Terminal illness - Aviva delaying tactics

stopplayinggames

Four months ago husband has received a terminal cancer diagnosis with a life expectancy of 3-6 months without chemotherapy or extended to 9-12 months with palliative chemotherapy.  The palliative chemotherapy is to alleviate symptoms so he can eat. (He has cancer of the oesophagus).  

Upon terminal diagnosis we claimed on our Aviva life policy and provided the evidence in accordance with their policy terms.  

We are now 4 months into a potential maximum life expectancy of 12 months with palliative chemo but Aviva now wants more evidence as to how he is responding to the palliative chemo.   Less than 20% of people with stage 4 oesophageal cancer survive a year.  Unlike other cancers there are no stats for five survival because people don’t survive.  In a court of law, the balance of probabilities is 50%, so it’s highly probable he won’t reach a year.  

Aviva is not holding up to its glossy brochures of ‘we will pay out upon diagnosis of a terminal illness’ as their delaying tactics are causing considerable distress.  They will be paying eventually so their delaying tactics are unfair, misleading and downright cruel.  It’s bad enough coping knowing my mid 50’s husband is likely to die soon without the additional financial stress caused by Aviva.   

Does anyone else have experience of this? 

stopplayinggames

To add:-
1.  In addition - the consultant immediately issued the SR1 form which was fast track PIP claims only issued to people with less than 12 months to live.  The Government accepts the life expectancy, why doesn’t Aviva? (Their own vested interests creating delays per chance?)
2.  The full pension pot is immediately accessible on the same grounds.
3.  Aviva’s policy is ‘upon diagnosis’ not elongated excuses of responses to treatment.  It’s terminal with odds stacked against reaching 12 months.   

Shame on Aviva for their shoddy behaviour.

dunstonh

Terminal illness - Aviva delaying tactics

Aviva are not known for "delaying tactics".   So, it's likely to be something else.  What exactly we can't say but frequently, it is either sluggish administration or poor quality or vague information coming back from the consultant/GP.

Aviva is not holding up to its glossy brochures of ‘we will pay out upon diagnosis of a terminal illness’ as their delaying tactics are causing considerable distress. 

I have taken a look at an Aviva brochure and it doesnt quite say that.  copy and paste:
Our policy also pays out the cover amount on a terminal illness diagnosis, that meets our definition and you're not expected to survive for more than 12 months.

I suspect in this case, the issue is that the treatment to extend life could take it beyond 12 months.

Shame on Aviva for their shoddy behaviour.

Your frustration is totally understandable, but it may be misplaced or it may be correct.    If the policy had critical illness cover on it, it would have paid out on diagnosis.   However, TIB is different and requires more information and that makes going back and forth a fair bit between insurer and consultant/GP to ascertain the details.   And frequently, neither the insurer nor the NHS work at speeds that you would want them to.

Ultimately, if you believe it is Aviva that is the problem, then you make a complaint to them and let their complaints team look into it.

CSI_Yorkshire

What 'vested interest' do you think they have that would make them deliberately delay?

us_too

Life expectancy is LESS than 12 months WITH treatment.  Without treatment it was just 3 to 6 months.  Treatment is palliative treatment to alleviate symptom - ie enable him to eat because his oesophageus is blocked by the primary tumour but sadly he is riddled with metastatic tumours elsewhere such as multiple parts of his liver, countless nodes and bones.  

us_too

The ‘vested’ interest is two fold:-

1. because there isn’t much left on the term of the policy, so it feels like they are hoping he will outrun the term payment terms

2.  It’s a seven figure sum so the interest is not exactly small.  Guess it’s better accumulating in their pocket than ours.

DullGreyGuy

us_too said:

Without treatment it was just 3 to 6 months.  Treatment is palliative treatment to alleviate symptom 

As you say, palliative treatment is simply done to improve quality of life/reduce suffering for whats left of their life. In this case the treatment is beyond simply palliative as its also predicted to double life expectancy. Treatments dont always go as is expected, sometimes patients dont respond and sometimes they respond much better than anticipated, its this uncertainty that makes an insurer want a revised view once the treatment has commenced. 

us_too said:

so it feels like they are hoping he will outrun the term payment terms

In most cases both insured and insurer hope the person outlives their policy... insurance is one of the few things people buy hoping never to use


Never dealt with Life insurance claims but my ex used to deal with ASU claims and I echo the previous comments, despite how much GPs/Consultants charge for medical reports etc they are very slow at providing information, some refuse to do so until payment is received and some are fundamentally lazy. Plenty of times she's said a fairly basic 2 page questionnaire asking the doctor to confirm the simple things like how long theyve been under their care, last time they saw the claimant, confirmation that there is no realistic prospect of them returning to work etc and despite a £150 charge they just sent a photocopy of the notes. Go back to the GP again saying we need the form completed, they ask for another £50, wont respond until its paid, then still dont fill in the form correctly 4 weeks later. All the time claimant is calling and complaining that we are delaying paying out their claim. 
 

us_too

DullGreyGuy said:

us_too said:

Without treatment it was just 3 to 6 months.  Treatment is palliative treatment to alleviate symptom 

 “ In this case the treatment is beyond simply palliative as its also predicted to double life expectancy. “

The timescale is increased because the palliative treatment enables him to actually eat mushy solids rather than only liquids so as not starve to death.  

Dull grey guy also said:

“ All the time claimant is calling and complaining that we are delaying paying out their claim.” 

Aviva FAILED to send the form to the consultant by over a month initially….the consultant provided it back promptly. 

So we continue to wait and sadly life expectancy gets shorter each day.