Insurance Payout Question

DullGreyGuy

Point of redundancy, I would argue, is the date of death given the contract is instantly frustrated when the employer no longer exists and its not like a situation where the executor may step in to run a business before a transfer. 

qwerty129

Quick follow up. Is there any downside to my accepting the £2,000 they are willing to pay, while continuing to query the other two issues?

Their answers so far basically seem to be a version of - "it doesn't matter what our policy wording says  - the intent of the policy is this, and this is all we agreeing to pay".  

DullGreyGuy

qwerty129 said:

Quick follow up. Is there any downside to my accepting the £2,000 they are willing to pay, while continuing to query the other two issues?

Their answers so far basically seem to be a version of - "it doesn't matter what our policy wording says  - the intent of the policy is this, and this is all we agreeing to pay".  

No, you can accept it as interim settlement. 

As to the second paragraph, the exact opposite is true. It only matters what the contract states, the intention is irrelevant. 

qwerty129

DullGreyGuy said:

Point of redundancy, I would argue, is the date of death given the contract is instantly frustrated when the employer no longer exists and its not like a situation where the executor may step in to run a business before a transfer. 

Update on this. After many months, the insurance company upheld our first complaint re: how they were calculating payouts as if the redundancies were sequential rather than simultaneous. They agreed to pay the £2600.

As for the second part of our complaint re: the definition of the "point of redundancy" that should be used in any calculations. They disagreed that the "point of redundancy" was the date the employees were legally made redundant and stated that in their eyes it was the latest date the bank statements went up to. This date they are using conveniently allows them to pay out less as the bank account had more money in it on that date.

Should I pursue the second point further? 

qwerty129

Just to close this out. Fish insurance in the end were forced by the Ombudsman to pay us the policy maximum of £4000, double what they were willing to pay when I started this thread.

Ty all for your help. Details below.

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I complained to Ombudsman that 'point of redundancy' should be the date the employees were made legally redundant, not some arbitrary later date they had chosen because the bank account had more money in it on that date and it thus allowed them in their calculations to pay us less. The ombudsman upheld our complaint pretty forcefully.

The funny thing is that if they had not tried to get out of paying the initial extra £600 using, imo, questionable calculations (see first few posts in this thread), I never would have re-read their terms more carefully and realised that, by their own terms, they owed us the full £4000.

A reminder to review and be skeptical of how insurance companies calculate payouts for claims.