total and permenant disability cover

moggitymog

we have this cover on our mortgage, partner has been diagnosed with avascular necrosis and will need both hips replacing at some point in the near future. We are looking to possibly claim as the condition is having a significant impact on mobility to the point where partner is unable to do his current job so off sick. I am concerned that if we claim and are unsuccessful is it possible they will increase payments or alter cover

dunstonh

They cant adjust policies that are already in force.

moggitymog

thanks for your quick response it is much appreciated

kingstreet

There is a very high bar to get over to be able to make a successful claim for TPD. It may also take a number of months for the necessary medical information to become available as a condition develops.

As an example, this is the 2009 Scottish Provident guide note to TPD;-

Own occupation total permanent disability

Definition

Becoming permanently disabled according to all the requirements
of any one of the following four definitions:

• Own occupation

Becoming permanently disabled:

i) before age 65;

ii) while having a full time (16 hours or more a week) remunerative occupation immediately before the start of the disability;

iii) through illness or injury;

iv) to the extent of being medically or physically unfit to perform
the material and substantial duties of that occupation; and

v) the disability is irreversible with no reasonable prospect of
there ever being any improvement.

What does this mean?

For a claim to be paid, the disability (which could be caused by an accident or illness) must be permanent and must prevent you from performing your own occupation.

We will require evidence to confirm the permanent nature of the condition, and in some cases there may be a delay before a claim can be accepted. This will normally be no longer than 12 months.

I believe you may have difficulty meeting the permanence/irreversibility requirement, if some mobility will be restored by the replacement of the hip joints.

As dunston has said, if your claim is unsuccessful at this time, the plan can continue and the insurer has no right to alter the terms, or the premiums against you.