Income Protection Policy

dazzer21

I've just had the shock result that I may *probably* need brain surgery, which is going to see me out of work for a while. I've been blindly paying into an income protection policy which has just gone out each month as a direct debit for the past 8 or so years. When something like this happens, all manner of things are explored for obvious reasons and I've dug out the paperwork on the policy for the first time since it was taken out.

While all the criteria at the time of taking out the policy were 100% correct at the time of signing up, there have been changes, but in the main this has just been changes to my medication over the years - I am on different meds to what I was then (bear in mind that 8 years has passed) so before I get involved in getting in touch in order to change things, I'm keen to know if anyone here has had any problems with regards to this sort of policy in the past, and what the reasons were.

It might look a little odd if I start changing things now, only to be claiming off the policy in the next month or two..

Thomas_Crown

Hi dazzer21, I'm sorry to hear that you are possibly going to need brain surgery. I hope that everything works out well for you.

The key thing in a claim will be that you didn't have any symptoms or treatment for your condition before/at the time of signing the proposal form.
Given that you are possibly facing surgery means that you must have been seen by one or more consultants at a hospital.

When/if the time comes to put in your claim a photocopy of a report from a consultant along with a report from your G.P. will undoubtedly be requested by the insurance company. They will pay the cost of the G.P.'s report. They will want you to fill in an application form detailing symptoms,treatment medication & a list of all the medically qualified people you have consulted over the duration of your illness.

What is the waiting period from you signing off work 'sick' to the insurance company hopefully paying out on your claim?

dazzer21

Hi Thomas

Thanks for your reply. The deferred period is 8 weeks. The reason for such a long time is that when I signed up for it, I had to make the insurance company aware that I had epilepsy - which is the case. I could have made that time shorter, but the increase in premium was astronomical! At the time, a copy of my GP's confirmation of my health was presented to the company and the application duly accepted. Having looked through the paperwork now, a note of my medication at the time was on the form. Over the course of time, my medication has been changed but by the same token, my 'complaint' has not changed. However -

I was presented with the bombshell just recently that there is a growth of substantial size on the front left of my brain, which is more than likely going to have to be whipped out some time soon. To mine and those around me's knowledge, nothing of the sort has every been mentioned before.

My concern so far has been the admission of my medication status at the time of acceptance and the changes that have taken place to it thus far - I haven't notified them of this as it hadn't occurred to me. I'm pretty sure that the dramatic change in my actual condition won't be a problem as there appears to be no documented evidence of it until now.

I know that Insurance companies will do whatever they can in order to not pay out, so I hope that my 'oversight' will not !!!! the whole thing up...

dunstonh

Proper income protection plans, known as permanent health insurance (PHI), are usually a snapshot of when you take them out and do not require you to inform the insurer when changes occur (unless they are changes that were known at time of application or before commencement of the policy).

budget income protection plans or mortgage payment protection plans can have far more clauses and it isnt a good idea to guess on these without reference to the policy details.

Is yours a PHI policy or an MPPI/ASU policy?

Zabytrid

dazzer21, sorry to hear about your health problems.
I agree you need to look at the policy wording. An Income Protection Policy, should not require you to tell the insurance company about any changes in health over the course of the plan. As long as you have disclosed what you should have on the application form, and as the company got a General Practioner's Report, it sounds like you have, then there should not be a problem. Anything that occurs after the commencement date would not be taken into account. Most policies would be worthless if you had to tell us about every change in health, it's completely different to car or home insurance in this regard.
I assume your pending surgery is related to your epilepsy? The policy was 'underwritten' when it was taken out, which means the company took your epilepsy into account and charged you accordingly for it (this could mean they took your policy at ordinary rates, or charged you a small extra called a loading). Therefore, if you are now due to have surgery on your brain, and are likely to to be off work, even if this is related to your epilepsy, it will be priced for in your policy.
The only exceptions to this would be if you have increased the amount of cover recently, in which case you would have been asked up-to-date medical questions, but again, it sounds like you would have disclosed everything on the form. Or, the underwriting of your policy may have resulted in an 'epilepsy exclusion' which could mean your claim was excluded - but I would very much doubt this is the case.
I assess Income Protection Claims for a living and I can assure you, we do not look for ways to get out of paying a claim! I've seen Income Protection claims for all kinds of nonsence, people who just can't be bothered going back to work, bunions to hysterical blindness. Your claim on the other hand, is exactly what IP was designed to cover and any company would be looking to pay you as quickly as possible. When the time comes, send in a claim form and be as open and honest as you can, and as mentioned earlier, send in any medical information or letters you might have as this can only help the assessment.
All the best.
ps. 8 week defer period is very short, most people take out 13, 26 or even 52 weeks.

dunstonh

ps. 8 week defer period is very short, most people take out 13, 26 or even 52 weeks.

It was that which made me wonder if it wasn't a PHI policy but an ASU/MPPI or general insurance income protection plan. 4-8 weeks is far more common on those.

With those of course, pre-existing conditions are not underwritten at point of sale. (some exceptions apply)