PLEASE Help me write letter to explain "discrepancies" to mortgage Insurance Cover Co

[lferr2002]

Hope this is in the right place if not please move to correct area. Sorry for the long post

Ok 2003 I gets my mortgage and also my ppi with Scottish Provident. At the time I completed an application form and answered no to the following questions....

Have you consulted your doctor and been advised to have an operation, check up xray or investigation in the last 3 years with the exception of minor ailments

and

Have you suffered from arthritis, or any back, spine or other recurrent joint injury.

Anyway I was off my work for 5 months till Feb this year with an anxiety disorder and I put in a claim and today recieved a letter stating that they had recieved my doctors report and would like me to write explaining why I ommited the following as your claim could be void

1. I was referred to a cardiologist in 2003 with a history of cardiac dysrythmia (what??) where I had investigations and I was found to be suffering from sinus tachycardia (was I???)

and

2. I attended my gp on more than 1 occasion with neck pain and it was discovered I was suffering from neck prolapse (What???)and I was prescribed painkillers.

Ok here is my version of events.

1. In 2003 I felt lethargic and dizzy I went to docs who advised to rest and come back I went back feeling better he sent me to hospital as a precautionary measure to be checked I went for the check went back to the docs who said everything ok however if I continued to feel unwell I "could" be prescribed beta blockers, which I never was prescribed nor took as I felt better. End of As far as I was concerned I was fine, maybe had had a virus and this would not ever affect me again - which it hasn't

2. I fell off a horse hurt my neck went to the doc who said I had muscle spasms prescribed anti inflammatory tablets I saw him a further 2 times as he wanted to make sure as it was a neck/shoulder injury anti inflammatory tablets worked pain went end of story. (and anyway since when were muscle spasms a joint disorder???)

As both these conditions were in my opinion both non recurring one off and needed no further treatment I didnt mention them as to be honest they were so insignificant it didnt even occur to me.

I have phoned my doc today but he is off and someone will call me back as apparently I have 3 medical conditions or have had 3 medical conditions I knew nothing about which is in itself a bit bloomin scary. But more importantly does anyone have any advice on how to respond in writing to this letter from Scottish Provident.

Please

Thankyou

[citizenB]

I think first of all you must see your GP and show him the letter you have received from the Insurance company. He/she can explain the content of the letter they have written to the Insurance company. Once you have that information you will be better informed to enable you to make your claim with Scottish Provident.

[Bookworm]

1 - Cardiac dysrhythmia is the accurate medical term for an irregular or abnormal heart rate.

2 - There is no such thing as a neck prolapse. You could have a disc prolapse, or a neck injury, but not a neck prolapse.

Here, fishy, fishy, fishy. SP are fishing away, see what they can catch or maybe scare away with those long scary words.

CitizenB is quite correct. Go see your GP and get him/her to clarify what is in your notes and how that relates to SP's letter.

On the dark side: "investigation" covers a multitude of things and if you went to a cardiologist for tests, it does come under investigation, and anything related to the heart will not come under "minor" ailments, although if the tests showed nothing serious, that should be arguable. Secondly, if you hurt your neck after a fall, then it may come under spinal injury, and that should have been disclosed.

The reassuring (believe it or not) part is that if they are using long complicated words, it means they are trying to make it sound worse than it was and seems to indicate they are not sure of their grounds.

See your GP, get an explanation, get back to SP, if they turn you down, don't muck about, straight to the FOS.

[ScarletPimpernel]

Sinus tachycardia simply means that you have an elevated heartrate - that ism, the heart is beating faster than usual. It most cases it is a perfectly normal cardiac rythm - most of us have experienced it - after exercise, for example. It's part of the 'fight or flight' response, and it's also often a feature of anxiety.

If it appeared on the ECG screen when someone was lying in the street having collapsed with chest pain, I'd suspect that it may be indicative of something more serious such as acute myocardioal infarct.

In this case, I'd suggest that one episode of sinus tachycardia, which was investigated as a precaution and has not recurred, could be viewed as a minor ailment.

[lferr2002]

Thanks guys. The GP who I actually saw at the time of the 2 disputed points was unavailable but I spoke with my own GP (who wrote the report) He advised that after requesting a report about my current condition (the one I am claiming for) they wrote back to hiom and asked him for any treatments I had recieved in the 3 years prior to November 2003 (date of signing application) He therefore advised them of the disputed events and also a bout of flu. He advised me that none of the conditions are serious and that a neck proplapse refers to a slipped disc - however at the time I was treated for muscle spasms (not the same)

I have written a letter but wondered if someone could advise of its content or improve it

Here is the content

Dear Mr XXXXX

Thank-you for your letter dated 15th April. I tried to call you today, however the number at the top of your letter and in the second last paragraph – XXXXXXXXXXX, appears to be a help desk or service desk number. I apologise that there seems to be discrepancies between my original application and the information you have obtained from my medical records, however I would like to say that the information you provided me with was quite disturbing as I had no knowledge of any of the 3 conditions I have been described as suffering from, and therefore I have contacted my GP to discuss these matters.

