Life Insurance - Critical ilness claim

W3DGE

Hi! At a bit of a loss as to what to do and hoping for some advice.

I've been diagnosed with a critical illness that would normally be included in the policy I have, but mild symptoms which weren't concerning me at the time had started before the policy cover began. A couple of weeks later, these symptoms developed to a point I went to A&E to get them seen to.

At the time I had no idea that 6 months later I'd eventually get the dreaded diagnosis...

My current intuition is to simply be completely upfront about it and highlight this in the claim, but concerned I might not be doing myself any favours. Would welcome any thoughts! Thanks.

Nearlyold

Did you answer truthfully to the questions about your health you were asked on the application form?

DullGreyGuy

W3DGE said:

Hi! At a bit of a loss as to what to do and hoping for some advice.

I've been diagnosed with a critical illness that would normally be included in the policy I have, but mild symptoms which weren't concerning me at the time had started before the policy cover began. A couple of weeks later, these symptoms developed to a point I went to A&E to get them seen to.

At the time I had no idea that 6 months later I'd eventually get the dreaded diagnosis...

My current intuition is to simply be completely upfront about it and highlight this in the claim, but concerned I might not be doing myself any favours. Would welcome any thoughts! Thanks.

When you purchased the product you will have been asked a series of medical questions about your existing medical health which includes any symptoms you were suffering even if not yet diagnosed.

So, given you are talking about being upfront, you already declared these symptoms to the insurer and their underwriters will have decided if to offer you full cover, cover with a loaded premiums or special terms applied (obviously the final option of a decline didn't occur).

As such what is the problem? The insurer accepted you with the symptoms so you make the claim.

Or do you mean you "forgot" to mention your symptoms and obtain the policy by deception?

AltoSereno

DullGreyGuy said:

Or do you mean you "forgot" to mention your symptoms and obtain the policy by deception?

And this is the crux of the matter for me.

In hindsight, even I'm struggling to see how any attempt at making a claim won't be construed as this. A couple of headaches, a bit of back pain, feeling tired. Nothing I would have even considered seeing a doctor about at the time, but now, looking back, turned out to be the heralds of a cruel twist of fate. 

Appreciate you having taken the time to respond.

DullGreyGuy

AltoSereno said:

DullGreyGuy said:

Or do you mean you "forgot" to mention your symptoms and obtain the policy by deception?

And this is the crux of the matter for me.

In hindsight, even I'm struggling to see how any attempt at making a claim won't be construed as this. A couple of headaches, a bit of back pain, feeling tired. Nothing I would have even considered seeing a doctor about at the time, but now, looking back, turned out to be the heralds of a cruel twist of fate. 

Appreciate you having taken the time to respond.

The nearer you are to policy inception the more the claim will be looked into... just look at all the cases on here where people starting to suffer symptoms of what could be a major illness and so want advice on buying private medical insurance for it... obviously too late but these episodes can be what triggers the desire to buy.

There is a difference however between having a headache for a day once every few weeks and having constant headaches and having some form of brain tumor. Clearly everything starts somewhere and may well ramp up quickly but I suspect most of us know when something isnt right -v- one of those normal things that happens occasionally. 

Nearlyold

I remember selling a client a Life/CI  policy, he was 32 years old, his wife had been badgering him for ages to take out some sort of cover since the birth of their son.  A week or so after paying the third premium the client woke up on Christmas morning with chest pains,  an ambulance was called,  rushed him to hospital where a heart attack was diagnosed. It did take about 2 months to pay the claim as the claims dept went over it with a fine toothcomb as they were naturally concerned there might have been some element of non disclosure, but in the end they were satisfied no fibs had been told on the insurance application and everything was above board. £60k + interest for the 2 month delay payout - Premiums paid totalled £54.

It's vital that Insurance underwriting questions are answered fully and truthfully to the best of the applicants knowledge however applicants are only expected to provide answers to questions that are actually asked.

Eg. Have you ever suffered from xxx? -  means just that,  it doesn't mean  Have you recently. nor does it mean. Only tell us if you think it's important.