How to word complaint letter to bank CI insurance?

BlondeHeadOn

I tried claiming on our joint CI insurance when my husband was diagnosed with cancer. The claim was turned down, and to be honest I was too much in a tizz with everything at the time to really question it much.

Today (a year later) we had a meeting with an IFA about some pension and annuity questions, and as part of this I mentioned the CI cover and claim. The IFA asked a few questions, then said he thought we should write a letter to the bank to raise this issue again, as he thinks we should be covered and have a valid claim. He suggested that if we raise it as a complaint, then the bank (HSBC Life) will be forced to take more notice of it.

Sooo.... does anyone know any suitable wording for such a letter, so that it gets looked at properly? I am not very good at 'pithy and succinct' wording, and I don't want to confuse the issue with waffle!

If anyone needs more details then let me know, and many thanks for any help with this.

ACG

Stick to the point...
You put a claim in on such a date for cancer.
This was declined.
You would like to make an official complaint and have this looked into as you believe you are entitled to the pay out.

Let them come back to you with their response.

kingstreet

If you don't mind sharing some further information, we might be able to tell you your chances of a complaint overturning the declined claim.

What year did you take out the policy?

What type of cancer did your husband suffer and if known, was there a Gleason score given by his consultant?

What reason was given for the decline?

BlondeHeadOn

kingstreet wrote: »

If you don't mind sharing some further information, we might be able to tell you your chances of a complaint overturning the declined claim.

What year did you take out the policy?

What type of cancer did your husband suffer and if known, was there a Gleason score given by his consultant?

What reason was given for the decline?

I thought Gleason scores are only for prostate cancer? It's not prostate but bladder cancer, but a high grade and aggressive one. I can let you know the grading etc. for that if it's relevant....

dunstonh

In addition to above responses...

keep the complaint short. War and Peace is not required. The more you waffle, the more likely key points will be missed or you end up contradicting yourself. Use bullet points to give your major complaint reasons and only provide information that is applicable. Make it easy to read.

BlondeHeadOn

kingstreet wrote: »

If you don't mind sharing some further information, we might be able to tell you your chances of a complaint overturning the declined claim.

What year did you take out the policy?

What type of cancer did your husband suffer and if known, was there a Gleason score given by his consultant?

What reason was given for the decline?

Year policy taken out = 1997

I'm having a look to see if I can find a letter from when they declined the claim, for exact reason.

Thanks for all replies so far, all useful !

kingstreet

In 1997, the HSBC definition of cancer read;-

Any malignant tumour characterised by the uncontroled growth and spread of malignant cells and invasion of tissue. The term cancer includes leukaemia and Hodgkin's disease but the following are excluded;-

All tumours which are histologically described as pre-malignant, as non-invasive or as cancer in-situ

All tumours of the prostate unless histologically classified as having a Gleason score greater than 6 or having progressed to at least TNM classification T2NOMO

All forms of lymphoma in the presence of Human Immunodeficiency Virus

Kaposi's sarcoma in the presence of Human Immunodeficiency Virus

Any skin cancer other than invasive malignant melanoma.

Once we know the reason for the decline and the condition actually suffered, we can see how the three things stack up.

BlondeHeadOn

kingstreet wrote: »

In 1997, the HSBC definition of cancer read;-


Once we know the reason for the decline and the condition actually suffered, we can see how the three things stack up.

Sorry for the delay in replying, but yesterday was a bit manic work-wise.

I still can't find the letter with the exact stating the reason for the decline, but I remember phoning HSBC because the letter stated that the cancer was not malignant. In fact the diagnosis was of a high grade tumour(s), and the consultant stated the cancer was/is both malignant and unusually aggressive. The hospital certainly acted very quickly - my OH was operated on within a couple of weeks of the diagnosis, and is midway through 3 years of treatment which will be followed by 10 years of regular 6-monthly camera investigations to check for its return.

The guy I spoke to at HSBC just kept saying that it didn't meet their criteria though, so the list of criteria posted by kingstreet is very interesting. One question: what does 'in-situ' mean? This is the only bit which could possibly apply as an exclusion, all the other exclusion criteria are not true in this case.

_Andy_

Structure complaint as

1) What's happened
2) Why you're not happy with it
3) Specifically what you want done to solve the complaint.

Keep it concise and away from emotion.

kingstreet

Online defintion;-

Cancer In Situ - An early stage cancer in which the cancerous growth or tumor is still confined to the site from which it started, and has not spread to surrounding tissue or other organs in the body. When cancer in situ involves cells that line the internal organs, or epithelial cells, it is called carcinoma in situ.

I suggest copying the HSBC definition I typed previously and putting it in front of your husband's doctor. Ask him if he feels the severity of his condition meets the requirements of the definition.

Did you make a formal written claim, with evidence gathered from the medical professionals by the insurer?

BlondeHeadOn

kingstreet wrote: »

Online defintion;-



I suggest copying the HSBC definition I typed previously and putting it in front of your husband's doctor. Ask him if he feels the severity of his condition meets the requirements of the definition.

Did you make a formal written claim, with evidence gathered from the medical professionals by the insurer?

Very good idea, will do.

No formal written claim, I phoned HSBC Life and spoke to someone who emailed me a form to fill in, and then he said it didn't qualify based on that. No-one contacted any of the medical professional concerned.

Thanks for all of this, I will proceed accordingly.