Please Help - Life Insurance Refusing Payout - how to complain

wishicouldaffordit

Hi

title says it all really

Father in law took out life insurance in 2002, since his death in Sep last year, a claim has been made, and the insurance company are refusing to pay out

They state he did not declare heart disease - policy was taken out over the phone - he told them about diabetes, sight problems, kidney problems, etc - and then they sent him documents which he could not read! I know he would not have lied about his conditions, i don't even know if he knew about this heart condition, or whether it was part of his diabetes illness - he had so many things wrong with him the list was endless.

I am hoping to complain on behalf of his new wife - and i know about insurance ombudsman - but i need to know - am i just wasting my time? Or is it common practice for them to refuse and then we need to fight

As far as i am aware he took the policy through his bank, Bank of Scotland, and i think the company name is Stonebridge I think?

Am desperate for help/advice - so thanks in advance

[Deleted User]

I'm sorry to hear about your loss.

The best thing I can suggest is that you try and speak to the company and ask about their formal complaints process - you can't go through the ombudsman until you've reached the end of the complaints process with the insurance company.

Becca

wishicouldaffordit

thank you for the quick reply

i am still waiting for his widow to send me all the paperwork so i can start the complaint - this is such an awful situation to be in - he died intestate after re marrying 14 months previously - the family home was promised to my oh as he is the only surviving relative, and his widow has told us if we want the house we will have to buy it from her (we were told this the day after he died) - she spent all his savings, and now receives a great big pension, plus she still owns her own house - but she wants all the money she can lay her hands on and leave us with nothing

we just want the insurance money to pay her so we have some chance of keeping the family home which has been in the family for generations - it is an absolutely dire situation

dunstonh

If it was taken out over the phone, then the call will be recorded. Plus they send a copy of the application out in the post and ask the person to check it is correct and notify them if it is wrong.

I would be surprised if they haven't already checked their recording to make sure disclosure took place or not. However, you never know.

If disclosure did not take place, then they are quite correct in not paying out. If disclosure did take place, then you would expect a pay out. The FOS usually come down on the side of the policyholder if it is a minor disclosure error and has no relevance. On major disclosure omissions, they will usually side with the insurer.

wishicouldaffordit

thank you - i am just doing some googling and am finding this information - I had thought about asking for a copy of the phone call recording

i just know he would not have lied/omitted information - he was a very intelligent, upstanding, honest man - i think i just have to try and prove that to them!

dunstonh

I dont want to sound like I am siding with the insurer but you need to be aware that people do fail to disclose things. Sometimes very important things. There is one particular insurer with an over 50s plan which is referred to internally as the liar plan due to the high number of non-disclosures that exist on this plan. This includes heart attacks, cancer and other serious illnesses that you really cannot realistically forget about. So it is not uncommon, even from those that you wouldnt expect it from. As I said, not siding with the insurer as we dont know what happened. I just want you to be prepared just in case the insurance company are correct.

Your best course of action is to go back to the insurer and say you dispute the non-disclosure and ask them to check their recording.

wishicouldaffordit

dunstonh wrote: »

I dont want to sound like I am siding with the insurer but you need to be aware that people do fail to disclose things. Sometimes very important things. There is one particular insurer with an over 50s plan which is referred to internally as the liar plan due to the high number of non-disclosures that exist on this plan. This includes heart attacks, cancer and other serious illnesses that you really cannot realistically forget about. So it is not uncommon, even from those that you wouldnt expect it from. As I said, not siding with the insurer as we dont know what happened. I just want you to be prepared just in case the insurance company are correct.

