What sports are covered under permanent income protection

Weighty1

Permanent Health Insurance contracts MUST state exclusions either within their policy summaries/key features documents OR in the terms they offer you are the point when you apply.  As user1977 states, if they don't say it's excluded then it ISN'T excluded either now or in the future.

Luke451

Weighty1 said:

Permanent Health Insurance contracts MUST state exclusions either within their policy summaries/key features documents OR in the terms they offer you are the point when you apply.  As user1977 states, if they don't say it's excluded then it ISN'T excluded either now or in the future.

This document wasn't shown to me, it's available for reading/download in the website.

It's the underwriting document, so probably it doesn't apply to me, but what I declared is that I don't do anything as such, and it's true, but I may do these things in future and it's something I kept for me, because I'm not sure I will btw.

In my contract, nothing as such appears, but you know how contracts are, they always point to some other document, I just wasn't able to find it by myself or maybe it skipped from my view.

Luke451

Does anyone know how this insurance works?

Just to recap, at the moment of signing the contract, it wasn't shown to me the document that excludes certain things, because it's part of the underwriting documents and at that time, I didn't do any sport that was excluded there.

This is the link, mainly at page 31: https://static.aviva.io/content/dam/document-library/adviser/individualprotection/pt15357c.pdf

So I wonder if I'll be covered in future, I made a summary below:

What is
Underwriting?
All applications go through a risk assessment process
to determine the applicant’s eligibility for cover and
the premium they should pay. This process is known
as underwriting.
The basic premium is determined by the applicant’s age and
whether they have smoked tobacco or used nicotine products
in the last five years. The information from the application
form is then used to determine whether there is any additional
risk, which is explained in this guide.
All applications are underwritten, and most will be accepted,
from the application alone. By using cutting edge technology
and expertly trained underwriters we ensure that even the
more complex cases are handled as quickly as possible.

Exclusions
If an exclusion is applied to a policy it means a claim will not
be paid for a specific event. Exclusions are not applied to
life cover, but are commonly applied to critical illness and
disability cover. We may exclude payment of a claim resulting
from a high risk pursuit, or a medical condition. For example
if the applicant has a recurring back problem and we apply an
exclusion, it means we wouldn’t pay a claim for that condition.

Pursuits

My concern is that in the event of a claim, they can just look at their "secondary" documents that they never show to you, and the say that they don't pay because it's written there...

On the key summary that they sent me, they specified that I don't need to mention life changes in future, but I'm not sure what's the baseline for the cover because nothing is specified...

Weighty1 Sorry if I've been repetitive but I need to be sure.

DullGreyGuy

With these classes of insurance full underwriting is done at the point of purchase so an underwriting document is about what should be asked about before buying the policy and considered when writing the insurance by the underwriter. So as you see it says if they ask you about motor sports and you say you are into it then the underwriter should exclude it. If they forget to ask and there isn't a blanket exclusion in the policy then motor sports won't be excluded for anyone who takes it up after buying the policy.

They can't rely on secondary documents, there are only two ways a claim can be denied...

1) Its against the terms and conditions in your policybook/schedule

2) You lied when you took the policy out

Luke451

DullGreyGuy said:

With these classes of insurance full underwriting is done at the point of purchase so an underwriting document is about what should be asked about before buying the policy and considered when writing the insurance by the underwriter. So as you see it says if they ask you about motor sports and you say you are into it then the underwriter should exclude it. If they forget to ask and there isn't a blanket exclusion in the policy then motor sports won't be excluded for anyone who takes it up after buying the policy.

They can't rely on secondary documents, there are only two ways a claim can be denied...

1) Its against the terms and conditions in your policybook/schedule

2) You lied when you took the policy out

Thanks for your response, but I need to ask you about something...

The advisor asked me questions, but I didn't talk to the insurance company, they're always third party advisors, they just wanna sell, so I can't trust him, but I can't even trust the insurance company, they would just think on selling.

I just need to be sure that what I signed is what I expect, I can't trust the entities.

In the main document I received, I didn't see any exclusions, and in the case of life changes (activity, sport etc I guess), I don't need to inform them.

I did some of those sport in the past, but more than 1y before I subscribed.

I'm planning to do some new sport that it's in that screenshot (or some that I already did in the past), but as of today, it's much later the day I subscribed, so, should I be fine?

Weighty1

Luke451 said:

DullGreyGuy said:

With these classes of insurance full underwriting is done at the point of purchase so an underwriting document is about what should be asked about before buying the policy and considered when writing the insurance by the underwriter. So as you see it says if they ask you about motor sports and you say you are into it then the underwriter should exclude it. If they forget to ask and there isn't a blanket exclusion in the policy then motor sports won't be excluded for anyone who takes it up after buying the policy.

