Insurance companies delaying paying out on claims

DenisThurley53

Can you give me a link to any conversation regarding Insurance companies prevaricating on making claim payouts?

If there isn't any such conversation, how do I go about starting one?

My wife and I have had to cancel a cruise because my father-in-law was recently given a terminal cancer diagnosis, with days/weeks as the likely timescale.
We made a claim, on a very expensive insurance policy, two months ago and have had no correspondence from the claims team since. My wife has suffered the stress of many, long calls to the company to try and get some information on the progress of our claim and every time she speaks to someone she gets a different excuse about why we're waiting but no substantive update on the claims progress.

In conversation with friends and colleagues, we are hearing we are far from the only people suffering like this at the hands of insurance companies failing to make legitimate payments. One colleague has a claim approaching its first anniversary and this was life insurance. A friend who is a travel agent has told me the practice is commonplace.

I'd be interested in your thoughts or advice please.

MyRealNameToo

DenisThurley53 said:

Can you give me a link to any conversation regarding Insurance companies prevaricating on making claim payouts?

If there isn't any such conversation, how do I go about starting one?

My wife and I have had to cancel a cruise because my father-in-law was recently given a terminal cancer diagnosis, with days/weeks as the likely timescale.
We made a claim, on a very expensive insurance policy, two months ago and have had no correspondence from the claims team since. My wife has suffered the stress of many, long calls to the company to try and get some information on the progress of our claim and every time she speaks to someone she gets a different excuse about why we're waiting but no substantive update on the claims progress.

In conversation with friends and colleagues, we are hearing we are far from the only people suffering like this at the hands of insurance companies failing to make legitimate payments. One colleague has a claim approaching its first anniversary and this was life insurance. A friend who is a travel agent has told me the practice is commonplace.

I'd be interested in your thoughts or advice please.

Payout timescales vary significantly depending on the nature of the claim, evidence needed/provided etc. Often insurers divide their claims teams up with a basic team fielding most the calls and better paid/trained people doing most of the actual claims handling. In some firms the first line will pass calls through to second line and in other firms they can't... even in ones they can they may well be discouraged from doing so as far as possible. The consequence of which can mean you get inexperienced staff trying to understand what another more advanced team is doing and not always getting the right end of the stick. 


The big challenge you will have is that you are making a medical claim. This will mean the insurer wants a report from the doctor (normally GP) of the person thats ill and in your case thats not you or one of the other insureds which means more hoops to go through to convince the GP they have the consent to share the information. 

In my experience its always a shared responsibility but often the bigger delays are caused by the GPs who, despite charging a very hefty fee, are often very slow at responding, often dont bother completing the forms correctly and often try to charge a second fee when we have to go back and point out that they failed to fill in the last page nor signed/stamped the statement of truth. 

The number of reports that I received back in under 2 weeks with the form fully and appropriately completed was a tiny proportion. Most the time you were lucky to get it back within a month and normally at least one thing needed to go back to them again which often meant another months wait and longer if they decide to send another invoice before even looking at it. 

My last Travel claim was paid out in under 2 hours. My last Home claim was paid out on the second working day after registering the claim (technically it was prioritised as I know the claim handlers but it was also slowed as they wanted the insurer to confirm they didnt have a conflict of interest because I am known to the claim handlers). Neither of these needed medical evidence though and that made things much simpler. 

DodgyDave88

Quick enough to take payments for the insurance though aren't they? Nothing but crooks !

DenisThurley53

Thanks for responding.
In our case we got the medical forms signed by the GP before submitting the claim.
Avanti (our insurer) outsource claim handling to Ergo.
Over the past 8 or 9 weeks various call handlers have told us there was no paperwork or that the case had had to be escalated or given us estimates that it would take 5 more days or 21 more days or someone would calls us back in a day or two, and none of these things happened.
Today my wife asked to speak to a manager or supervisor and the call handler told her she'd get her an email update, which has just arrived!! It's apparently "in its final stages and should be complete by the end of this week". We shall see.

DenisThurley53

Still no correspondence from the claims processing company but yet another lie when my wife called again - "you'll hear from someone by COB tomorrow". We didn't. That's another 10 days.
Avanti then told us our claim should have been settled by now and the delay was unacceptable. They said they'd raise an "official" complaint with Ergo. Two days later we had an email from Avanti's Complaints Team, confirming our complaint had been logged and to expect an update from them "WITHIN EIGHT WEEKS"!! Irony or what
It is now clear that Avanti and Ergo can afford to employ teams of people to lie, prevaricate, obfuscate and delay and frustrate their customers when they dare to make a claim. I wonder if there's a way to find out just how much interest they are making by not paying out legitimate claims.
Next stop Financial Ombudsman Service. Anyone had any luck dealing with them?

dunstonh

 confirming our complaint had been logged and to expect an update from them "WITHIN EIGHT WEEKS"!!   Irony or what

Not sure why you think that is incredulous.    They have to say 8 weeks as that is the default timescale they are required to state.  no irony. Just what the rules say.

Next stop Financial Ombudsman Service. Anyone had any luck dealing with them?

You cannot go to the FOS.  You have to wait until the 8 weeks is up before you can do that.   Which is what your complaint response tells you.

MyRealNameToo

The rules give a firm up to 8 weeks to respond to a complaint, if they fail to respond by then you can go to the Ombudsman despite not having the final response from the insurer. 

Not saying it never happens but the majority of complaints are dealt with significantly quicker but they have to tell you the time limit. 

Unfortunately when customers will switch insurers to save less than £5 a year then firms have to look at how to cut costs and yes having less staff and accepting longer waiting times does save costs enabling you to offer lower premiums. 

DenisThurley53

Avanti have raised a complaint wth Ergo, the company they outsource claims handling to. Ergo have already spent nine weeks doing nothing, as far as we know as we have had zero communication.
Avanti's website states customers making a claim will hear within 5 days and most claims are settled in another five working days - nothing about eight weeks.
Our complaint to Avanti is that we have waited nine weeks with zero communication.
I'm sure most people will see a certain irony in these numbers.
My question was what experience have readers had dealing with the FOS?