Had a income protection claim turned down

marcox1

Hi, I'm not the most switched on financial person ,but would like some clues what to do.
I took out income protection with Midland Bank(the policy was with Norwich Union,now Aviva) 17 years ago along with a personal pension.I was told that this would pay some of my salary after 6 months. I thought i was good cover,never expecting to use,but you never know what's around the corner. I was also sold Income protection 12 years ago on a share isa i took out with HSBC. Not realising that i was probably over insured.This policy is pretty much the same as the first policy i took out.
Anyway,in july 2012 i had an accident in work to my hand,which has mean't over 6 months off work with 3 operations and plenty of physio.My job is as a delivery driver for a furniture company and requires very physical work.I have contacted both companies with regards to putting in a claim. I have sent off all the required documentation and filled in all the forms with a bad hand the best i could. Last week Aviva phoned to say they will not pay my claim because they feel i could be doing lighter work in another occupation. There are no light duties in my job and my company haven't offered this anyhow. How am i supposed to be doing other work when,A.I'm still employed with my company? B. I wouldn't be able to get a job with the current state of my hand?This fit for an other occupation clause could be used by the insurance company to get out of paying 99% of claims. I haven't heard back on the claim with HSBC yet because they are waiting on paperwork. I don't hold out much hope of them paying up much. If i'm lucky with the hand, i should be back in work in a couple of months. So i wasn't expecting that many months payment. Any ideas where i go from here? Thanks. Rant over.

ACG

With Income Protection there are 3 main types;
Own occupation - pays out if you are unable to do your own job.
Own/Suited - pays out if you cant do your job or a similar job (if there are any).
Any occupation - pays out if you are unable to do any job (sounds like you have this with the one thats been turned down).

This is becoming more of a rarity for a lot of occupations but was more common when you took out the policy. Unfortunatly if its deemed you can do a job (and that job could be anything - admin for example). If you feel like you couldnt do any job then appeal the decision, however the fact you have completed your paperwork means its probably unlikely you will have it overturned.

Its great that you have income protection. In all honesty, i swear by it - i sell more of that than life insurance or critical illness cover (its the only 1 of the 3 i have myself). It sounds like you dont have the policy that does what you want/need, this is why having regular reviews is important.

marcox1

Thanks. It sounds like i don't have any actions left to take? I wouldn't have taken this type of policy out if it was expalined to me,all those years ago.Stumped.

ACG

I dont know, how bad is your hand?

i dont see many people in jobs who have 1 hand, if you have very little use of it, then you could argue nobody would take you on. But as you think it will be ok in a few months then you could argue that its not that bad.

I know some policies do "means testing" similar to how the govt do it and it involved things like reading, writing, walking etc - based on those you would never pass/fail (depending on your outlook).

I dont think you would get an own occupation policy based on your job to be honest as the risk of claiming on a bad back is too high. I do think you would be able to get an own/suited once your back up and running though.

marcox1

Thanks again. I just don't know what to do now. I have paid all this money to the insurance company over the years and when i need some of it back they refuse. I can't really afford the premium at the moment,but should i keep paying while i ask for a review of my case? I'm thinking of contacting the ombudsman because i think i was mis sold the policy or at least not told what i was actually covered for.As i have said before,i wouldn't have committed to the policy if it was explained that to qualify you couldn't work ever again.How often does that happen??