They can't rely on secondary documents, there are only two ways a claim can be denied...

1) Its against the terms and conditions in your policybook/schedule

2) You lied when you took the policy out

Thanks for your response, but I need to ask you about something...

The advisor asked me questions, but I didn't talk to the insurance company, they're always third party advisors, they just wanna sell, so I can't trust him, but I can't even trust the insurance company, they would just think on selling.

I just need to be sure that what I signed is what I expect, I can't trust the entities.

In the main document I received, I didn't see any exclusions, and in the case of life changes (activity, sport etc I guess), I don't need to inform them.

I did some of those sport in the past, but more than 1y before I subscribed.

I'm planning to do some new sport that it's in that screenshot (or some that I already did in the past), but as of today, it's much later the day I subscribed, so, should I be fine?

There is zero reason to believe that you can't trust the person who has advised you on this policy.  The vast majority of insurance advisers DO do right by their clients.  Also, around 99% of life insurance plans pay out, about 93% of critical illness policies and around 90% of income protection plans and more often than not they don't pay out either cos the policyholder has misunderstood what they are covered for OR due to applicants not being truthful.  In fact, Aviva paid out around £1bn in life, critical illness and income protection claims last year.  On this basis, it would very much suggest that you can trust the insurer as well.

As DGG points out, those listed exclusions would only have been relevant if you had disclosed that you do, or intend* to do, those hobbies at the point when you applied or prior to the policy starting.  

The base line for this is that if you don't currently do them then you are covered if you take them up in the future.  For example, I took my L&G income protection out about 10-years ago.  Since they I've started rock climbing and mountaineering, which would definitely be excluded.  Have I informed L&G, no, because there is no requirement to.

*(by intent an insurance company would mean you have a firm intention of doing them in the near future, not that you may but also may not do X, Y or Z activities 2, 5, 10 or 20 years down the line).

Luke451

Weighty1 said:

Luke451 said:

DullGreyGuy said:

With these classes of insurance full underwriting is done at the point of purchase so an underwriting document is about what should be asked about before buying the policy and considered when writing the insurance by the underwriter. So as you see it says if they ask you about motor sports and you say you are into it then the underwriter should exclude it. If they forget to ask and there isn't a blanket exclusion in the policy then motor sports won't be excluded for anyone who takes it up after buying the policy.

They can't rely on secondary documents, there are only two ways a claim can be denied...

1) Its against the terms and conditions in your policybook/schedule

2) You lied when you took the policy out

Thanks for your response, but I need to ask you about something...

The advisor asked me questions, but I didn't talk to the insurance company, they're always third party advisors, they just wanna sell, so I can't trust him, but I can't even trust the insurance company, they would just think on selling.

I just need to be sure that what I signed is what I expect, I can't trust the entities.

In the main document I received, I didn't see any exclusions, and in the case of life changes (activity, sport etc I guess), I don't need to inform them.

I did some of those sport in the past, but more than 1y before I subscribed.

I'm planning to do some new sport that it's in that screenshot (or some that I already did in the past), but as of today, it's much later the day I subscribed, so, should I be fine?

There is zero reason to believe that you can't trust the person who has advised you on this policy.  The vast majority of insurance advisers DO do right by their clients.  Also, around 99% of life insurance plans pay out, about 93% of critical illness policies and around 90% of income protection plans and more often than not they don't pay out either cos the policyholder has misunderstood what they are covered for OR due to applicants not being truthful.  In fact, Aviva paid out around £1bn in life, critical illness and income protection claims last year.  On this basis, it would very much suggest that you can trust the insurer as well.

As DGG points out, those listed exclusions would only have been relevant if you had disclosed that you do, or intend* to do, those hobbies at the point when you applied or prior to the policy starting.  

The base line for this is that if you don't currently do them then you are covered if you take them up in the future.  For example, I took my L&G income protection out about 10-years ago.  Since they I've started rock climbing and mountaineering, which would definitely be excluded.  Have I informed L&G, no, because there is no requirement to.

*(by intent an insurance company would mean you have a firm intention of doing them in the near future, not that you may but also may not do X, Y or Z activities 2, 5, 10 or 20 years down the line).

When you say "prior to the policy starting", what does it mean?

I've been doing some of these sports, but like up to 1.5y before I subscribed.

Now, due to life changes, I want to do them again + other sports too, this surely falls under the unpredictable future...

I also want to do rock climbing, the guts still say no way, but one day who knows .

What's the near future for an insurance? Months? Years?

