Failure to pay out under an Income Protection Policy

DEBRAKING

I have been declined my claim under an IPP. The Insurance Company is UNUM. Although they have all the medical evidence they are still declining my claim. Has anyone else been a victim of this insurance company. i am having to take them to Court for breach of contact.:eek:

Hippychick

I am in receipt of IPP from this company, it was arranged by my employers, I was told that if I was deemed unfit to work then the claim would stand.

The T's&C's do say that they have to accept the claim first before they will pay out.

Can you appeal? was it arranged through your employers can they help at all?

DEBRAKING

I am self employed and did the occasional contract work. I was told that if i was unable to work through illness or accident then i could claim. As a result of a car crash i have not been able to work for nearly 2 years. I have been put back together by screws and other bits. unum have had all the medical evidence but state i am not injured. I have appealed 5 times and they still will not pay. they keep changing the goal posts. I am now having to sue through the Courts. Even if i had the policy through an employer they still would not pay. I feel very angry as they are still taking my premiums. They know how injured i am, they just do not want to pay out.

Hippychick

OK, i'm not sure what advice I can give as my experience with them has been different, good luck with the court claim I hope it works out for you.

dunstonh

I noticed you have commented on a few threads involving PHI and must ask you to refrain a bit because you have not stated the type of income protection policy you had.

Was yours a mortgage payment protection or budget income protection or a standard or comprehensive permanent health insurance?

What was the reason for refusal?

artyj_2

I too am self emplyed. I am well now, but was diagnosed with ME 18 months ago. I have waited 1 year for UNUM to resolve my claim and they have just written to me saying 'there is not enough evidence to support the fact that I had ME at the time of my claim' It is utterly utterly mind boggling. I was tested over and over and given the diagnosis my a Doctor that follwed all the MR guidlines. They are saying i could not have had ME because the Doctor offred me no treatment 0 THERE IS NO TREATMENT!!! Nothing on the NHS anyway. I went to a private osteopath and homeopath and got well relatively quickly
This company are fraudsters and NO ONE should ever take out a policy with them. I wish I could find more ways of exposing them.
I have a low income and struggled to pay the premiums after being persuaded by an insurance broker i needed the cover as a self emplyed person. I paid over severla years and i would give anything to have that money now
What can we do about these people?
How can they turn down a claim when i was signed off sick and recieved incapacity benefit. Did i take out ME insurance? What difference does their opinion of the diagnosis make? I was too sick to leave the house - do they think just cos they think ' it wasn't ME' that i was lying and fooling the doc and should have been at work
I am going to appeal, but don't hold much hope from what is written here
We MUST expose these thieves

dunstonh

fter being persuaded by an insurance broker i needed the cover as a self emplyed person.

Good recommendation. Self employed get lower state pensions and less state benefits.

What can we do about these people?

If you feel that the insurance company is wrong then you should raise a formal complaint to them stating your opinion. They will review this and then give you a decision and ultimately if you cannot agree, they will issue a deadlock letter. That will allow you to pursue the complaint to the Financial Ombudsman Service (FOS). They will see if you have been treated in accordance with the policy rules and make a decision.

What difference does their opinion of the diagnosis make?

It can depend on the type of policy you have and if you have had pre-existing conditions.

We MUST expose these thieves

I suggest you keep a level head when you make your complaint. That style of language isnt going to aid you. Factual, bullet points in a short letter are the best.

jennywhite

Good luck with your claim. Make sure you write again stating you want to make a complaint and want a reply withing 6 weeks. State you will take them to the ombudsman