Miss selling of Critical Illness Cover it didn’t pay out when I lost my sight so we lost our home

RufCutRus

In 2005/2006 I lost my sight in my right eye and was diagnosed with a rare disease-Behcet’s disease-which lead to other disabilities like chronic arthritis, meningitis headaches, comprised immune system amongst many other chronic illnesses which consequently lead to me having to be medically retired as I was not able to carry out any work of any kind because of my disabilities. We tried to claim against the Critical Illness cover we were advised to get, which would cover the repayments or a lump sum if myself or my partner Stacey was unable to work due to illness or disability, but to only be told that my rare disease wasn’t covered under the policy and that as I had only lost sight in one eye and because the disease mainly affected just the right side of my body they rejected my claim. I appealed their initial rejection accompanied by a report from my GP stating how bad the disease and sight loss was and that I would not be able to return to any work let alone the job I was doing. I was registered sight impaired with arthritic disabilities but the claim was still rejected. In 2012 I complained to CO-OP for miss selling us the policy but that too was rejected. The reason for the delays in getting this sorted was and still is due to my illness taking over my life leaving me unable to carry out simple tasks and unfortunately things like complaints etc etc take a back seat whilst I battle this horrible horrible rare chronic critical illness. This illness has made me feel guilty that I lost our family home and have lived with that guilt since 2005. Please please please could someone either point me in the right direction as to whether it’s worth me still chasing this up or can I take them to the cleaners as I am very very prepared to go all the way to courts if I have to! Either complaint to be held would be good ie accept my initial claim for critical illness OR for miss selling us the policy as it didn’t pay out when I was critically ill and YES Behçet’s disease is classed as a critical chronic illness. Where do I stand and can I stand up to them? This PPI reclaiming has got me back on it after much success with PPI reclaiming payouts.
Please could someone help me either way or dare I ask-Martin;- please could you advise or even gift your time to assist me in getting what should essentially rightfully be what I am entitled too?
Thank you to anyone who takes the time to read this and thanks in advance of any advise.

boliston

Most critical illness policies will list the types of critical illness that are covered - is behcet's disease listed on the policy?

RufCutRus

Unfortunately Behcet!!!8217;s disease wasn!!!8217;t listed under the policy however after recent research Behçet!!!8217;s disease now is listed under their policy. Also just for the know-Behçet!!!8217;s disease is a syndrome of many chronic illnesses and disabilities which are listed under critical illness policy ie Sight Loss, arthritic disabilities, meningitis etc

Nasqueron

You complained in 2012, if you did not take up the option to go to the FOS your complaint is over as it's time barred. The time to take action was when you were rejected and told you could go to the FOS. Any attempt to complain now will be rejected by both the bank and the FOS

dunstonh

We tried to claim against the Critical Illness cover we were advised to get, which would cover the repayments or a lump sum if myself or my partner Stacey was unable to work due to illness or disability,

That isnt what critical illness does. That is a different type of insurance called permanent health insurance.

I appealed their initial rejection accompanied by a report from my GP stating how bad the disease and sight loss was and that I would not be able to return to any work let alone the job I was doing.

CIC has nothing to do with employment. You could suffer a CIC and be back at work in weeks and still get paid out (as happened to a client of mine).

Please please please could someone either point me in the right direction as to whether it!!!8217;s worth me still chasing this up or can I take them to the cleaners as I am very very prepared to go all the way to courts if I have to!

If it is not on the list of critical illnesses (and it almost certainly isnt) then you wont get paid out. Courts wont change that as a policy will only pay out what you are covered for.

OR for miss selling us the policy as it didn!!!8217;t pay out when I was critically ill

Misselling isnt an issue here. You suffered an event you were not insured for. That doesnt make it missold.

My understanding is that Behcet's disease is a chronic illness but not a critical illness. Especially as Behcet's disease doesn't prevent the purchase of life assurance

Please could someone help me either way or dare I ask-Martin;- please could you advise or even gift your time to assist me in getting what should essentially rightfully be what I am entitled too?

I'm sorry but you are not entitled to it. Not matter how much you want it. If the policy doesn't cover it then you are not getting paid out.

Putting it another way, it is a bit like saying your car insurance hasnt paid out if you had a fire in your home. Sorry.

RufCutRus

I think I did go through the FOS at the time BUt ended up in hospital for about 5 years on and off so again things got waylaid. I need to find all the records but surely they have extenuating circumstances? But if not is there nothing I can do? Thanks for all the replies.

RufCutRus

Thank you Dunstonh and whilst I appreciate everything you sated however like I stated Behcet’s disease is a syndrome of many chronic and critical illnesses like loosing sight etc and Behcet’s disease is now listed under their critical illnesses!

Nasqueron

RufCutRus wrote: »

I think I did go through the FOS at the time BUt ended up in hospital for about 5 years on and off so again things got waylaid. I need to find all the records but surely they have extenuating circumstances? But if not is there nothing I can do? Thanks for all the replies.

It takes literally seconds to refer a rejected case to the FOS via email or a few minutes on the phone/letter. You would have to explain why you were unable to do so not only for the SIX MONTHS you are given after rejection - you opened the letter, you could have gone to the FOS that very minute, but also the next 5 years as to why you were unable to do so

RufCutRus

OH and Dunstonh just for the record Behcet!!!8217;s disease affects arranging Life Insurance-150% premium increase in one case which was initially refused recently.
I would like to pick your brains some more though if possible?

-taff

If you were in and out of hospital, that could be a mitigating factor. Try it.

RufCutRus

‘Mitigating’ was the word I was meant to use not ‘extenuating’! Thank you -taff lol