Mppi claim and pregnancy - rejected

Saltfish

Hello - interested in your opinions on this one:

Mppi taken out on nationwide mortgage to cover my partner's salary - she was made redundant about 6 years later so we made a claim for redundancy.

The insurers accepted the claim but to continue she had to meet their conditions - to be 'continually registered with job centre' and provide evidence of 'looking for work throughout, the period of the claim.'

At this time she was pregnant and due to give birth about 3 weeks after the redundancy claim. For this reason, she could not meet these conditions and continue with the claim; we informed nationwide of this problem but were offered no solution.

I have since claimed misselling of mppi, on the grounds that pregnancy is a sufficiently normal and usual condition for it to be highlighted to a female customer that it would prevent a redundancy claim; these terms and conditions were given to us but the implications in pregnancy were not mentioned ; had she been made redundant at any other time, she would have been able to claim; had this issue been highlighted we may have chosen to cover my salary instead.

Nationwide have rejected my claim on the following grounds; policy was sold on a 'non-advised basis ' and terms and conditions were clearly set out to us.

Is this worth taking to the FOS? Surely, given that it is effectively illegal to work for at least a week after childbirth (statutory maternity) , not even considering medical advice, this effectively bars all heavily pregnant women from employment-related activities and so from claiming; is this not something that should be explicitly highlighted in these terms and conditions and at sale?

Saltfish

The terms and conditions were set out in the policy, yes, but not explicitly in relation to pregnancy; no she wasn't pregnant when she took out the policy, but had she been it still wouldn't have been clear. For example, why couldn't they put something in like 'you may not be able to claim if you are made redundant when pregnant '?

Maybe you are correct and this is not technically misselling ? Is this more a case of unfair terms?

[Deleted User]

Saltfish wrote: »

Nationwide have rejected my claim on the following grounds; policy was sold on a 'non-advised basis ' and terms and conditions were clearly set out to us. this effectively bars all heavily pregnant women from claiming; is this not something that should be explicitly highlighted in these terms and conditions and at sale?

Sorry but her pregnancy did preclude her from claiming on the insurance and this would would have been listed in the terms and conditions of the policy she purchased.

She certainly wasn't available for work any longer, but this wasn't due to an illness (or actual unemployment).

Not a valid mis-selling complaint, I'm afraid.

Of course, the circumstances were pretty unique in that she was made redundant at the same time as being pregnant but it's hardly a possible eventuality that one would have expected to be discussed at the time of the sale .

Saltfish wrote: »

The terms and conditions were set out in the policy, yes, but not in explicitly in relation to pregnancy; no she wasn't pregnant when she took out the policy, but had she been it still wouldn't have been clear. For example, why couldn't they put something in like 'you may not be able to claim if you are made redundant when pregnant '?

Maybe you are correct and this is not technically misselling ? Is this more a case of unfair terms?

The policy was put in place to protect her if she was made unemployed through no fault of her own. Unfortunately, her pregnancy precluded her from both being actually in their definition of "unemployed" and from claiming on the insurance.

You are, of course, allowed to refer your "complaint" to the Ombudsman. Unfortunately, I would expect the Adjudicator to side with the Bank in the circumstances you have described.

Saltfish

Moneyineptitude wrote: »

Of course, the circumstances were pretty unique in that she was made redundant at the same time as being pregnant but it's hardly a possible eventuality that one would have expected to be discussed at the time of the sale .


The policy was put in place to protect her if she was made unemployed through no fault of her own. Unfortunately, her pregnancy precluded her from both being actually in their definition of "unemployed" and from claiming on the insurance.

I struggle with the idea that these were unique circumstances and that this is not a possible eventuality to be discussed when selling a redundancy policy to a woman of child-bearing age; most women become pregnant at some point and I'm sure many of these experience job insecurity or redundancy, for this very reason there are laws to protect them from redundancy when on maternity leave, but I see your point about their definition of "unemployed."

[Deleted User]

Saltfish wrote: »

I struggle with the idea that these were unique circumstances

A pregnant woman being made redundant is hardly a run-of-the-mill event.

Regardless, if you feel so strongly, then make your case to the Ombudsman.

It is not me you have to convince

Expect nothing and you won't be disappointed.

societys_child

I don't think even travel insurance covers against pregnancy? PPI wont.

Have you looked into discrimination at work?
https://www.citizensadvice.org.uk/work/discrimination-at-work/common-situations/discrimination-at-work-redundancy-and-pregnancy/

Saltfish

We weren't claiming for pregnancy - we were claiming for redundancy.

dunstonh

I have since claimed misselling of mppi, on the grounds that pregnancy is a sufficiently normal and usual condition for it to be highlighted to a female customer that it would prevent a redundancy claim

No it doesnt. Pregnancy is not an illness. It does not make you redundant.

