Fibromyalgia life insurance incapacity claim

Runtus

I was diagnosed with Fibromyalgia earlier this year and have been under both NHS and private continual medical care since then. I am really struggling to maintain my 30hr week job and would like to know the likelihood of a successful life instance claim, under the incapacity criteria. My policy is with Legal and General and the policy started in 2013. I have paid all premiums on time and have never claimed on the policy before. My HR Director is fully aware of my situation and very supportive so I am confident that she would speak for me if it was necessary. I am happy to undergo any medical assessment deemed necessary by the insurers.

It is really difficult to find accurate information online as fibromyalgia has only been accepted as a chronic illness since earlier this year and everything I can find predates this. I don't know if the information is out of date or if the situation has not changed......

Any advice much appreciated.

Nearlyold

What sort of L&G life policy due you have, is it a Critical Illness policy with permanent disability cover which you hope to claim on, or are you talking about waiver of premium on a life cover only policy?

Weighty1

As above it will depend on what you are looking to claim for, however, unless it is either a waiver of premium claim or an income protection claim then I, personally, think the chances of making a successful claim are minimal.

Within critical illness policies, as mentioned above, there can often be a Total & Permanent Disability element, but as the name suggests your consultant would need to confirm that you are totally and permanently unable to either do your job or do certain activities of daily living. I don't think either is likely to happen unfortunately.

If there is waiver of premium included on your plan, you are much more likely to be able to claim on this and this would at least mean you'd not have to maintain your premiums for the cover to continue so the insurance can at least stay in force. The question is, what this included in your plan? Unfortunately, few people who self-arrange their plans include this but those who arrange cover via an adviser far more regularly do.

Runtus

Its a Decreasing Term Assurance policy, 21 years. Within the T'&C's it lays out the Incapacity criteria:
Depending on the Life's Assured (i.e. me) status when a claim is made, incapacity is defined as:

The life assured is totally incapable of carrying out their normal occupation by reason of an illness or injury which occurred after the policy start date (01.10.13), necessitating medical or surgical treatment and is not carrying out any other occupation or in paid employment.

Weighty1

Runtus wrote: »

Its a Decreasing Term Assurance policy, 21 years. Within the T'&C's it lays out the Incapacity criteria:
Depending on the Life's Assured (i.e. me) status when a claim is made, incapacity is defined as:

The life assured is totally incapable of carrying out their normal occupation by reason of an illness or injury which occurred after the policy start date (01.10.13), necessitating medical or surgical treatment and is not carrying out any other occupation or in paid employment.

If this is the same policy conditions booklet that I've just looked at then this section (4) is headed "waiver of premium".

This basically means the premiums will be waived if you are unable to work for longer than 26-weeks and you'll no longer have to pay the premiums until there is either a life insurance claim, you return to work or the policy reaches its end date. It DOESN'T mean that you can make a claim on the life insurance plan itself.

Also, just because this section is included in the policy conditions booklet doesn't mean it is included on your plan. Waiver of premium is an add-on to the basic life insurance cover and as I mentioned whilst advisers will often add it on, those self-selecting their cover often don't.

You'd need to either call L&G and ask or check your policy certificate to see if waiver of premium is included on your plan.

Life insurance as a product is very simply, it will pay out if you die during the term or normally, if you are diagnosed with a terminal illness and it is anticipated you have less than 12-months to live. Cover for incapacity is not included as a payout until it is for the previously mentioned Total & Permanent Disability, which itself is unlikely to qualify for a claim in this instance, unfortunately.