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Re Son Died For Bookworm


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Can you post some more details, like for example, on what grounds the insurance company refused?

iGroup (GE Money) - AoS Filed late, defence late, amended defence also late despite extra time requested and granted.

Vanquis - Claim issued, no AoS or Defence received

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All insurance companies are different and it depends on what insurance your MIL took out. (ie: gold insurance for example will cover you for more then a standard policy).

 

They will look at many factors of the claim, like for instance, was her son dependant on her and did she advise them of anyone who may cause her to cancel. I'll try and make this make more sense. If you book a holiday and say you look after your sick mother, and if the mother takes a turn for the worse or dies before the holiday, the insurance company want to know about it before you take out their policy, its then to their discretion whether or not to insure you for those purposes or not. Just like they can not cover you for an illness you have. (sorry if this is not making much sense!)

 

Was your brother in law ill, and if he was, was he ill at the time your Mother in law booked the holiday? If he was and you Mother in law did not advise them, they will not cover her for that purpose. If he became ill after the hoiday was booked, then you may have grounds to appeal the decision. Insurance is a very difficult topic to broach lightly, there are so mant clauses and laws on advice (FSA etc etc) the best thing to do is seek some professional advice by someone qualified to do so. Its so easy for someone to get into trouble by giving out such advice. You cant even sell an insurance policy now without being a member of the FSA.

 

Sorry about your loss too, I hope you manage to get something sorted out. I'm afraid the information you have given us isn't enough to give you exact guidelines and advice. I appreciate you may not want to go into so much detail with complete strangers, but theres only so much we can tell you with vague information.

 

Take care, and please feel free to tell us more, only if you want to, and I'm sure one of us on here can try and help you out!

 

Heidi

I am not a legal expert, any advice I give is based purley on experience or opinion.

Please tip the scales if you feel I have helped you!! :D

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Hi Yes, My brother inlaw was ill but he had his own family 2 kids and lived separatly fro my MIL his death was caused by Alcoholism for which he had been being treated for a number of years. He was taken ill suddenly and died almost overnight hense the cancellation my MIL did not consider this when she took out insurance for the hooliday who expects a 47 YO man to die suddenly even though they are a Alcoholic.

 

I

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Can you post some more details, like for example, on what grounds the insurance company refused?

 

The grounds for refusal were stated as:

 

Any claim which arises directly or indirectly from depression, stress, anxiety or mental disorder.

 

Suicide, attempted suicide, self inflicted injury, alcohol or drug abuse, alcoholism, drug addiction, solvent abuse, wilful exposure to exceptional risk (unless you are trying to save human life).

 

But I thought that all the above applied only to the policy holder not their relatives who are not event travelling?

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Hi.

 

Although the alcoholism may have been a large contributory factor, it is not a cause of death as such. What I mean is that it wouldn't say that on his death certificate. Could you find out (difficult, I know) what it says on the death certificate?

 

When you say, he was taken ill "suddenly", how suddenly do you mean? And how long before your MIL was due to go on holidays?

 

Who is the insurance company? And can you get hold of the policy (not the certificate of insurance, the policy wording) and e-mail it to me?

 

[email protected]

 

What were the reasons given by insco to decline the payout? (I'm going to take a guess at pre-existing medical history :rolleyes:). If you can, e-mail me that too (remove identifying markers if you want first).

[edited: you typed the above while I was typing my answer, so don't worry about that part]

 

Once I have all that, I can see if there are grounds to argue. At some point, your MIL might have to get a letter from her son's GP, but we'll come to that when I have more info.

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Oh, sly, very sly... But yes, despite the "indirectly", they are skating on thin ice here... What if your MIL was run over by an alcoholic drink driver, would they refuse to pay out there as well? :mad:

 

Please get me the info I asked for ASAP, and we'll get things rolling.

