Critical illness claim rejected - can I take it further?

starrybear

Hi all,
My Aviva CI claim has been rejected due to a couple of things on my medical record (that, at the time did not seem of any significance) that I hadnt remembered about and therefore didn't disclose.

There is also an instance where the wording of the question was fairly vague.

Now, I know that looking back, this was my fault, but they were genuine oversights, and I feel like I ought to have a go at fighting my corner, not least because at the time of filling in the form I was reeling from a recent miscarriage, and also trying to buy a house.

Question  is,  would there be any point in appealing?

Should I look at getting some legal representation at this point?

P.S. Please dont take this opportunity to tell me what a fool I have been. I know that, and I now also have a critical illness to deal with, so I couldn't really feel worse xx

dunstonh

Question  is,  would there be any point in appealing?

We don't know enough to say.    You are able to raise it with their complaints department if you disagree.

Should I look at getting some legal representation at this point?

No. Statistically, you are likely to fail and end up with costs.  With the complaints process free of charge to use, it makes far more sense to use that.

The FOS publish non-disclosure guidelines and generally, insurers follow those.  Have you taken a read of the FOS non-disclosure guidelines?

https://www.financial-ombudsman.org.uk/businesses/complaints-deal/insurance/misrep-and-non-disclosure

Have Aviva said they are going to refund the premiums and void the policy or are they classing it as intentional non-disclosure?

starrybear

They're refunding and avoiding the policy.
I feel gutted about it because ultimately I now have MS, which was never, ever alluded to on any of my medical records and is mentioned as a condition on which they'll pay out, but it feels like I've been caught on a couple of unintentional technicalities :-(

starrybear

*voiding! 

dunstonh

Voiding and refunding is the method used when they consider that the non-disclosure was accidental.  However, they would never have accepted the policy in the first place had they known that additional information.

If they thought you did it intentionally, they would have kept the premiums and voided the policy.

All you can do, if you feel they are wrong, is make a complaint and give your reasons.