Surely, given that it is effectively illegal to work for at least a week after childbirth (statutory maternity) , not even considering medical advice, this effectively bars all heavily pregnant women from employment-related activities and so from claiming; is this not something that should be explicitly highlighted in these terms and conditions and at sale?

You are still employed during that period. So, there is nothing to claim on the policy.

Is this worth taking to the FOS?

We know from FOS publications that they accept the requirement of needing to sign on.

Your issue doesnt seem to be one of missale but one about lack of flexibility during the claims process.
How long did your partner delay going to sign on after giving birth?
Did the benefits agency take into account childbirth and allow flexibilty on dates?

Saltfish

“ I have since claimed misselling of mppi, on the grounds that pregnancy is a sufficiently normal and usual condition for it to be highlighted to a female customer that it would prevent a redundancy claim
”
No it doesnt. Pregnancy is not an illness. It does not make you redundant.

I'm afraid I don't understand - No it doesn't what? I'm not saying pregnancy is an illness or that it made her redundant - she was made redundant, along with other colleagues, by her employers restructuring; I'm saying pregnancy prevented her from continuing with a redundancy insurance claim, because she couldn't be continuously attending the jobseekers and jobsearching, as the t&cs required, when she was about to give birth.

“ Surely, given that it is effectively illegal to work for at least a week after childbirth (statutory maternity) , not even considering medical advice, this effectively bars all heavily pregnant women from employment-related activities and so from claiming; is this not something that should be explicitly highlighted in these terms and conditions and at sale?
”
You are still employed during that period. So, there is nothing to claim on the policy.

I am talking about a redundancy situation; how could she be employed when she had lost her job?

Your issue doesnt seem to be one of missale but one about lack of flexibility during the claims process.
How long did your partner delay going to sign on after giving birth?
Did the benefits agency take into account childbirth and allow flexibilty on dates?

Timeline is as follows:
1. Given notice of redundancy in April.
2. Employment terminated end of June.
3. Made claim for redundancy on the policy start of July. (Informed insurers of her pregnancy by phone & letter)
4. Made a claim for jobseekers allowance, July 18th, as instructed by insurers.
4.Claim accepted by insurers start of August; we realised then full implication of t&cs - that she had to continue attending jobcentre throughout late pregnancy.
5. Attended a few more jobcentre appointments, struggling, until no longer able to. JSA paid for 2 weeks total. (Jobcentre thought it was ludicrous that she was trying to attend in late pregnancy.)
6. Gave birth to our daughter 2nd week of August. Childbirth & recovery obviously prevented her from rushing back to jobcentre -so t&cs were not met!


Yes, perhaps it is about lack of flexibility not misselling, but I find it outrageously unfair.

Let's say there was another employee in her company, with exactly the same insurance policy, facing exactly the same redundancy process who was not pregnant, or in the early stages of pregnancy; she would have been able to continue with her claim.

Both women would have evaluated the policy in the same way at sale i.e. how does it relate to my employment situation, mortgage and financial circumstances, probably neither woman would have considered the t&cs in the very common context of pregnancy. The insurers however, deal with the implications of their terms & conditions on a daily basis, and could reasonably have highlighted this possibility i.e. 'you may not be able to claim for being made redundant if you are pregnant.'

IAmWales

Did the employer not pay her maternity pay as part of her redundancy package?

When did she resume claiming JSA after the birth?

dunstonh

5. Attended a few more jobcentre appointments, struggling, until no longer able to. JSA paid for 2 weeks total. (Jobcentre thought it was ludicrous that she was trying to attend in late pregnancy.)

I do understand that it may seem ludicrous but signing on doesn't just qualify you for the insurance payout. It also gets your NI paid by the state. So, it protects benefits that may be necessary for future and it keeps your qualification towards the state pension going.

I once had to sign on for 3 months with no intention of getting a job. It followed a redundancy but I was going self-employed and had to wait 3 months whilst that side was sorted. The money was pointless to me and I hated the experience but it kept my stamp paid.

6. Gave birth to our daughter 2nd week of August. Childbirth & recovery obviously prevented her from rushing back to jobcentre -so t&cs were not met!

The insurer themselves don't actually check the visits are made. They just check that you are still signing on. She could get income support from 11 weeks before baby's due to date to 15 weeks after its birth (and theoretically upto the age of 5). The frequency of having to visit is reduced during those weeks because of the clear inconvenience.