AXA life insurance denied due to non-diagnosed epileptic seizure 7 years previously

[sazz]

Hi Everyone!

 

I must say, it's been a LOOOOOOOOOOOOONG time since I have been on the furums! Finished university (get results on 26th!), started working as a support worker and planning my wedding! But there was an element of rubbishness and I wish I was here under better circumstances.

 

Last July, my mother's partner started to show signs of a stroke. After a dash to the hospital, he was told it wasn't, but obviously something was going on. After a few weeks of tests, he was diagnosed with a brain tumor. By this point, the tumor was apparently a 'Stage 3' - apparently the stage scale goes from 1 (Teeny) to 4 (Goodnight Vienna). He had a round of radiotherapy and chemo, both of which were unsuccessful and caused him to deteriorate further and was stopped midway. By september, he was unable to support himself and had no real means of communication. At the beginning of October, he had a morning of seizures (as is common with such brain diseases) and passed away.

 

Now, he never signed a will: he got round to almost completing one but it wasn't finished and it wasn't signed/witnessed. He and my mum were also not married, although they had the usual joint financial stuff together, which resulted in his mum, whom he had no relationship with and didn't even bother to show at his funeral, is probate... Her other son is trying to take over the estate management so it'll be easier for my mum to sort out, as she has dealt with the funeral and stuff... They have a life insurance policy with AXA (still waiting on full info and a copy of the policy) which was submitted in November 2010. They have been humming and hawing for months, about the claim, then sent a letter asking for access to his GP records. AXA got the approval and in March 2011, they denied the payout and claim 'based on a technicality'. The technicality is apparently because he had taken epilepsy meds 7 years previous to taking out the policy. He had a few random seizures years ago, and took some meds for a few years, but came off them as they made him feel awful or something... He didn't have epilepsy, he was told by doctor that it was 'idiopathic epilepsy' i.e., the catchall condition for when you show symptoms of something, but there are no signs...

 

Anyways, the claim was denied because of this, even though the neurology consultant has stated that this epilepsy drug years ago is irrelevant to his death. We are unsure if he even mentioned the non-epilepsy at the time of applying or the meds, as he did it by phone... This claim has resulted my my mother being screwed by her bank with the mortgage, and she is now being taken to court by the funeral directors due to non-payment, despite offering repeated payment plans. Ive asked her to get a dosclosure on his med records, something from Neurology to state that the meds/epilepsy issue is irrelevant, and, most importantly, a great big dirty disclosure on AXA...

 

Sorry it's sooooo long, but thought best to give as much info as I could in order to receive some much needed help. My mum has an appointment with a CAB officer next week so I'll see what happens...

 

Cheers

 

Sazz

[citizenB]

Have alerted the site team for you.

[honeybee13]

Hello there. I've only just seen this, having been off the forums. Has anything else happened since you last posted?

 

I think it could be helpful if you would post up the wording in the policy that Axa are relying on, if they've told you. Was the epilepsy problem declared on the proposal form for the policy?

 

Please post what you can. You might also consider contacting the FSA on Monday. Someone on their helpline should be able to advise you.

 

My best, HB

[caro]

Hi Sazz.

 

I've a feeling that your Mum is probably going to need specialist help with this. The only thing that I can think of is to ask the doctor to write to the insurance company to say that this is unrelated to any previous episode, as you said. However if your Mum's partner failed to disclose that there had been a problem then I have an awful feeling this will be an uphill struggle.

 

The only other thing is that she could just follow the insurance companies complaints procedure, and if she can't get a satisfactory result she could take it to the insurance ombudsman.

 

Regarding the funeral, if the family are dealing with probate perhaps they should help out or cover the cost of the funeral.

 

Regarding the lack of a will, if the insurance policy was intended for your mother, then that must be a strong argument that the intention was that everything should go to her. If the partner's share of the house goes to someone else then they need to take over payment of his share - or will his mother want to cash in on this?

 

What an awful situation for your Mum. She must be at her wits end.

[ukaviator]

You need to see if the policy is one of 2 ms sold back in 2004. They were fined £500,000 by the FSA, it maybe of help to read through these links:

 

http://www.fsa.gov.uk/pages/library/communication/pr/2004/111.shtml

 

Full Final Notice version here:

 

http://www.fsa.gov.uk/pubs/final/axa_21dec04.pdf

 

Hope this helps. . .

[sazz]

Hi Everyone,

 

Many thanks for all your suggestions so far... I have just finished work and will be calling the Mumsie tomorrow, so I'll update with relevant info Still awaiting a copy of the policy documents too...

 

Sarah

[ihateyes]

Good luck,

 

These insurance companies look for technicalities....

I remember one guy got refused a payout for critical illness cover, because he didnt note on the application form that he had a big toe nail removed, due it ingrowing

 

Absolutely absurd.