Your best course of action is to go back to the insurer and say you dispute the non-disclosure and ask them to check their recording.

thank you for your reply - i appreciate realistic answers, so please don't feel bad if you are the bearer of bad news as it were

this insurance policy was our only hope of paying of the widow in the hope of keeping the family home - this is why i am trying to take up the fight on her behalf as she has said she will complain and so far has done nothing - except tell all our friends she is going to sell the house even though she promised him it would never be sold and would be kept safe for my oh and our daughter

i shall definately get in touch with the insurers in the first instance and then take it from there

if only he had made a will we would not be going through all this now - he made us promise him the house would never be sold - and now we are powerless - this is the only way we can fight, in the hope that we can get her enough money to let us keep the house

lisyloo

the family home was promised to my oh as he is the only surviving relative

I'm afraid this counts for nothing.

and his widow has told us if we want the house we will have to buy it from her (we were told this the day after he died) - she spent all his savings, and now receives a great big pension, plus she still owns her own house - but she wants all the money she can lay her hands on and leave us with nothing

How much was the house worth?
Who does it belong to?

Has everything been done properly according to the intestacy laws, because she is not automatically entitled to everything.

http://www.icr.ac.uk/support_us/help_us_in_your_will/intestacy_laws/index.shtml

If there is a surviving spouse and surviving children:
The spouse takes:

• The personal effects (the deceased’s personal belongings and chattels).
• £125,000 free of Inheritance Tax.
• A life interest in half the remainder of the estate.

The children take:

• The other half of the remainder of the estate.
• The capital comprising the spouse’s life interest fund when the spouse dies.

wishicouldaffordit

house valued at £100k

we have taken legal advice, and understand she gets the first £125k - probate is going through now

apparently the land the house is on was also owned by him, so it has gone to land registry to be put in her name - will take 2-3 months

this is a scottish home, but i don't think that makes much difference

i know without any will being found we are scuppered - this insurance is our only hope

wishicouldaffordit

stunnin007 wrote: »

Ok first off how old was your father in law when he died?
When did he take out the policy?
Why did he take out the policy and how long was it for, I'm assuming there was no mortgage as you havent mentioned that the mortgage needs to be paid.

The reason I ask this is, if he was quite old and the policy was recently taken out and he disclosed that he had diabetes the insurance company wouldn't really take on that sort of liablity, if they did then it would be very heavily rated, twinned with the fact that if he disclosed he had heart problems and a number of other conditions there just isnt a chance he would even get insured. I recently did a case for a woman who was 50 with diabetes and a couple of other minor problems, she wanted to be insured to the age of 65 and she got declined and that was just for diabetes let alone other conditions.

Which leads me to the point of if he declared everything over the phone, then they would just underwrite him there and then, it would be sent off for medical reports etc.

You really need to find out what he declared he had to the company.
If the policy was taken out sometime ago then the likely hood of you getting a recording of the actual conversation (if indeed that conversation was recorded) are very slim.

I don't mean to be negative but it sounds like you are going to be fighting an uphill battle. if you want to give me a shout and talk to me over the phone you can do, I have been succesful in helping a couple of my clients win claims (critical illness), my number is 01162387715.

Hope this helps

thank you so much - he was 61 when he died in sep 2006, he took the policy out in nov 2003 so would have been 58

i am afraid i do not have any details at the moment, only the letter from the insurance company stating they would not be paying out because of the exclusion, 'pre-existing condition which would have caused an ordinarily prudent person to seek medical treatment or advice'

there was no mortgage - i think he took this policy out to either benefit my oh or my daughter in the event of his death - at the same time as doing this he also made my daughter sole beneficiary to his naval pension from 30 years ago - she received only a small portion of this, as they had to give the rest to his widow

he remarried in 2006, made no changes to anything, and as far as we know made no will - he was planning to do one, but died unexpectedly

my oh is contacting the widow today to ask her to send me all the insurance info and then i will take it from there and contact them

thanks again - this is a dire situation and i am just trying my best to save the house - she can keep the money, if of course there is any!

RibAd

I'm sorry for your situation - but the quicker you start the formal complaints procedure, the quicker the results.
In following the complaints procedure you have the opportunity for the situation to be clarified and make way with furthering the complaint.


Under freedom of information act, for a small fee, you'll be able to see any notes that were made under his policy.

Chances are if you going to get the recorded call it'll be in a backup database/disc in storage so it will take time to locate it. Ask for transcripts of the call (depending on how many calls and the length that can take about a week {i know as I once had to help out complaints dept in transcribing a call}) and a copy of the call on cd and ask it to be sent recorded delivery.