I agree that in 2003 (perhaps the June) I was advised to have a check up at the hospital, having been to see the doctor with fatigue, dizziness and nausea. I do not recall how long I felt unwell, so cannot confirm if this was the 6 week period you refer to. When I returned to the doctor for the same condition and reported feeling better, he suggested a check up at the hospital just to ensure “it was nothing more than a virus”. I saw someone, but had no idea they were a cardiologist, as your letter states, and he stated that there were no problems, I had a slightly increased heart rate and pulse, but that was due to the fact I was attending an unfamiliar place and doctor, and this was a normal response, often known as “white coat syndrome”. He said he would send a letter to my doctor. I then had my follow up appointment, where my doctor confirmed there was no obvious cause for concern, and stated if I continued to feel unwell, I could take a course of tablets (perhaps the beta blockers you refer to). However, I never took these tablets, the check up had proved I was healthy, I continued to feel well and therefore assumed it was a virus and that this therefore was considered a minor ailment, which I truly felt there was no need to mention on the application form. It was, in my opinion, the same as me having, say, the flu.

In your second point you indicate I have suffered from a neck prolapse, again I am unaware of this condition or even what this is. In 2003 I fell off a horse and went to the doctors with a sore neck and was prescribed medication, anti-inflammatory tablets I believe. My neck pain reduced, it became better and I assumed that was that, my doctor did ask me to come back on 2 or 3 occasions as he said you can never be too careful with neck or back injuries, had it not been for this I would have just finished the tablets and continued with daily life. Again, I did not feel that this was a major illness nor arthritis nor any back, spine or other recurrent joint disorder. I understood I had pulled a muscle, which with rest and time had healed. Therefore, I believed that I was telling the truth and not withholding any relevant information on the application form.


I hope this information is useful and will allow you to recognise that I was unaware that I had any of these conditions and truly felt that any illness I had experienced was short term one off minor conditions.

Yours Sincerely






XXXXXX

[lferr2002]

Managed to speak to my doctor who stated that Sinus tachycardia is not a medical condition (phew) and that unless I had been rigged to a heart monitor which I hadn't, then a diagnosis of cardiac disrhythmia for 6 weeks is innaccurate and there is no such thing as neck prolapse so I have put together another letter can anyone tell me what they think?

Dear XXXXXX

Thank-you for your letter dated 15th April. I tried to call you today, however the number at the top of your letter and in the second last paragraph – XXXXX, appears to be a help desk or service desk number. I apologise that there seems to be discrepancies between my original application and the information you have obtained from my medical records, however I would like to say that the information you provided me with was quite disturbing as I had no knowledge of any of the 3 conditions I have been described as suffering from, and therefore I immediately contacted my GP to discuss these matters and would now like to clarify the points you raised.

I agree that in 2003 (perhaps the June) I was advised to have a check up at the hospital, having been to see the doctor with fatigue, dizziness and nausea. I do not recall how long I felt unwell, so cannot confirm if this was the 6 week period you refer to. When I returned to the doctor for the same condition and reported feeling better, he suggested a check up at the hospital just to ensure it was nothing more than a virus. I saw someone, but had no idea they were a cardiologist, as your letter states, and he stated that there were no problems, I had a slightly increased heart rate and pulse, but that was due to the fact I was attending an unfamiliar place and doctor, and this was a normal response, often known as “white coat syndrome”. He stated he would report his findings to my doctor. I then had my follow up appointment once my doctor received this report, where my doctor confirmed there was no obvious cause for concern, and stated if I continued to feel unwell, I could take a course of tablets (perhaps the beta blockers you refer to). However, I never took these tablets, the check up had proved I was healthy, I continued to feel well and therefore assumed it was a virus and that this therefore was considered a minor ailment, which I truly felt there was no need to mention on the application form. It was, in my opinion, the same as me having, say, the flu.

