Vitality income protection rejected

Bear21

Has anyone had problems claiming after being unable to work? 

I’ve been paying Vitality for an income protection plan for many years and never claimed. Recently I’ve had an accident which has stopped me working and Vitality has taken over a year to decide to reject my claim. The claims process has been painfully slow and the lack of response has caused even more health related problems. They didn’t even ask my GP for the medical records for over 7 months and then allegedly went through to a Vitality advisor, senior advisor, medical advisor, senior medical advisor and then a final manager to conclude the findings to reject the claim.  

I was signed off work by my doctor and after months of Physiotherapy & MSK I have been told I need an operation. All the relevant medical information and specialist reports have been submitted but they have basically dismissed it. 

I raised an official complaint to which the 8 weeks timeframe passed with no resolution / response. 
I have now contacted the financial ombudsman for assistance in getting this resolved. 

Any assistance / advice would be greatly appreciated. 

born_again

Bear21 said:

Has anyone had problems claiming after being unable to work? 

I’ve been paying Vitality for an income protection plan for many years and never claimed. Recently I’ve had an accident which has stopped me working and Vitality has taken over a year to decide to reject my claim. The claims process has been painfully slow and the lack of response has caused even more health related problems. They didn’t even ask my GP for the medical records for over 7 months and then allegedly went through to a Vitality advisor, senior advisor, medical advisor, senior medical advisor and then a final manager to conclude the findings to reject the claim.  

I was signed off work by my doctor and after months of Physiotherapy & MSK I have been told I need an operation. All the relevant medical information and specialist reports have been submitted but they have basically dismissed it. 

I raised an official complaint to which the 8 weeks timeframe passed with no resolution / response. 
I have now contacted the financial ombudsman for assistance in getting this resolved. 

Any assistance / advice would be greatly appreciated. 

Nothing more you can do. You will just have to wait until FOS make their decision. Which could be months.

DullGreyGuy

I'm afraid you dont give us anything to go. Have they said it's related to a pre-existing condition that was excluded? Are they saying they believe you are fit to work? 

Ultimately having passed the complaint to the Ombudsman then you simply have to wait for them to make their Adjudicator decision, both you and the company get asked if you agree, if either dont it goes up to an Ombudsmand who's decision is binding on the company. 

As soon as I hear somethings gone to a GP I get twitchy. Was declined insurance based on whatever it was my GP told them (Aviva for PHI, Vitality for Life) but my consultant not only got them to offer terms but offered at standard rates which is a massive uturn. 

Bear21

I’ve got no pre-existing health / medical issues. My medical reports after the accident are conclusive of my injuries that have prevented me from working. 

Vitality just seem to be giving me the runaround….. my doctor sent a letter to Vitality stating that with my prognosis I was not fit for work and requiring further medical treatment (waiting for an operation) They just seem to disregard any medical evidence that has been submitted without giving any valid reason. 

There was a long delay responding to my original claim (6 weeks) and when I contacted them for an update they told me that my claim from was missing and could I please resubmit it.
I was also told that by the advisor they have had a massive influx / backlog of claims and would escalate my case and get back to me regarding my claim. They didn’t and I’ve been having to chase for updates ever since. 

wjr4

There must be something on your medical history for them to decline it. Have you asked for the reason?

sheramber

g and Vitality has taken over a year to to reject my claim.

What reason did they give for refusing your claim?

Bear21

I’ve got No previous medical conditions.  All Vitality has said is that their medical advisor have reviewed my case notes and rejected my claim stating that I could continue working with my injuries. I do a physical job in a garage and with my injuries I’m on painkillers and unable to complete my day to day role or adapt my role to accommodate me. 

csgohan4

The question here is, is your income protection specific to your job role or just can't work at all? If the latter, then I can see why they have rejected. Please clarify

Bear21

It’s an income protection for any eventuality - weather it be through accident or sickness or redundancy. My financial advisor set it up years ago to safeguard me against any of the above as I went through a divorce and I was living by myself and paying all the bills / mortgage ect…. 

No special terms or conditions were added and my line of work is still the same. 

I have submitted a SARS request for the information regarding the rejection of my claim to which I still haven’t received. They have acknowledged my request but that was over 8 weeks ago. 

DullGreyGuy

Bear21 said:

It’s an income protection for any eventuality - weather it be through accident or sickness or redundancy. My financial advisor set it up years ago to safeguard me against any of the above as I went through a divorce and I was living by myself and paying all the bills / mortgage ect…. 

No special terms or conditions were added and my line of work is still the same. 

I have submitted a SARS request for the information regarding the rejection of my claim to which I still haven’t received. They have acknowledged my request but that was over 8 weeks ago. 

You didnt answer the question CSGO asked... IP can be written such that you have to be unfit to do any job or can be written such that you only have to be unfit to do your own job and it doesn't matter that you may be fit enough to be a call centre agent etc. 

Which is yours? If its any job then clearly makes it easier for them to reject when you have a physical job.

kingstreet

There are definitions of disability, such as "work tasks," "suited occupation" or "own occupation" and these are used to determine the likelihood of a successful claim.

Work tasks basically says if you can use a pen, keyboard etc you will be unable to claim. Therefore this is the cheapest premium option.

Suited occupation means something you could realistically do instead of your own job. A bit easier to claim and a bit more expensive each month.

Own occupation is the most expensive option. It pays if you can't follow the basic requirements of your own job.

If you are some kind of mechanic, your occupation class 4 would make Own Occupation very expensive and it's not beyond the realms of possibility your adviser used a harder definition to bring down the premiums.

Could you look at your policy and tell us the definition used, please.

Could you also tell us the deferred, or waiting period as this can often be lengthened to reduce the premiums but leaves you unable to claim for a longer period at the outset of the claim.

If you do have own occupation and the insurer is saying you can do your job, you need to question the medical data and consider making a complaint and escalating to FOS if you don't get an acceptable response within the accepted timescale.