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Critical Illness Insurance

Saddlers2007
Posts: 8 Forumite
I’d be really grateful for some advice.
I’ve had a modest critical illness policy since starting a family 30 years ago. A recent claim was refused by my Insurer. I will pass the condition related test (Parkinson’s) but would only fail two out of the three required Activities of Daily Living (ADLs). Hence their decision to refuse.
An old thread on the Parkinson’s Forum referenced the old DDA (now Equality Act) and suggested that any policy where ADLs said assessment would take into account a disability aid could be rigorously contested because medication cannot be treated as an aid and folk should ask to be assessed as if not medicated. Some secured a payout on this basis. Frankly I’d fail all ADLs if this was the case.
My Insurer absolutely insisted that medication was an aid. I checked this out by taking my complaint to the FOS who said it was reasonable to consider medication as an aid. When I queried the definition of an aid, the response was that since I’m medicated there was no way to assess me otherwise so that was that. I can have my case reviewed by the ombudsman if I request it. Should I bother?
Of course I’m trying to secure a payout. I know my policy is old and not carrying latest ADL wording that now refers to aids and medication. Mine just says aids. I feel it’s a catch 22, if they do agree medication is not an aid (unlikely) I’d have to come off my meds to be successful - and my condition would deteriorate.
I feel outraged the Insurer is applying their own definition of my policy terms and I will have to wait until I’m bedridden to claim. Wise words appreciated please.
I’ve had a modest critical illness policy since starting a family 30 years ago. A recent claim was refused by my Insurer. I will pass the condition related test (Parkinson’s) but would only fail two out of the three required Activities of Daily Living (ADLs). Hence their decision to refuse.
An old thread on the Parkinson’s Forum referenced the old DDA (now Equality Act) and suggested that any policy where ADLs said assessment would take into account a disability aid could be rigorously contested because medication cannot be treated as an aid and folk should ask to be assessed as if not medicated. Some secured a payout on this basis. Frankly I’d fail all ADLs if this was the case.
My Insurer absolutely insisted that medication was an aid. I checked this out by taking my complaint to the FOS who said it was reasonable to consider medication as an aid. When I queried the definition of an aid, the response was that since I’m medicated there was no way to assess me otherwise so that was that. I can have my case reviewed by the ombudsman if I request it. Should I bother?
Of course I’m trying to secure a payout. I know my policy is old and not carrying latest ADL wording that now refers to aids and medication. Mine just says aids. I feel it’s a catch 22, if they do agree medication is not an aid (unlikely) I’d have to come off my meds to be successful - and my condition would deteriorate.
I feel outraged the Insurer is applying their own definition of my policy terms and I will have to wait until I’m bedridden to claim. Wise words appreciated please.
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