Scottish Provident Critical illness insurance - claim process is stacked against the policyholder from DayOne

[Angry Policyholder]

This is a deeply distressing story of what can happen when you are let down by the NHS and then the insurance you rely on when you are critical ill. We advise anyone using this company to think very carefully and to check your critical illness policies straight away to find out if you have a policy based on "work tasks".

 

My husband and I are desperate for help dealing with Scottish Provident and their critical illness cover. The problem is the policy is work task based for example can you walk 200 metres, can you hold a pen, speak or hear all with or without the use of aids.

 

He was critically ill in 3 hospitals for 3 months so as you can imagine our first concern was not claiming on an insurance policy. When the claim forms were finally sent to the hospitals there was up to 4 months since the consultants had seen my husband and filled out the medical forms. As the forms only asked for CURRENT restrictions on the work tasks the hospitals said should be able to do but not seen since discharge. The only person who had all his current information was his GP who confirmed he was still unable to do at least 2 tasks which would enable a valid claim.

 

My husband also suffered medical errors in hospital including being told he had cancer and epileptic of which it took 6 weeks to find out neither was true. This led to further complications when requesting the hospitals comment further and tell Scot Prov the forms were wrong and did not take into account his restrictions whilst in hospitals.

 

We got answers to confirm his restriction and also who was in charge of his care. This led to an admission that the form was filled out wrong by a person not in charge of his care. This now supported what his GP had always said.

 

Now we had the evidence we thought they would pay out but this was not the case. In Scot Prov's last letter this week turning the claim down again it Scottish Provident say that yes there is confirmation of his inability to do the tasks but they were neither measured or appraised to their requirementsand therefore this evidence is not valid. At no point did Scot Prov ask on their forms that these tasks must be measured in anyway, they are yes or no answers. Its also telling that when his GP disagreed with the original hospital forms they never rang her up to ask to asses them.

 

Our point is how when you are not in the care of the specialist anymore due to being transferred or discharged can they asses the ability to do the tasks. They clearly stated due to his underlying medical conditions the following tasks were not possible? The next point is how can a consultant who last saw my husband 4 months ago be over ruling his GP who is looking after his current care.

 

Everything has been nightmare dealing with this and we are desperate for help.

 

This needs highlighting to the public We are at rock bottom.

 

For a company who starts off a claim process that is stacked against the policyholder from day one we never had a chance. Be warned...

 

Sorry its so long

Edited April 24, 2011 by Angry Policyholder

[silverfox1961]

Hi and a proper welcome to CAG

 

Now that you have reposted your situation I will remove the post you made in the blogs section.

I do hope you will get some good responses

[rebel11]

Hi angry

 

Welcome to CAG

The guys will advise as soon as they are available.

 

Where is the story? And what help is needed?

[Angry Policyholder]

Has anyone who feels they had a genuine claim against a critical illness been turned down

[1957]

Hi Angry Policyholder,

 

It is not good to hear your story, But sadly you are not the only one that has been let down by an Industry that has known for many years that these types of Protection policies are Flawed & contain Fluffy and Confusing Definitions, The same Fluffy & Confusing Definitions they use to assess your claims.

The FSA who are on record as "Criticizing" TPD & the failures by firms concerning oral disclosure in sales of protection products, in particular "Critical Illness Cover (CIC)" to consumers by phone or face-to-face.

The insurance industry & the ABI are looking I beleive to change the way that TPD is worded as they know that the current system is flawed.

If like most people you purchased your policy in Good Faith (Good faith forbids either party by concealing what he privately knows to draw the other into a bargain from his ignorance of the fact and his believing the contrary ) you would assume that the oral & written product information was clear, fair and not misleading, but I have never seen any that point to the failures within these products.

 

Remember as a consumer you do have rights so Complain & Complain Again, Complain to the FOS, Write to your MP & Newspapers.

 

Best wishes & keep us informed.

[Angry Policyholder]

Thanks for your message. What amazes us it when we talk to people about his problems including medication he was on the only people who don't think he had any restrictions is scot prov.

 

On Saturday his story will be highlighted in a national newspaper and after that 3 magazines are going to print stories regards how this company has treated him.

 

His local mp's office was shocked at his story and we have wrote to the PM as this needs highlighting to the public. Everyone we have told this story to has said we have a case for medical negligence but neither of us have the energy to spend the next xxx years fighting the NHS.

 

We are hoping the first article will be very supportive of our claim and highlight their dodgy tactics.

 

We wil not rest till this company is held to account.

 

Hi Angry Policyholder,

 

It is not good to hear your story, But sadly you are not the only one that has been let down by an Industry that has known for many years that these types of Protection policies are Flawed & contain Fluffy and Confusing Definitions, The same Fluffy & Confusing Definitions they use to assess your claims.

The FSA who are on record as "Criticizing" TPD & the failures by firms concerning oral disclosure in sales of protection products, in particular "Critical Illness Cover (CIC)" to consumers by phone or face-to-face.

The insurance industry & the ABI are looking I beleive to change the way that TPD is worded as they know that the current system is flawed.

If like most people you purchased your policy in Good Faith (Good faith forbids either party by concealing what he privately knows to draw the other into a bargain from his ignorance of the fact and his believing the contrary ) you would assume that the oral & written product information was clear, fair and not misleading, but I have never seen any that point to the failures within these products.

 

Remember as a consumer you do have rights so Complain & Complain Again, Complain to the FOS, Write to your MP & Newspapers.

 

Best wishes & keep us informed.

[Angry Policyholder]

Hi,

 

Its been a while but I have an update. Last year The Times covered our story and following this we setup a Twitter account which currently has over 5k followers. This led to experts following me who explained more about these policies. Thankfully The FT and The Times along with other publications have kept up the pressure with leading UK trade magazine starting a campaign this month

 

I can't put links in here but search my name on social networks to find our FB or Twitter account.

Hi Angry Policyholder,

 

It is not good to hear your story, But sadly you are not the only one that has been let down by an Industry that has known for many years that these types of Protection policies are Flawed & contain Fluffy and Confusing Definitions, The same Fluffy & Confusing Definitions they use to assess your claims.

The FSA who are on record as "Criticizing" TPD & the failures by firms concerning oral disclosure in sales of protection products, in particular "Critical Illness Cover (CIC)" to consumers by phone or face-to-face.

The insurance industry & the ABI are looking I beleive to change the way that TPD is worded as they know that the current system is flawed.

If like most people you purchased your policy in Good Faith (Good faith forbids either party by concealing what he privately knows to draw the other into a bargain from his ignorance of the fact and his believing the contrary ) you would assume that the oral & written product information was clear, fair and not misleading, but I have never seen any that point to the failures within these products.

 

Remember as a consumer you do have rights so Complain & Complain Again, Complain to the FOS, Write to your MP & Newspapers.

 

Best wishes & keep us informed.