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CO9680

L&G Life insurance claim miss-handled / refused

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Hello

 

Sorry about the length of this post but it briefly covers a 10 year story.

 

Back in December 2008 I was diagnosed with testicular cancer.

Fortunately following an operation and chemotherapy I was declared clear of cancer after 5 years of monitoring.

 

In 2009 we contacted our life insurance provider (Legal & General) to inquire about making a claim on our policies.

One covered an endowment mortgage and the other a repayment mortgage.

Both of these polices included critical illness cover. 

We called L&G and explained what had happened but we were told that we were not covered as the cancer was not serious enough.

 

We made a foolish, and what appears to be a common mistake, in thinking that as I hadn’t died the critical illness cover was not being taken in to account.

By this I mean we were getting confused with critical and terminal illness cover.

Because of this confusion and as L&G had refused our claim, on first contact with them, we left it at that figuring they know best.

 

Fast forward 10+ years and my wife has a new work colleague in her office.

Somehow the conversation got round to cancer and he told my wife he had had testicular cancer a few years ago but one ray of sunshine was his mortgage was paid off.

 

My wife told him of our experiences and asked who he was insured with

– yes you guessed it Legal & General and he had critical illness cover.

This chap didn't even require chemotherapy so I can only surmise that my cancer was more serious.

 

We dug out the paperwork which confirms that cancer is covered and contacted them again.

Fortunately we had kept a piece of paper with brief notes that included the date we called them in 2009 and the name of the agent.

The new agent listened and then apologised and said ‘from what I had told them we should have been paid out on the policies in 2009’.

 

At this current time we have filled in and submitted a claim form (about 1 month ago) and L&G are looking in to our claim.

We are nervously hopeful that they will approve the claim and pay out what they should of done on the date of diagnosis (Dec 2008).

 

The issue is that as we were misinformed by the L&G agent in 2009 we have, for 11 years, continued to pay both the endowment and repayment mortgages and pay the premiums to keeps the life insurance policies going when in fact we should have been mortgage free in 2009.

We’re not sure if they will take this in to account.

Obviously we hope and think they should.

 

We’re not wealthy individuals and we cannot afford to engage a solicitor to dig in to this on the off chance that we have a case.

This must be a fairly unusual, if not unique, case as I can find nothing online remotely similar.

 

It’s a long shot but does anyone know of a similar case or what our best course of action would be?

We did wonder about a loss adjuster but can find none that deal with life insurance claims.

Has anyone got any advice?

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This is a very sad story – and I'm afraid that insurance companies are renowned for practising "lost denial". Many customer service people in insurance companies consider their doing their job if they say their company a few quid by depriving their legitimate customers with the cover that they have paid for. The lack of humanity is disgusting.

I don't understand why they should have taken a month to look into your claim. He should have had a response by now. Have you been calling them at all?

Also, please read our customer services guide and implement the advice there before you have any telephone dealings with them at all. This is very important. Although you wouldn't have known this in 2009, if you had had recordings of the calls at the time this would have been enormously helpful to you now.

In terms of what you are entitled to, it certainly sounds as if you should a payment equivalent to your mortgage outstanding in 2009. However, as you have pointed out, you have been making payments since then including interest payments and course the question eventually will be whether you are entitled to recover these. This may eventually be a question for the financial ombudsman service or even for litigation.

For the moment, please tell us the status of your claim and whether you have heard from them and whether you have chased them? If you haven't chased them after having submitted your claim a month ago and not hearing anything, then I'm afraid that I have to say that you need to review your approach to these kinds of things because it is for this kind of reason that you accepted their initial opinion in 2009 and therefore apparently have lost out on a huge payout.

From what you have told us, it seems to me that you would be entitled to your mortgage payments to cover an outstanding mortgage at the date of 2009 plus repayment of all of the premiums you have been paying since then which of course were unnecessary plus interest on those. As I have already said, whether you might be able also to claim the interest which you have needlessly been paying out on a mortgage which should have been paid off in 2009, could become a difficult issue.

Are you still paying the mortgage or has it been satisfied now?


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Hello

 

 

We did chase L&G after about a week, the claim form was sent Recorded Delivery so we knew they had it. When we spoke to them they hadn’t yet looked at it.

 

At this current time we have only had one letter back from L&G, about 2 weeks ago.

 

Both myself and my wife read it independently and we both came to the conclusion, it reads as if they will honour our claim subject to confirmation from my doctor and I guess possibly the consultant that I did have cancer.

 

What is not clear is if they will take in to consideration the 10+ years of payments we have made that were unnecessary.

 

The letter received does not ask for any further information from us, for example mortgage statements.

 

 

We are currently still paying our mortgage as this is not with L&G.

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Thanks. That sounds positive. When you refer to the 10 years of unnecessary payments, are you referring to the insurance payments or are you talking about the premiums that you paid and which were unnecessary?


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Hi, I was talking about the 10 years of mortgage payments and also mortgage/life insurance premiums. All of these, in theory, should have stopped in 2009 as the mortgage would have been paid off by the L&G payout had they not (possibly) mishandled our claim.

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My own view is that recovering the insurance premiums will be straightforward and also I think it is reasonable to expect that you will be able to receive the standard 8% per annum simple interest. It's not a great deal but it's not bad.

What is likely to pose a problem is their willingness – or otherwise – to compensate you for all of the extra money you have spent over years of mortgage payments. You have an answer my question as to whether the mortgage is still running.

I think on this issue you are going to have to get ready for a fight


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