Having spoken to my GP today, he informed me that in order to state that I suffered "Cardiac disrythmia" for a period of 6 weeks I would have had to undergo monitoring for the period involved as this would be the only way to conclude I had suffered an irregular heartbeat, as quite often people feel this is the case when it is actually just a perception e.g. "pounding heart" or "my heart missed a beat", when in fact if the heart beat of such individuals is monitored it proves to be entirely normal. So without undergoing a six week monitoring period, which I had not undergone, it is impossible to state I was suffering from "cardiac disrythmia". Furthermore he went on to clarify “sinus tachycardia” is not a medical diagnosis; rather it is a medical term for the physiological condition that is part of the normal way the body works. Saying that you suffer from it, is almost like saying that you suffer from “Diaphoresis” (sweating) when you are too hot, it is just the body’s normal coping mechanism, and indeed it is reassuring in this case, as it rules out any other problems and indicates my body was, and is, perfectly healthy. He also stated that “slight hypertension” is again a common physiological response to unfamiliar situations and that it was not indicative of serious or long term conditions in this situation. In addition he advised it extremely unlikely that a doctor would report to a patient that they were displaying these “normal” responses, thus explaining my knowledge that I had experienced these responses.

In your second point, you indicate I have suffered from a “neck prolapse”; again I am unaware of this condition or even what this is. In 2003 I fell off a horse and went to the doctors with a sore neck and was prescribed medication, anti-inflammatory tablets I believe. My neck pain reduced, it became better and I assumed that was that, my doctor did ask me to come back on 2 or 3 occasions as he said you can never be too careful with neck or back injuries, had it not been for this I would have just finished the tablets and continued with daily life. Again, I did not feel that this was a major illness nor arthritis nor any back, spine or other recurrent joint disorder.

Having spoken with my GP, he confirmed that I have never been diagnosed as having a “neck prolapse” nor a “disc prolapse”(indeed a medical condition which can be diagnosed by undergoing a scan), and, in fact he is unaware of any such medical condition as “neck prolapse”, he, having re-read my notes sees that statement as a doctor writing in the notes that it may be a possibility to look at if the condition continued, almost like putting a question or a reminder in my notes. He also stated that, if there had been a genuine and serious concern about a “disc prolapse” I would have been referred for a scan, which is the only way to diagnose such a condition. He believes that, as I believed, I had pulled a muscle, caused by the muscle overstretching due to the unexpected movement when I fell from the horse, which with rest and time had healed. Therefore, I believed that I was telling the truth and not withholding any relevant information on the application form.

However, as I said at the beginning, I would like to thank you for bringing these issues to my attention, as I have now been able to discuss exactly what is written in my medical notes and also ascertain that I am fit and healthy. I hope this information is useful and will allow you to recognise that I was unaware that I had any of these conditions and truly felt that any illness I had experienced was short term one off minor condition.

Yours Sincerely

[Bookworm]

Honey, no offence, but you're waffling.

Try something like this:

Dear insurance company,

I do not have, nor have had either of the conditions you have referred to, namely sinus tachycardia and neck prolapse (which is not a real medical condition anyway), and having spoken to my GP, he has confirmed this. Not having had either of those conditions, I couldn't possibly have revealed them to your company.

I expect to hear shortly from you with your proposal on how and when I can expect full payment as regards my current claim.

Yours, etc...

[lferr2002]

Waffeling is something I am very good at

Its like talking!! Good do both all day

[citizenB]

Short n Sweet.. nice one Bookworm

[lferr2002]

Finally got a letter back.

They think it was unreasonable I did not disclose the conditions I was unaware of in my original application and therefore they have voided my policy and I will recieve a refund of premiums paid in due course

[citizenB]

Originally Posted by lferr2002

Finally got a letter back.

They think it was unreasonable I did not disclose the conditions I was unaware of in my original application and therefore they have voided my policy and I will recieve a refund of premiums paid in due course

Is that exactly what they say ??? "They think it was unreasonable that you didnt disclose conditiions you were unaware of" ??.

Heeheh.. I think I would be prepared to send a complaint to the Financial Ombudsman Service.

[lferr2002]

Not quite their exact wording is...

"Having taken account of the comments noted in your letter dated ???? I am writing to advise you that we have decided to decline your claim and to void your policy from commencement

This decision has been based on the facts that you visited your doctor on more than one occasion with neck pain for which you were prescribed painkillers and additionally that you were referred to a cardiologist. Had we been provided with this information at the application stage we would have contacted your doctor for a concise medical report and would have been unable to offer you disability cover.

Whilst we understand this is not the outcome you hoped for we do not feel it unreasonable as these facts should have been provided to us at the application stage.

You will shortly receive a full refund of all premiums paid"

If they had got a doctors report it would have said I had a straiuned muscle and that I had had tests which proved without doubt that my heart functioned normally and there was no need for concern...and they would have refused me cover on those grounds, what? i don't get it???

So now i have no cover, no payments and am off ill so no other company will give me cover

[citizenB]

If your Doctor is happy to confirm that the reasons you visited him were quite temporary and would have not prevented you from getting the insurance cover then I think it would be in your interest to make a complaint to the FOS. You will need to send them copies of all the correspondence you ahve had with your (ex) insurers and from your doctor. You can download a complaint from from their website