Critical Illness - Legal and General

[Kizan]

I didn't want to get drawn into this one (this being my first day and all) but feel I need to add a few factors into this one.

 

Firstly, let me declare that I am a financial adviser; ex IFA and now an independent mortgage broker.

 

Please dont tar us all with the same brush, we are not all commission hungry fat cats with no scruples.

 

FWIW, I've been in this industry for 15 years now and have helped numerous clients successfully receive their critical illness payouts from various life companies.

 

Critical illness plans have been getting some real bad press this year; in particular The mail on Sunday finance section has featured a number of such cases where the life company refuses to pay out on the basis of "non disclosure". There are some valueable lessons for us all here:

 

1. When applying for this type of cover, disclose ALL illnesses you have ever had.

 

2. Always read the small print of the declaration you sign at the end of the application form, it specifically mentions failure to disclose previous illnesses (known as "non disclosure")

 

3. If by reading this thread you are now in doubt about your own critical illness policy (assuming of course that you have one, as the majority of people dont) then review it ASAP. If you are unsure then either talk to your insurance broker or the life company direct

 

4. There is pressure on life companies to underwrite these policies very quickly now (if mortgage related or the application is submitted via the internet for example) and therefore, in very many cases, the life companies no longer contact your GP at the point of sale. This therefore means that they only check your medical records if you make a claim and therefore if you have omitted a previous illness in your application, it will come to light when they check your medical records; so declare ALL previous ailments, no matter how small or immaterial you may feel they are.

 

5. It is a good idea for everyone to review their policies every few years. In the case of critical illness policies, premiums have actually been decreasing as actuaries have more data now on aids. Also, some of the newer life companies coming into the market offer more comprehensive policies which cover far more critical illnesses than some of the earlier plans. One word of warning though, check to see if your monthly premium is guaranteed or reviewable. If you have a guaranteed premium now, make sure the new quote you receive is "like for like". In other words, make sure it is also a guaranteed premium also and not reviewable.

 

6. For matters such as these it is always best to seek unbiased, independent advice.

 

My heart genuinely goes out to the original poster on this one. I survived cancer myself, so I have a better idea than most of what you are going through and this L & G aggro is the last thing you need.

 

Feel free to pm me and I will gladly assist you in any way I can

[Kizan]

The original poster needs to see a solicitor ASAP. In view of the illness any court action can be brought forward by application to the court

 

I'm sorry but I have to disagree.

 

The proper process to take on this one is:

 

1. Complain in writing to L & G

 

2. Ensure you ask in the letter if they contacted your GP at the point of sale for your medical records (this is known as a PMAR)

 

It is unclear from your posting exactly how far down this road you are. If you get no joy from L & G then it is probably best to refer the matter to the Ombudsman. If the Ombudsman feels that the selling agent should be made accountable for this, he may well refer it back to that company/individual. However, this raises some other issues:

 

1. Term assurance has only been regulated by the FSA for a couple of years now, so, depending upon when you were sold the policy, the individual may not have been regulated by the FSA (you didn't say where you bought the policy from, bank, insurance company salesman, IFA, supermarket, etc)

 

2. If it comes down to "your word against the adviser" then remember that you will have signed an application form giving the life company authority to contact your GP for access to your medical records and you also signed to confirm that you had told the truth about your medical history and had not omitted any relevent illnesses.

 

Personally, I think you would be throwing good money after bad getting a solicitor involved until you had completely exhausted the above system, which is completely free of charge to you.

 

Forgive my directness on this, but I do not know all the details of your medical condition. If your illness is terminal and your policy covers you for death or critical illness (most of these policies do), it is likely that there will be an option for L & G to advance you the life insurance, before you die, on the proviso that your doctor confirms in writing that your condition is terminal.

[Kizan]

JonChris,

 

I think you and I are going to have to agree to disagree on this one.

 

For a start, the original poster has not divulged enough information to allow anyone to give him specific advice.

 

I'm also not anti solicitors; I have both friends and clients who are solicitors. Two things to always remember about the legal profession:

 

1. They are only ever correct 50% of the time

 

2. Win or lose, they ALWAYS get paid

 

Judging by the number of posts you have made you have clearly been a member for a long time (or you are a very busy poster ), whilst I have only joined last night, so I have no wish to cross swords or fall out with anyone over this matter. I therefore think that until the original poster either gives more facts on the open forum or pm's you or I, it will be impossible for anyone to help him further. Also, I'm surprised at you advising to seek legal advice on this so soon. I thought the whole ethos of this site was for members of the public, like you and I, to fight banks, insurance companies, et al without legal assistance. It must be bad enough for this unfortunate individual to have the worry of fighting a large insurance company without him having the additional worry of how to pay his legal bill as well.

[Kizan]

JonChris,

 

As I said previously, there is no point in you & I crossing swords on this one.

 

I seriously doubt this person will find any solicitor in the UK who will represent him on a "no win, no fee" basis. If you are so confident about this, can I respectfully suggest that you pm details of this solicitor to the original poster. I see from your profile that you are a solicitor yourself; therefore would you or your practice be prepared to take on this case on a "no win, no fee" basis?

 

Regards your statement about the ombudsman, leaving your personal feelings aside for a moment, this individual must follow due process. Isn't this what this website advocates within the FAQ section and what you tell EVERY new member who joins, myself included? The ombudsman route therefore MUST be exhausted before going down the legal route.

[Kizan]

As before, I believe that you must go through the due process which is:

 

1. Complain to the life company. If no joy there then

 

2. Complain to the ombudsman. If no joy there then

 

3. Seek legal advice (ideally no win, no fee if you can get it)