Critical Illnes cover Scottish Widows

crazybass

Hi

I took a policy out 8 years ago for life insurnace / critical illness with Scottish Widows.

I have been told I need a heart valve replacement and that would mean under my policy I would be covered as it is open heart.

If I have the surgery and make a recovery do they still have to pay me out.

I have had a look at there keyfacts and they say they would but I know what insurance companies are like.....

Regards

Steve

MarkyMarkD

Insurance companies aren't "like" anything. They investigate the circumstances of each claim and if it is covered under the policy terms, they pay out.

It is only where there is doubt about the eligibility of a claim that matters get complicated.

crazybass

I just thought that allthough I need to get it done and it is in there policy and I make full recovery and back to work I wouldn't be able to claim. I only took out the policy as a mortgage broker said I needed to.

Thanks for reply Marky

shackalak

I would say it depends on the conditions covered by your policy. Most cover heart attack but i'm not sure heart surgery would be covered under a critical illness plan, unless it had been caused by an insured critical illness. Some older policies provide cover for angioplasty but many newer plans don't include this now because insurers were having to pay lots of claims for this purpose and as a result, this was pushing up premium rates.

If you suffer an insured event and recover well enough to go back to work, a critical illness plan would still pay out but then the plan would stop.

Bear in mind that if you claim on a critical illness plan which includes life cover too, in the event of a critical illness claim, the life cover element is lost. If this cover is to cover a mortgage, the plan pays out and you don't use it for that purpose, your mortgage may then be unprotected. If you've had heart surgery, you may find it difficult to get new life cover.

ACG

If the conditions say it will pay out then its in black and white there is no argument it will pay out.
Critical Illness claims are paid out over 90% of the time for most companies. The reasons for non payment are non disclosure (where the client hasnt been totally honest at application stage) or where the condition doesnt meet the definition.

If your documents say it is covered and you havnt lied at the application stage then you have nothing to worry about.

weighty1_2

I'd be surprised if heart valve replacement surgery isnt covered. If it isn't but open heart surgery is then you'd likely still have a valid claim, presuming surgery isn't via a keyhole procedure. Just check the key facts document and see if it's on the list.

dpac123

If the key facts document states that your claim would be valid, Scottish Widows would pay out. Obviously they would investigate and ensure that your claim is valid, and assuming it is, they would pay out. Some policies pay out a lump sum and others pay out an income, or a combination of both, so it is worth checking which option you have on your policy.

kingstreet

crazybass wrote: »

Hi

I took a policy out 8 years ago for life insurnace / critical illness with Scottish Widows.

I have been told I need a heart valve replacement and that would mean under my policy I would be covered as it is open heart.

If I have the surgery and make a recovery do they still have to pay me out.

I have had a look at there keyfacts and they say they would but I know what insurance companies are like.....

Regards

Steve

Steve, critical illness cover pays out on the diagnosis (or after a specified period following diagnosis) of a listed critical illness or condition, but isn't dependent on your ability to work afterwards.

You receive your benefit, then are fit to return to work a few months later. You keep your benefit. There is no requirement for you to repay it.

Hope that makes you feel a bit better. I don't have a copy of the Scottish Widows critical illness definitions from 2003 but I do feel you have a good chance of making a successful claim, based on the small amount of information available. Good luck.