Critical Illness - Legal and General

[circuscircus]

Anyone had any experience of non payment of a critical illness claim?? L & G are refusing to pay out to me - I claimed as I have been diagnosed with an invasive and aggressive cancer which does constitute a critical illness. Having scrutinised my medical records they now say my policy is null and void as I omitted to declare a viral illness on my original application form. If I had declared this viral ear infection they would not have insured me in the first place yet they acknowledge that viral labrynthitis is NOT a critical illness. I did not disclose this viral illness as the Financial Adviser who sold me the policy advised me that viral illnesses where irrelevant! I am now in process of taking it to the Financial Ombudsman. Any experience/advice welcome please.

hi there im a neewbie, ive also had my ci insurance turned down throu non discloser innocent i must say, i need some advice well i was diagnsd with cancer sept 2006 found out yesterday my claim is void due to non disclosure of pelvic pain,that is linked to infertility and depression, i did not disclose this info as i thought my depression was over 6yrs ago, however its only been 4 and a half an oversight on my part.

i also had a mole checked by doctor he told me nothing to worry about mole turned cancerous 1 yr later where do i stand help please.

[JonCris]

As in the case I referred to in my earlier post the Ombudsman is a joke & had sided with the Insurance Company a decision overturned by the court.

 

The OP should as I have said see a solicitor with a view to litigation.There are those who would love to take these shameful people on.

[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)

[martell]

I have just briefly scanned through some of the messages above. I recently found out that Direct Debits have been coming out of my bank account for the past 4 years (I have asked they are suspended whilst I make enquiries) and these have been paid to Pinnacle Insurance for critical illness cover, my bank details were apparently given to them to access my account by Standard Life without my knowledge! I have made enquiries about this and disputed that I never gave permission for Pinnacle Insurance to access my bank details independently, and I have never received any information regarding this policy because I also believe I would not be accepted under their terms and conditions because I have a serious renal condition which has been apparent since birth and something I have never hidden from insurance companies! Please can you advise what course of action I may take to recover my premiums which go back to 2003 when the policy came into force apparently. I believed the direct debit was for motor insurance not knowing about the critical cover as I had never signed a direct debit guarantee and Pinnacle Insurance do not hold one on file they informed me.

[Pliny the Penuriosus]

You need 1st to establish who is drawing on the DD then we can taylor advice accordingly

[martell]

I have been told by my bank Pinnacle Insurance is drawing the DD and have disputed the access with them (also suspended the DD for the moment) and am still waiting for their reply but I have never signed a mandate for Pinnacle to gain access to my account and believe Standard Life shared this information for critical illness cover - can they do this? Feeling frustrated and don't know what I can do about it. Please note this is not legal and general and I am not sure if I should have started a new thread for standard life or not

Thanks for the quick response:) look forward to any other comments.

But just to let you know I would not have been accepted for this type of policy because I only have 1 kidney and have been told this by Pinnacle when I enquired about getting my premiums back.

[Kathy Baguley]

Quick question to all you IFA's & Ins brokers out there......what is the position of someone who applied for critical illness policy & whose GP was then asked for a medical report? Are the contents of the GP report deemed sufficient if/when a claim is subsequently made or does the insco then trawl through every GP recorded detail in someones files in the hope of finding something that later may be claimed was relevant ie lung cancer not paid out on because of a previous chest infection years beforehand?

 

I am very interested to see the replies.

[andrewcaldin]

Critically ill and left naked by a fraudulent insurer Scottish widows Plc

Thursday, 22 July 2010

Dear SIR/MADDAM

I need help I tried to make a claim on my critical illness policy to be told that I didn’t have one I asked to see a copy and they sent me a photo copy, I FOUND THE FOLLOWING PROBLEMS:

1) The Tied agents name had changed

2) The start date was 09-12-1997 when I signed in October 1997 as i needed the life policy and critical illness to support my application for my mortgage as it was part of the conditions on the application.

3) I received my mortgage offer before i had signed the application as it is now dated the 09-12-1997 which would have been impossible.

4) They sent me a further report which showed my date of birth wrong and the start date as 2003 when I signed in 1997.

I started legal action against them on my own and made an allegation of fraud to them on my claim form. They produced further documentation to show that I had signed before December 1997 and a copy of a fax to show it was sent prior to the 09-12-1997. I asked to view the original to which I signed they came back and told me it had been destroyed.