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Oh, sly, very sly... But yes, despite the "indirectly", they are skating on thin ice here... What if your MIL was run over by an alcoholic drink driver, would they refuse to pay out there as well? :mad:

 

Please get me the info I asked for ASAP, and we'll get things rolling.

 

I will scan that once i get home will send it tonight thanks for you help much appreciated

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I have, and I am actually furious. They are trying to wriggle out on sleight of hand, which is despicable at any time, and in this instance more than ever.

 

Right, here goes, feel free to copy and paste, and alter as needed:

 

Dear Mr xxx,

 

I am amazed at your response. Following your specious argument, am I to understand that if I had to cancel my holiday after being knocked down by an alcoholic driver, you would also refuse to pay up? If I were to die whilst on holiday after being attacked by a drugged-up local, would you refuse to repatriate my body? Your argument goes beyond the absurd.

 

My son was not named on the policy, and therefore the exclusion doesn't apply to him. I am the one who's got a policy with you, and any exclusions will apply to me, not the world at large.

 

I am asking you to now review your decision, and if you insist on refusing, must ask you to let me know what is the next step up to escalate my complaint. Please be advised that I am not prepared to let you get away with such an appalling response and will take it as far as I can, up to and including the Insurance Ombudsman and/or County Court.

 

Please respond within 14 days.

 

Yours etc...

 

:mad: :mad: :mad:

 

Your MIL will need to have a word with her GP and double-check that if asked, he will confirm that although your BIL had a chronic condition, he was stable and there was no reason to expect his death any time soon, so that the insco can't use that as an excuse. (pre-emptng their thinking here!)

 

Keep us updated.

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Buglelight I just wanted to add my good wishes and hope that you're all coping ok with this sad situation.

You're in good hands here with our Bookworm and others who are trying to help you out.

Good luck mate.

1/6/06 request charges

16/6/06 received charges

18/6/06 first request for refund

3/7/06 "No" letter from bank

13/7/06 LBA

7/08/06 handed claim to court

10/8/06 court stamped as date of issue

24/8/06 deemed to be served

25/8/06 Sechiari filed acknowledgement of service

6/9/06 defence served

9/9/06 copy of defence and AQ received by me

25/9/06 deadline for AQ submission

25/9/06 call Sechiari confirm safe receipt of my AQ

26/9/06 received copy AQ from Sechiari

29/9/06 letter to SCM to say "you want 1 month to settle, so settle"

18/10/06 after "strained communications"and how !

verbal offer of full settlement with conditions

communications rejecting conditions from me

5/11/06 received letter offering settlement with conditions

7/11/06 sent fax rejecting conditions etc

14/11/06 unconditional settlement in bank and how !;)

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Although the alcoholism may have been a large contributory factor, it is not a cause of death as such. What I mean is that it wouldn't say that on his death certificate. Could you find out (difficult, I know) what it says on the death certificate?

 

Hi buglelight.

 

Before getting to the point of this post, may I offer my deepest sympathies to you and your family over this tragic loss.

 

I have to disagree slightly with Bookworm over 'Alcoholism' not appearing on a Death Certificate.

 

Some twelve years ago someone very close to me died in hospital in the Midlands and, when I went to register the death, one of the three causes listed (not, I agree, the main cause) by the hospital doctor was 'alcoholism'.

 

This was accepted by the Registrar and duly appeared on the Death Certificate issued to me.

 

There was some discussion between the Registrar and me about this at the time and she was extremely apologetic at having to record it, but explained she had no choice as the hospital doctor had included it.

 

I feel sure that, had I agreed to a post mortem as the hospital suggested, the word would not have been present and that this was their way of making their point over my refusal.

 

It was, and still is, distressing but is something I've learned to live with.

Jimbo 44 - always happy to help, but always willing to learn from being corrected too!!! Whilst any advice given may be based upon personal experience, please always be sure you seek guidance from a professional in the particular field.

 

Never be afraid to try something new. Remember that a lone amateur built the Ark, but a large group of professionals built the Titanic.

