Critical illness claim

Weighty1

If you provided them with letters detailing the degree of hearing loss and they are then obtaining a GP report this would lead me to believe they think the claim is valid and are just proceeding with the standard process. Getting a doctors report can be as much about checking that mistruths weren't told when applying as they are about getting full details of the condition you are claiming for.

I'd read this as being a good sign.

Good luck.

MyRealNameToo

https://forums.moneysavingexpert.com/discussion/comment/82061806#Comment_82061806

I would be surprised if they would make an advance payment if there was any material concerns however some customers can be selective of what evidence they submit and things get more ropey when the insurer gathers its own evidence - note not talking about fraud, that goes down a whole different path.

Similarly it also depends on how much underwriting was done at quote stage, if full medical reports were obtained then matters are quicker, if they weren't obtain then they get obtained at claim stage to ensure all relevant declarations were made so its as much an indemnity check as a claim check

Hearingloss2026

https://forums.moneysavingexpert.com/discussion/comment/82062647#Comment_82062647

I sent them basically everything I had to date. Full SAR request all letters and reports and my initial puretone test. I explained the stress I was under away surgery etc and they offered an advance payment to take pressure off whilst they get necessary reports etc…

I am worried sick tbh as if it’s declined I genuinely don’t know how I will cope financially as I won’t be able to work and have children all under 16.

I can’t thank you enough replying.

Do you think if it was an no they wouldn’t have given the adv payment?

Hearingloss2026

https://forums.moneysavingexpert.com/discussion/comment/82062647#Comment_82062647

do you think so?

I really am beyond stressed, feel physically sick and barely getting through the days.

I have never had negative thoughts before until now and only thing keeping me going is my children.

can’t thank you enough replying.

Weighty1

https://forums.moneysavingexpert.com/discussion/comment/82064195#Comment_82064195

Can you imagine how difficult it would be for an insurance company to get back the money they'd paid out if they regularly had to ask for it back? It'd be a nightmare for them.

I honestly don't think they'd have provided the advanced payment if they thought they were going to decline the claim. The fact that they've had such detailed information prior to making the payment to you also suggests they obviously believe they will be paying out, otherwise why would they give you an advance payment and state it doesn't need to be repaid if they decline the claim? They wouldn't!

I know these situations are difficult but I think you are in a very good position based on your situation.

Hearingloss2026

https://forums.moneysavingexpert.com/discussion/comment/82067986#Comment_82067986

Thank you for replying.

My GP report is now with the insurer and my specialist report was posted last week but hasn’t arrived with them as of yet.

My specialist did want to speak to me direct and explain areas of the report so I was not upset or anything came as a shock. They explained my condition does meet the policy wording and it is permanent.

I’m hoping that his report is enough for them to agree however can’t help think they will look for reasons to not pay out. I’ve seen so many comments on the forum saying insurance companies have been very challenging.

Having the forum has been a great help and your advise has genuinely been comforting

kingstreet

https://forums.moneysavingexpert.com/discussion/comment/82076962#Comment_82076962

The stats indicate 90% - 93% critical illness claims are accepted so it's not as bad as you might think.