would be aware of current “medical definition” of say a MI (heart attack), and how to diagnose a heart attack via that definition. Now look at the IC’s definition of a heart attack and compare.

Or……..look at any Medical definition and compare with the IC’s definition. and see which one has bells on

These definition discrepancies are what form part of the IC’s “limbo dancing under a grass snakes belly” techniques to avoid payment, and of course there are other get clauses they have.
These are just a few causes of the “lack of public confidence” the ABI spout about addressing :rotfl:

OshayAway

pedro123456 wrote: »

As a GP, you would be aware of current “medical definition” of say a MI (heart attack), and how to diagnose a heart attack via that definition. Now look at the IC’s definition of a heart attack and compare.

At the risk of opening a can of worms there is an important point here that highlights the benefit of advice.

Not all insurers provide the same conditions but in order for them to state that they cover a specific condition, it has to conform to a minimum definition set out in the ABI Statement of Best Practice for Critical Illness Cover. However, some providers chose to go above and beyond the minimum definition to make it less likely for a claim to be turned down.

Your example of Heart Attack is a good one. It's also the second biggest cause for claims industry wide. It is estimated that 15% - 25%+ of heart attacks are classed as "silent", that is, there is an absence of pain (or only mild chest pain). Prior to just a few years ago, it was very difficult to categorically diagnose such cases. But roughly 10 years ago, it was discovered that a simple blood test to check for the presence of cardiac enzymes or Troponins recorded at a certain level does provide a definative diagnosis.

Many critical illness plans still include the clause that a valid claim requires "evidence of typical chest pain" so would not pay out on a silent heart attack even though it could be clinically diagnosed by a cardiologist. In contrast, there are many that now have removed that clause and at least one that never even introduced it (Scottish Provident if memory serves).

All of this information, and similar things for other conditions, is made readily available. But without a good advisor to point advantages like this out, how many individuals would take on board these differences?

pedro123456

" However, some providers chose to go above and beyond the minimum definition to make it less likely for a claim to be turned down"

Really OshayAway? who?, would you like to put up their definition of a "heart attack" so we can have a look please?, we can then compare it with a medical definition.

pedro123456

OshayAway
In the past a heart attack would have been diagnosed by a patient having any 2 of these 3 symptoms.
1 Typical chest pains/shortness of breath.
2 raised cardiac enzymes.
3 changes in ecg , flipped t waves and or st elevation.

More recent developments suggest raised Troponins alone are sufficient evidence to diagnose a heart attack.
Maybe Percy will correct me if I am wrong.

OshayAway

pedro123456 wrote: »

OshayAway
In the past a heart attack would have been diagnosed by a patient having any 2 of these 3 symptoms.
1 Typical chest pains/shortness of breath.
2 raised cardiac enzymes.
3 changes in ecg , flipped t waves and or st elevation.

More recent developments suggest raised Troponins alone are sufficient evidence to diagnose a heart attack.
Maybe Percy will correct me if I am wrong.

No, you are right. That is my point. Regardless of definitive clinical diagnosis, if a policy specifies the clause I refer to it will not pay out.

Hence, the value of (good) advice where things like this are brought to the attention of the person wanting critical illness cover.

Regarding naming providers that do have the enhanced ABI+ condition, I don't want to stray into giving advice on here but any protection adviser /broker or insurer will provide that information on request.