L&G rejected claim

Crazycat_2lady

Recently been having health issues that potentially will make me unable to continue working still waiting  
Had a L&G life insurance & critical illness cover policy for 21 years ( expired 31st august, claim was in before this date)& decided to make a claim which has taken forever to gather relevant information required by L&G.
Fast forward to present day 
Phone call today from an assessor explaining that due to my non diagnosis as yet from rheumatology (awaiting PETscan 15th oct for diagnosis & potentially treatment) they are saying that they are assuming that there will be treatment after the results? And because of this they are saying that I could go back to work? the policy has expired they won't be able to put this on hold until the results & they are rejecting the claim??? 

EthicsGradient

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MyRealNameToo

Crazycat_2lady said:

Recently been having health issues that potentially will make me unable to continue working still waiting  
Had a L&G life insurance & critical illness cover policy for 21 years ( expired 31st august, claim was in before this date)& decided to make a claim which has taken forever to gather relevant information required by L&G.
Fast forward to present day 
Phone call today from an assessor explaining that due to my non diagnosis as yet from rheumatology (awaiting PETscan 15th oct for diagnosis & potentially treatment) they are saying that they are assuming that there will be treatment after the results? And because of this they are saying that I could go back to work? the policy has expired they won't be able to put this on hold until the results & they are rejecting the claim??? 

So were you claiming for a particular condition or a general "total and permanent disability"? 

Presumably you are suspected of having an inflammatory disease other than arthritis? 

If there is no diagnosis yet then there is no way of saying it's permanent and total plus certainly the current policy wording states the diagnosis must be before the end of the policy. 

Tax_Slave

Typical insurance.
Take your money for 21 years plus and now squirm their way out of paying.

Let this be an advertisement for anyone thinking of taking this type of cover.

MyRealNameToo

Tax_Slave said:

Typical insurance.
Take your money for 21 years plus and now squirm their way out of paying.

Let this be an advertisement for anyone thinking of taking this type of cover.

Typical trolls claiming it's squirming their way out rather than actually stopping to think for 30 seconds if the claim should have been covered or not. Guess they'd be happy to pay 20x the premium in exchange for any claim being paid unquestioned. 

Personally I dont like Critical Illness as a product and it would be at the bottom of my list of protection policies to buy. It does however do what it says on the tin, pays out in the event of one of the listed conditions being diagnosed within the term of the policy with the level of severity required. 

The OP hasn't said their condition only that rheumatology are looking into it and they dont have a diagnosis. So problem 1 is that rheumatology and illnesses covered by CI do not have a very good overlap but the OP knew that from the outset when they were told which illnesses were covered. Problem 2 is that they dont have a diagnosis yet so dont meet the fundamental requirement of the policy. 

Better policies do cover permanent total disablement but again without diagnosis you can't say it's permanent. Permanent Total Disablement is a high bar esp when not an "own occupation", exact tests will vary by insurer but its typically things like not being able to climb 12 steps, walk 200m, pick up a 2kg item from a table and hold it for 60 seconds etc

Have no idea of the OPs premiums or limit but had I taken out CI cover I'd have paid out £21k over a longer period than the op to cover £400k of payout... personally would be happy if I never had a claim, would be annoyed if I got ill just after it expired but thats life, clearly at premium to claim value limit not everyone is claiming. 

Things like PHI are much better in many respects as it doesnt matter what the illness is, just that you are too ill to work. The downside is it pays a monthly amount so with the OP at the end of their policy even if the claim was accepted it'd only be a few payments left rather than the large lump sum of CI

Tax_Slave

MyRealNameToo said:

Tax_Slave said:

Typical insurance.
Take your money for 21 years plus and now squirm their way out of paying.

Let this be an advertisement for anyone thinking of taking this type of cover.

Typical trolls claiming it's squirming their way out rather than actually stopping to think for 30 seconds if the claim should have been covered or not. Guess they'd be happy to pay 20x the premium in exchange for any claim being paid unquestioned. 

Personally I dont like Critical Illness as a product and it would be at the bottom of my list of protection policies to buy. It does however do what it says on the tin, pays out in the event of one of the listed conditions being diagnosed within the term of the policy with the level of severity required. 

The OP hasn't said their condition only that rheumatology are looking into it and they dont have a diagnosis. So problem 1 is that rheumatology and illnesses covered by CI do not have a very good overlap but the OP knew that from the outset when they were told which illnesses were covered. Problem 2 is that they dont have a diagnosis yet so dont meet the fundamental requirement of the policy. 

Better policies do cover permanent total disablement but again without diagnosis you can't say it's permanent. Permanent Total Disablement is a high bar esp when not an "own occupation", exact tests will vary by insurer but its typically things like not being able to climb 12 steps, walk 200m, pick up a 2kg item from a table and hold it for 60 seconds etc

Have no idea of the OPs premiums or limit but had I taken out CI cover I'd have paid out £21k over a longer period than the op to cover £400k of payout... personally would be happy if I never had a claim, would be annoyed if I got ill just after it expired but thats life, clearly at premium to claim value limit not everyone is claiming. 

Things like PHI are much better in many respects as it doesnt matter what the illness is, just that you are too ill to work. The downside is it pays a monthly amount so with the OP at the end of their policy even if the claim was accepted it'd only be a few payments left rather than the large lump sum of CI

Feel free to call anyone you don’t agree with a troll. I’m a grown up so will ignore the childish name calling. That’s for school playground 😀
On the topic of insurance ‘squirming way out of paying’ as if by magic this article on BBC webpage today…
🤔

https://www.bbc.co.uk/news/articles/c87yey5neggo