Income Protection Insurance exclusions...

jjbrowning87

Hi there, new to this forum, but long-time fan of MSE and saving money in general.

Does anyone have any experience with challenging exclusions on a similar policy? Whole sordid tale below for context / laughs...

I recently took out some Income Protection Insurance (IPI) with Legal and General. I disclosed that my father had MS, and the broker I used mentioned there would be an exclusion for MS - not unexpected. When I chose this provider and then received all the policy docs, I had a read and found that the exclusion said MS, and also "any other disease or disorder of the central nervous system". This felt a little vague to me, so I asked my broker for a list of what wouldn't be included. She came back saying that they (L&G) had told her something along the lines of the following "Central Nervous System disorder such as: Meningitis, Epilepsy/Seizures, Encephalitis, and even Alzheimer’s or Parkinson’s could be excluded". "Could be" was the bit that got me! So I have lodged a complaint with L&G and they got back me to recently saying no dice (as in no they will not supply a definitive list of what is not covered and no they won't change the exclusion). The chap seemed a little surprised when I said I wasn't happy with that, and the complaint is now going to their "reportable complaints dept", whatever that is. I will update when I have more info.

I am wondering whether it will be worth my while complaining to the financial ombudsman about this ridiculously unfair clause/exclusion? As far as I could find from a little research, there is no extra risk factor for those mentioned disorders from a family history of MS, in fact there is only a small increase in risk for MS itself!

[Deleted User]

jjbrowning87 wrote: »

I will update when I have more info.

Do keep the PPI forum updated...

Otherwise, find and pay for insurance which does cover the conditions you mention. I fully expect it to be far more expensive than what you currently have though...

dunstonh

I recently took out some Income Protection Insurance (IPI) with Legal and General.

Not a great choice. L&G have mostly focused on the bottom end of the market in terms of quality but cheap price.

"Could be" was the bit that got me! So I have lodged a complaint with L&G and they got back me to recently saying no dice (as in no they will not supply a definitive list of what is not covered and no they won't change the exclusion).

They have to add the word "could" as some conditions could be linked and some may not be. If you blanket ruled out a certain condition then that would be more unfair.

I am wondering whether it will be worth my while complaining to the financial ombudsman about this ridiculously unfair clause/exclusion?

You dont have access to the FOS yet. However, when L&G reject your complaint, you can then if you disagree with them.

s far as I could find from a little research, there is no extra risk factor for those mentioned disorders from a family history of MS, in fact there is only a small increase in risk for MS itself!

Maybe look for better quality than L&G then.

[Deleted User]

Who would be the top 3 in the list of companies please ?

RonoB

My husband has a vitality policy and it covers just about everything. It’s excellent but not cheap. Take a look.

tacpot12

I think requiring L&G to clarify what conditions it excludes is reasonable.

The purpose of insurance is to protect the purchaser against any unforeseen event. If there is a history of MS in the family, the other conditions that become more foreseeable as a result should be a finite list based on medical knowledge at the current time.

To my mind, the insurer should cover the risk that you contract something that is later found out to be something that was more likely given a history of MS, but was known to be more likely at the time the policy was taken out.

I think they are trying to have too much latitude in excluding a claim at a later date and should be challenged on this.

An alternative view is that you can always get a medical opinion at the time of a claim to say that what you are suffering from is NOT a disease or disorder of the central nervous system and challenge them to prove otherwise. It will become a battle of medical experts with costs on both sides. Better to sort this out now, or buy a policy that doesn't have this exclusion.

jjbrowning87

Hello all, well before the reportable complaints department could do anything, the original person got back to me saying someone higher up who'd been reviewing the complaint had agreed the exclusion could be changed in my favour. Success!

So now the exclusion will just say "MS or complications thereof". Pretty happy with that, especially as I didn't think I'd get very far! Always worth a complaint it seems.