Anyway, I'll be doing several sports, I'm not doing something dangerous every day or any extreme sport on weekly basis, so it's like monthly basis for some of them due to the high cost, like rent a car in a professional track etc...

Luke451

Weighty1 said:

Luke451 said:

DullGreyGuy said:

With these classes of insurance full underwriting is done at the point of purchase so an underwriting document is about what should be asked about before buying the policy and considered when writing the insurance by the underwriter. So as you see it says if they ask you about motor sports and you say you are into it then the underwriter should exclude it. If they forget to ask and there isn't a blanket exclusion in the policy then motor sports won't be excluded for anyone who takes it up after buying the policy.

They can't rely on secondary documents, there are only two ways a claim can be denied...

1) Its against the terms and conditions in your policybook/schedule

2) You lied when you took the policy out

Thanks for your response, but I need to ask you about something...

The advisor asked me questions, but I didn't talk to the insurance company, they're always third party advisors, they just wanna sell, so I can't trust him, but I can't even trust the insurance company, they would just think on selling.

I just need to be sure that what I signed is what I expect, I can't trust the entities.

In the main document I received, I didn't see any exclusions, and in the case of life changes (activity, sport etc I guess), I don't need to inform them.

I did some of those sport in the past, but more than 1y before I subscribed.

I'm planning to do some new sport that it's in that screenshot (or some that I already did in the past), but as of today, it's much later the day I subscribed, so, should I be fine?

There is zero reason to believe that you can't trust the person who has advised you on this policy.  The vast majority of insurance advisers DO do right by their clients.  Also, around 99% of life insurance plans pay out, about 93% of critical illness policies and around 90% of income protection plans and more often than not they don't pay out either cos the policyholder has misunderstood what they are covered for OR due to applicants not being truthful.  In fact, Aviva paid out around £1bn in life, critical illness and income protection claims last year.  On this basis, it would very much suggest that you can trust the insurer as well.

As DGG points out, those listed exclusions would only have been relevant if you had disclosed that you do, or intend* to do, those hobbies at the point when you applied or prior to the policy starting.  

The base line for this is that if you don't currently do them then you are covered if you take them up in the future.  For example, I took my L&G income protection out about 10-years ago.  Since they I've started rock climbing and mountaineering, which would definitely be excluded.  Have I informed L&G, no, because there is no requirement to.

*(by intent an insurance company would mean you have a firm intention of doing them in the near future, not that you may but also may not do X, Y or Z activities 2, 5, 10 or 20 years down the line).

In addition to the previous message, I'd like to ask how the insurance determines that I had a firm intention to do some of those sports... I don't think they can, and neither I can, because I'd like to do rock climbing for example, that is a firm intention, but my guts don't even think about it , so, how do they determine if mine was a firm intention to do some of the excluded sports or not?

Weighty1

Only YOU can decide what you put on the application.  The questions asks "do you regularly take part in any of the following activities, or do you intend to do so within the next 6 months?"  If you are doing something regularly it doesn't need to be on a daily basis, it could be weekly or even monthly and in my experience people doing things like tracks days don't typically do them much more than once a month anyway.  

Take the question at face value and answer honestly.

Luke451

Weighty1 said:

Only YOU can decide what you put on the application.  The questions asks "do you regularly take part in any of the following activities, or do you intend to do so within the next 6 months?"  If you are doing something regularly it doesn't need to be on a daily basis, it could be weekly or even monthly and in my experience people doing things like tracks days don't typically do them much more than once a month anyway.  

Take the question at face value and answer honestly.

They didn't ask me anything about what I would like to do, they just asked me what I'm doing probably, if any sport at all, or if any extreme sport at all.

At that time, I wasn't really doing sport and I didn't plan to do it anytime soon, just the intention was there but there was no plan because I had issues to solve.

Plus, some of those sports are not possible in the winter, like rock climbing, you can only do ice climbing if you wish , I'm so curious to know if doing only summer sports enters in the disclosure agreement.

Now, the life changed and I want to do some of those sports which they exclude apparently, but in the underwriting...

I should be still on the safe side, but is it not better to have a dedicated insurance for those sports? My personal issue is that they may be too many...

I don't think it's as you say, if I declare that I do any dangerous sport, they all remove the cover for those specific activities. Certain insurances don't cover them at all, not only if present in the underwriting document signed, I'm talking about the major insurances like L&G, LV etc...

So, I wonder what's the solution for those sports.

I anticipate that I don't want an insurance that pays a lump sum in case of an injury, like SportDirect, in any case injuries for "dangerous" sports are paid very low and the monthly insurance cost may even exceed the one of an income insurance.