They sent me a witness statement from a lady called Kirsty ann. Douglass within that statement it showed that a waiver of premium had been allocated with a sum of money meaning that the waiver of premium must have formed part of the policy.

All of these were put to the judge in Manchester after they applied for summary judgement, i believe they done this to prevent a Trial and the public finding out what they had done to thousands of policies.

When Scottish widows were sold to Lloyds bank in 2000.The judge also explained that he had an account with Lloyds bank.

They then applied for summary judgement and won. I decided I Would appeal on the grounds that the judge didn’t hold up several acts which protect the consumer. I made my appeal with in the correct time period. I submitted the appellants notice and latter on the skeleton argument all sent recorded delivery.

A High court bailiff HAS NOW TURNED UP AT MY House to remove my goods. I don’t have the £20,000 they want for a day’s hearing and i am on benefits and have been from 1998 that is why i have been trying to make a claim but being prevented. I tried to make a claim on my critical illness but was refused as the provision was not there. After receiving a letter from the insurer Scottish widows and accusing them of Fraud I received a further letter to say that they had found a provision in my policy that was free of charge and they were going to let me claim under that provision!

My illness is very rare and they decided i could claim under the terminal illness side so that payment could be made quickly when the lady returned from the Usa Beck Pearson. The lady explained to me that she was the person who put pen to paper .I explained to her that I had out lived the twelve months because of the delay in allowing me to make a claim she explained that this was being done because their offices were being closed and huge redundancies were being made in Chatham. I made the claim under the provision she gave me and followed her instructions I gave them my doctor’s details and a new professor that had taken over my case I signed for the release of the reports and i was sent a copy of the report by each doctor before Scottish widows received them. Scottish widows decided it would write to my old doctor to whom I had left and I had given no consent I had left him because of his lack of knowledge with my illness. They still received a report saying that I had out lived the time and that he didn’t think i would die within the next twelve months. Scottish widows have used this evidence now to get out of not paying my illness. I have since contacted the doctor and he has told me in a form of letter that he was not sent a full copy of the Consent form and he only received the back page showing my signature if he had seen the other two doctors involved he would have not replied.

Since the summary judgement new evidence has been forth coming from the ombudsman as i asked to see all of their investigation file as Scottish widows wouldn’t send me any information or copy documents.

With I the file was a copy of a letter sent to me in 2003 welcoming me to Scottish widows and enclosing a copy of my insurance schedual key feature document and insurance policy. It had been sent to my old address to which i had originally made my application from, but it clearly shows that my policy was reinvented again in 2003 six years after I had made my application.

My own opinion is that Scottish widows was taking money on a regular monthly debit on a low start endowment for a period of 18 months and that I wasn’t to know that I was going to fall seriously ill and that I wasn’t going to be able to work again. I disclosed in the APPLICATION everything I knew about my health I had nothing to hide. Scottish widows knew that my policy hadn’t been started and that they needed to recreate the policy on their new computer system now under the new bank Lloyds.

They prevented a payout by taking off the provisions and they were only highlighted to the fact that no policy was live on their system was when I tried to make a claim.

I have written to thousands of solicitors and my Msn box has over a thousand recorded names and addresses my MP Grant SHAPPS has also tried, Even the Bar Pro Bono unit couldn’t find me a solicitor to help in my circumstances.

Half of the solicitors on the cls web site have left and no longer assist with legal aid work so what is left for the critically ill and disabled people.

The Access to Justice Act 1999 explains that I should be on the same footing as the defendant but I don’t have the money due to my disability and illness.

The Community Legal Service should be there to help people like myself and to up hold our rights and liberties to justice.

I have had to apply on my own to HIGH COURT MASTER to allow me time to send my skeleton argument off to Manchester Court in support of my appeal he has allowed me seven days but i am sure the bailiffs will be back soon.

If you’re a solicitor /barrister who knows anybody who might be able to help me please call me on 01707 690605 or email me [email protected] PLEASE PASS THIS EMAIL ON

[Endymion]

eh?

[Bookworm]

Please copy your message on to Notepad first then paste it here instead of doing it straight from Word, it will remove all the formatting.

 

Also I strongly suggest you remove your personal communication info from your post, as i don't think you really want your details plastered for any Tom, Dick or Harry to have your tel no. ;-)