Critical Illness Payout

DullGreyGuy

born_again said:

DullGreyGuy said:

born_again said:

Do the T/C of the LV policy state that they need to be informed of such changes?

Raise a complaint. You can then got to FOS if not resolved to your satisfaction & FOS will make a judgment on the case. 
Will not be quick.

You aren't required to tell them about changes @born_again, the issue is the OP had high blood pressure before taking the policy out and failed to declare it when getting their quote. 

OP said The LV was taken out before the Aviva in May 2022. 

So I took this to mean the policy was already in place when taking out the Aviva one.

But seems odd to have 2 critical illness policies.

Perhaps OP could confirm exactly when LV policy was taken out 👍

They've already said that the high blood pressure was found by the assessment done on behalf of Aviva which was before the LV policy incepted. 

As to why have two CI policies taken out more or less simultaneously? I'll leave that to the OP or one of our IFAs to explain why it may be a sensible strategy -v- one higher sum insured policy. 

dunstonh

As to why have two CI policies taken out more or less simultaneously? I'll leave that to the OP or one of our IFAs to explain why it may be a sensible strategy -v- one higher sum insured policy. 

Given the sum assured involved, I can only think the of the following reasons:
1 - if one was a LTA and the other was a DTA (or FIB) and the provider terms meant separating them resulted in a lower premium cost than having two segments on the same plan.   
2 - the lives assured knew there were potential medical issues and were hedging their bets.
3 - there was no adviser used, and the purchaser didn't really know what they were doing and decided to split providers for some reason. (maybe thinking that smaller sum assureds would reduce the chances of tests etc)

I think the OP would need to explain why they did it. 

Coffee10

@dunstonh two policies were taken on advice from our financial advisor. As for point 2 there were no potential medical issues...I can assure you we didn't see a fatal brain tumor coming.

dunstonh

Coffee10 said:

@dunstonh two policies were taken on advice from our financial advisor. As for point 2 there were no potential medical issues...I can assure you we didn't see a fatal brain tumor coming.

My responses were generic as I didn't know why you did it that way.

What reasons did your FA give for doing it like that? 
What advice did they give to you when they found out about the medical condition?

sidn3y

I'm having trouble with LV fight now under the terms of my terminal illness cover on my life insurance. Apparently I'm not dying early enough.

I can't post links here so checkout the full story on Trust Pilot.

 

DullGreyGuy

sidn3y said:

I'm having trouble with LV fight now under the terms of my terminal illness cover on my life insurance. Apparently I'm not dying early enough.

I can't post links here so checkout the full story on Trust Pilot.

Claim denied because I’m not dying quickly enough!

My Terminal Illness claim is now with the ombudsman. When I took out my mortgage, I took out a life insurance policy with LV. It came with Terminal Illness Cover. The definition of terminal illness according to LV: “means an incurable illness where, in the opinion of an attending consultant and our Chief Medical Officer, you would not be expected to live for more than 12 months from the date you are diagnosed.”
So, at the beginning of April I was diagnosed with a glioblastoma. A highly aggressive, incurable, stage 4 brain tumour. The prognosis then was 12-14 months life expectancy.

The tumour was removed very quickly (thank you NHS) and after my neurosurgeon removed it, my oncologist took over with a treatment plan of chemo and radiotherapy. I am now in palliative care and the plan is to extend my life as much as possible.

I, therefore, put in a claim for the terminal illness cover on my policy and my oncologist filled in the form, identifying my prognosis as less than 12 months.

LV responded that their doctor, citing a trial paper from 20 years ago, wants to wait until the result of a scan in 3 months’ time to determine if the prognosis changes. The trial that was cited, identifies that people who had this very same cancer, lived an average of an extra 2 months on the same chemo/radiotherapy treatment plan I am on.

So, I might live an extra 2 months but the scan they want to wait for is in 3 months? 
As part of this illness, I now have seizures (life-threatening) and the next could be my last. I had one a week ago. I have also lost the peripheral vision in my left eye and can no longer drive. Walking is a challenge.

So, in summary, a doctor at, LV, whom I have never spoken to and possibly may or may not specialise in Oncology and Neurosurgery, quoting a 20-year-old study, contradicts the medical professionals who specialise in those areas and have physically (and regularly) seen/spoken to me.

I don’t see anywhere in the terms and conditions where it states “we will continually monitor you in case your prognosis changes based on your treatment cycles.

Based on the seizures, loss of vision plus the damage chemotherapy does to my good cells, there will soon come a time where I am unlikely to be able to work. No work means no mortgage, Help to Buy or life insurance payments (which would null and void the policy). I may even require 24/7 care towards the end.
5% of people with a glioblastoma can make it beyond 5 years potentially. It’s a small number.
Maybe I make 5 years, maybe I don’t wake up tomorrow but as far as LV is concerned (based on their doctor, I will live beyond 12 months. But only by 2 months as cited by the trial paper.

I get it! They are a big corporation (part of the Allianz Group) and looking at profit and loss only. They don’t look at the human side at all. It’s business. Maybe their doctor is under KPI’s to save as much money as possible. Rejecting my claim would do that.

I am not claiming for a dink in my bumper, I’m claiming because I want to enjoy the little life I have left.

As I said, this claim is now with the financial ombudsman. I have highlighted, in my complaint to them, that the lack of information regarding having to keep monitoring scans, for a prognosis change, are not in the terms and conditions and that may mean they mis-sold me the policy. £50+ a month over 11.5 years, + interest could amount to a fair bit, so let’s see what comes back from that. That could take another 8 weeks to process though so there goes another 2 months.

Of the fights in my life right now, fighting an insurance company shouldn’t be one of them.
I guess if the ombudsman doesn’t find in my favour, the only recourse available to me then is legal and social media.

So, would I take out another insurance policy with LV? Not even to insure a hairbrush (something else I won’t need soon).

Apologies for the long review but thank you for strapping in until the end.

Sorry to hear about your diagnosis @sidn3y.

Normally its the other way around, you take out Critical Illness and it comes with Life insurance because the CI represents the vast majority of the premiums, in some policies adding Life is even free on a CI policy. 

It's unclear however what happened? You state your prognosis at time of diagnosis was 12-14 months (which for the avoidance of doubt isnt less than 12 months) but your oncologist subsequently stated less than 12 months post surgery... was this a case of 3 months having lapsed so fundamentally agreeing with the original diagnosis or that the oncologist disagreed with the original prognosis? 

Why has this been considered under terminal illness rather than Cancer? Is it actually a claim on the Life side (which often do have a payout for under 12 months to live) because it's higher than the Critical Illness cover? 

As to not being able to afford mortgage, unfortunately this is why Income Protection is so much more important than Critical Illness as it will replace your income if you are too ill to work no matter the prognosis. 

dunstonh

 get it! They are a big corporation (part of the Allianz Group) and looking at profit and loss only. They don’t look at the human side at all. It’s business. Maybe their doctor is under KPI’s to save as much money as possible. Rejecting my claim would do that.

When did Allianz buy LV Life & Pensions?   They bought the GI book but last I saw, LV L&P was still independent.

DullGreyGuy

dunstonh said:

 get it! They are a big corporation (part of the Allianz Group) and looking at profit and loss only. They don’t look at the human side at all. It’s business. Maybe their doctor is under KPI’s to save as much money as possible. Rejecting my claim would do that.

When did Allianz buy LV Life & Pensions?   They bought the GI book but last I saw, LV L&P was still independent.

You're correct but it is confusing as both GI and L&P products are still advertised on LV.com but the footer does change depending on which group of products you are viewing.