decreacing term assurance with criticall illness cover without profits

sammy_a.

please can anyone help ! im sooo confused we were told to take out the above with legal and general through a mortgage advisor who told us that because my husband had a pre excisting condition it would be the safest move to make to protect our self financily then if any thing happens in the future we will be covered, also he said it was part of the mortgage proposal anyway so you could say it was compulsary !!!
well a year and half later we put a claim in because my husbands illness deteriated and he was off work on the sick we only had stattutary sick pay to live on and there were 6 of us in the house great stuff eh! we put a claim in to the leagle and general so we could pay the mortgage but guess what we recieved a reply 3 months later stating that they refuse to pay out anything because my husband had a pre-excisting condition we were devestated and eventualy our lovely home was reposesed, do you think that we have grounds to put a miss-sold claim in or was it just our bad luck ?:(

ACG

Definitely!

Your broker should/would have known that pre existing conditions are not covered.
If he has sold it on the basis you can cover existing conditions then hes either a con man or very inept.

Find your paperwork if you still have it, it should say what to do if you have a complaint.

dunstonh

well a year and half later we put a claim in because my husbands illness deteriated and he was off work on the sick we only had stattutary sick pay to live on and there were 6 of us in the house great stuff eh! we put a claim in to the leagle and general so we could pay the mortgage but guess what we recieved a reply 3 months later stating that they refuse to pay out anything because my husband had a pre-excisting condition we were devestated and eventualy our lovely home was reposesed, do you think that we have grounds to put a miss-sold claim in or was it just our bad luck ?

We need to clarify some things first. CI cover is underwritten at point of sale. A pre-existing condition is declared and the insurer decides whether they will offer standard terms, rate the premiums or put restrictions on the policy.

If restrictions are put in place you are told of these and given the choice to accept them or not. A pre-existing condition would not make the policy mis-sold

I'm surprised L&G referred to it as a pre-existing condition though. I would have thought they would have mentioned it as an exclusion or pointed to the exclusion given at point of sale. That is unless it was not disclosed at application (which could be a mis-sell reason)

So, at this stage, I dont want to go in quite as strong as ACG has as saying yes you have been mis-sold as many advisers quite correctly put in CI applications for people with existing conditions and there is nothing wrong with that. It depends on what was declared and what happened next.

magpiecottage

dunstonh wrote: »

It depends on what was declared and what happened next.

It also depends on what you can show was declared. Without evidence it will be difficult.

If you do have evidence that is persuasive, it will depend on the status of the adviser - were they independent or working as Representative of Legal & General. If the latter then FOS is likely to require them to honour any promises he made - but cannot do so if he was independent.

weighty1_2

dunstonh wrote: »

We need to clarify some things first. CI cover is underwritten at point of sale. A pre-existing condition is declared and the insurer decides whether they will offer standard terms, rate the premiums or put restrictions on the policy.

If restrictions are put in place you are told of these and given the choice to accept them or not. A pre-existing condition would not make the policy mis-sold

I'm surprised L&G referred to it as a pre-existing condition though. I would have thought they would have mentioned it as an exclusion or pointed to the exclusion given at point of sale. That is unless it was not disclosed at application (which could be a mis-sell reason)

So, at this stage, I dont want to go in quite as strong as ACG has as saying yes you have been mis-sold as many advisers quite correctly put in CI applications for people with existing conditions and there is nothing wrong with that. It depends on what was declared and what happened next.

I agree.

The vast majority of conditions within plans happen on an acute basis, with immediate and critical health consequences. By virtue of the fact that the OP has said that her husbands condition "deteriorated" leads me to conclude that it may well not have been one of the critical illnesses covered that they were trying to claim for.

Obviously, it's difficult to assess without more information regarding the medical condition, acceptance terms, application disclosures etc. however, I'd be surprised if L&G had done anything wrong. The broker may have done an inadequate job of verbally explaining what critical illness cover is and what it pays out for but that's difficult to prove and as you always say "paperwork is king" in these sorts of instances.