Critical Illness claim - smokers declaration

onefurlongout

Hi all,

Has anyone got any claims experience in this area?

I was diagnosed with Colon cancer in April aged 35. I have submitted a claim on my policy but this is taking ages to finalise.

I have now been sent a smokers declaration to complete as my doctors records states that I was an ex smoker in April 2005 yet I put a non smoker on my claim form, the isnurer wants clarity. I assumed that the smoking question was during the policy term and leading up to and taking the policy out, I recall a question asking if I had smoke in the previous 12 months. essetially I smoked for a brief period up to 1999 whilst I was at uni. I took my policy out in Feb 2006 and declared that i was a non smoker.

April 2005 was my first appointment with my GP since moving to his practice. Hence why I am recorded as an ex smoker.

If I havent got enough to worry about I'm now worried that my claim will be declined . I hadnt smoked for 6/7 years leading up to taking the policy out.

Will my claim be rejected and is the insurer just looking for a way to stop paying out? How do I prove that I didnt and havent smoked since this time. I'm more than happy to take any test to prove this.

Thanks

InsideInsurance

Ultimately need to see the exact question asked and, if multiple choice, all the options that there were -v- what you declared.

If you were asked "have you smoked in the last 12 months" any you answered no then this would be fine based on what you say. If you were asked if you have ever smoked and you declared no then evidently there may be a problem.

JimmyTheWig

onefurlongout wrote: »

I have now been sent a smokers declaration to complete as ... the isnurer wants clarity. I assumed that the smoking question was during the policy term and leading up to and taking the policy out, I recall a question asking if I had smoke in the previous 12 months. essetially I smoked for a brief period up to 1999 whilst I was at uni. I took my policy out in Feb 2006 and declared that i was a non smoker.

So what does the declaration that you have been sent ask?
The fact that you say you "assumed" what the question meant doesn't bode well. But the memory of the "previous 12 months" question does.

Can you ask them to send you a copy of the form that you filled in?
Presumably you didn't keep a copy yourself, but have you got a copy of the documents that they sent you afterwards? This may indicate what you told them.

dunstonh

Will my claim be rejected and is the insurer just looking for a way to stop paying out?

Non-disclosure falls into multiple categories by the FOS. If it is deemed intentional non-disclosure then they can refuse to pay out and keep the premiums paid.

If it is deemed accidental non-disclosure then they will pay out but deduct the cost of any premium difference from the claim. That is unless they would never have covered you from the outset. In which case they would return the premiums you have paid and not pay out the lump sum (unlikely in this case).

At the moment, they have some potentially conflicting information which they are just looking to get verified. Not likely to be a concern unless you know you were telling porkies.

kingstreet

Back then, it was popular to ask if someone is a smoker, yes or no, with a requirement to enter a daily/weekly amount if the answer is positive.

Now, you can be asked the same question, and also if you have ever smoked.

You don't mention the company concerned, but if you did, it's possible one of us would have a copy application on file we could look at to see what was asked at that time, before you obtain a copy of your submitted application from your provider.

onefurlongout

On the application form that I have a copy of in 2006 it asked if I had smoked within the last 12 months. I hadn't, I smoked a few times whilst at uni in 1999 so have never seen myself as a smoker

Having re read the claims form it just asks if I have ever smoked tobacco. To which I answered no.

Upon receipt of my GP report it states that in 2005 I was classified as an ex smoker. The insurer has asked for clarity.

The declaration only goes back to 2003 so I've stated a non smoker. It was 1999 when I last smoked.

Will the incorrect answer on the claim for go against me even though I hadn't smoked at the time the policy was taken out or in the preceding 12 Months (as per the application).

I have failed to disclose anything at the application stage I have just mis read the claims question

dunstonh

Having re read the claims form it just asks if I have ever smoked tobacco. To which I answered no.

You let the insurer know that you made a mistake on the claim form as you misread it and that you did smoked until 1999.

Will the incorrect answer on the claim for go against me even though I hadn't smoked at the time the policy was taken out or in the preceding 12 Months (as per the application).

Unlikely it would but you are not doing yourself any favours giving them incorrect information. So clear it up ASAP.

onefurlongout

Thanks for the replies.

To be honest its been a whirlwind couple of months and very stressful. I'll clarify this ASAP