 

A 'click' on the scales is always appreciated if I have helped. Many Thanks!

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Hi,

 

Just to add to Bookie's comments

 

It may well be that they are relying on this part to claim that your MiLwas suffering from one of these conditions:

 

Any claim which arises directly or indirectly from depression, stress, anxiety or mental disorder.

 

 

In this respect you might want to add something regarding the fact that grief is a natural response from the death of a loved one and thus does not constitute depression, stress, anxiety or mental disorder which all represent clinical conditions.

 

All the best

 

Zoot

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Buglelight I just wanted to add my good wishes and hope that you're all coping ok with this sad situation.

You're in good hands here with our Bookworm and others who are trying to help you out.

Good luck mate.

Thanks freebird much apprieciated
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Hi Buglelight,

 

Just to wish you all the best again, Bookworm is working very hard to help you the best way he/she can (sorry Bookworm!!) Its awful that the insurance are being more than difficult in an already difficult situation.

 

Most insurance co's are very reluctant to pay out at the best of times, but in these circumstances, a little bit of compassion goes a long way.... something ins co's lack greatly!

 

I wish you all the best, I'm sorry that I cant be much help, insurance isn't one of my strongest points I'm afraid!

 

Heidi

I am not a legal expert, any advice I give is based purley on experience or opinion.

Please tip the scales if you feel I have helped you!! :D

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Hi Buglelight,

 

Just to wish you all the best again, Bookworm is working very hard to help you the best way he/she can (sorry Bookworm!!) Its awful that the insurance are being more than difficult in an already difficult situation.

 

Most insurance co's are very reluctant to pay out at the best of times, but in these circumstances, a little bit of compassion goes a long way.... something ins co's lack greatly!

 

I wish you all the best, I'm sorry that I cant be much help, insurance isn't one of my strongest points I'm afraid!

 

Heidi

Thanks you very much for your consideration
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  • 3 weeks later...

Hi Sent the letter as suggested on 2 Dec giving 14 days for reply they have not bothered to reply. To add insult to injury they paid my Mother-in-laws sister for her having to cancell the same holiday for the same reasons. Where do I go from here? I was thinking of sending the letter again (recorded) giving them 14 days saying if we dont get a reply we will go to the small claims court.

 

Any advice would be helpfull.:(

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I think that the Insurance Ombudsman is the way to go. I feel that this claim would be too complex for small claims, which is geared for simple monetary claims. (anyone feel free to contradict me if they disagree)

 

The Insurance Ombudsman, unlike the Financial one, is not afraid of using its teeth. Lay out the case very clearly, the way you did here, include all correspondence, and go for it. Do tell them about the lack of response to your latest letter, and keep us updated.

 

All the very best.

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  • 1 month later...
  • 3 months later...

just came across your post,

 

Have they paid up now?

Nat West Settled 2 acct's before action:

 

£2194.77 settled £1904.00 08/01/2007 less interest

£650.93 Settled overpaid GOGW £850.00 02/01/2007

 

Applied Abbey statements -40 day up 24/04/06(arrived 30/06/06)

Prem 04/01/2007 - reply rcvd 22nd Jan advising not paying

LBA 22/01/07

 

14/02/07 N1 filed @ local court

21/02/07 issued claim

23/02/07 deemed served

25/02/07 Abbey acknowledgement defend in full.

19/03/07 defence + 50% GOGW

13/04/07 AQ final day for submission

30/04/07 DEFENCE STRUCK OUT "ABUSE OF PROCESS"

01/05/07 Judgement order

8/05/07 Warrant of Execution requested

 

 

Media coverage :D

 

http://news.bbc.co.uk/1/hi/business/6701231.stm

 

http://www.newburytoday.co.uk/News/Article.aspx?articleID=4505

 

 

If you find my post helpfull then please click my scales:)

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Me too. If it was the same insurance company that paid out on a different policy, but in regards to the same situation, they surely can't suggest that the reason for denying this claim is the cause of death?

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