Pinnacle Income Replacement Insurance

[mooreda]

so that we can give you the best possible help - please consider posting the replies you get - basically copy the letters onto here

[suecrill]

Hi Mooreda

thanks for your help, as soon as the letter comes I will either scan or type it in (depending on its length!!!)

I have however just received a copy of my policy and terms but will need to take into the office tomorrow to scan it in

I really appreciate everyones help on CAG - all this is not helping my husbands recovery, he is so worried, he has lost his baby(his pub) through his heart condition and now pinnacle are making it difficult for him. £940 a month which he is insured for means we either keep or lose our home.

Anyway, I will fight it all the way with all the kind help from everyone here.

Regards and have a good weekend

Sue

[reidnet]

We are all here to fight along with you Sue..

 

Ian

[suecrill]

Hi everyone

I have received the reply from Pinnacle as follows:

 

I write in reference to your claim and note from our records that your wife has recently contacted this office to register a verbal appeal against the decision made Your wife has stated that none of the credits showing between the period of 29th July 2006 to 13th December 2006 were in regards to payment received from the business. I would therefore be grateful if you could provide us with evidence to confirm what these credits are for.

 

Please find enclosed copies of the bank statements.

 

I look forward to hearing from you shortly.

 

Yours sincerely

 

Lisa Church

Senior Claims Administrator.

 

Enc. Complaints Leaflet

 

 

Well, interesting letter !!! I did not state that the credits were not in regards to payments received from the business. I said that they were!

 

So any advice on how I should reply to this letter would be received gratefully. Should I ask for a transcript of my telephone conversations also a copy of the notes they have made on my file?

 

Should I send the letter that was suggested previously and include in that a denial of what they are saying I told them ?

 

Thanks in advance

 

Regards

Sue

[reidnet]

Hi Sue,

I would tend to deal with this lot by Letter rather than by Telephone, (Unless like me you have the abillity to record Telephone Conversations ?). It is amazing how these companies can contardict themselves by letter, and of course when it is in print they cannot deny it..lol. I have one like that with GE Money..They state they had documented evidence of an additional signature regarding my PPI, this never showed up Under my SAR so looks like someone telling porkie pies.

 

Just in my opinion (others may advise diffentrly) I would follow their Complaints Procedure stating clearly that they have still not given you a full in depth answer as to their refusal to pay out on your claim.

 

I would expect that they have a procedure within their complaints procedures regarding appeals to claims ?.

 

If you did want to try and obtain a copy of any telephone calls from or to them you would have to do this with a SAR under the data protection Act. This of course could also delay the claim as they would have 40 days from the day they recieve your SAR to comply.

 

Ian

[suecrill]

Hi all, letter sent special delivery today and also faxed to Pinnacle (with much thanks to Mooreda for help composing it) as follows :

 

Dear Sir/Madam

Complaint regarding Claim Number XZY

 

I am writing to complain about the decision made by your office to decline my claim although at this stage I have not been advised of the specific exclusion in the terms and conditions of the policy where your refusal to deal with my claim relies.

As you should know from your records I suffered a series of heart attacks on 31/07/06, followed by hospitalisation and cardiac surgery on 13 September 2006 and have been unable to work due to ill health since the onset of my heart condition. I personally do not receive any income from employment and only get Incapacity Benefit from Social Security.

It is true following my heart attacks on 31/07/06 that my wife had to take on the day to day running of our business, as I could not contribute at all. In fact the doctor advised that if I did do any work of any kind until I had my stress test, which is due in February 2007, I could be putting my heart under stress and my condition could deteriorate. Therefore, due to my ill health, we had to terminate our tenancy with the brewery and vacate the premises on 12/12/06.

I wish to make it quite clear again that I was not earning an income whatsoever and I personally had no earned income at all since 31st July 2006, until I was awarded Incapacity Benefit on 10/01/07. If you refer to my bank statements, the credits into our joint bank account relate to sales in our establishment for the work undertaken by my wife only and not myself.

I therefore contend that as far as I can see, the terms and conditions provide cover as I am unable to see any exclusion which applies on this occasion.

I trust you will look at your decision again as a matter of urgency and furnish me with a response as to whether you will deal with my claim or not. If you are unable to provide any financial assistance on this occasion, please confirm in detail as to the reasons why and what exclusions are applicable. This decision should be made on behalf of the Chief Executive as I will require this to enable me to refer my complaint for adjucation by the Financial Ombudsman Service.

Yours faithfully,

 

 

Will let you know what transpires

 

Thank you all

regards

sue

[suecrill]

Hi again everyone

received letter yesterday from pinnacle dated 26th jan as follows:

 

I write in reference to your claim and acknowledge receipt of your recent letter. Having reviewed your claim and taken into consideration your comments I must advise as follows.

As detailed in the policy terms and conditions, disabled is defined as being unable to work at your normal occupation (or any job which you are reasonably able to do, given your experience, education or training) because of an accident or condition. If you are self employed, you cannot be receiving any form of payment or helping, managing or carrying on with the running of the business while you are disabled.

 

When we commence with the assessment of a claim of this nature, we would need to make sure that the insured person meets this definition; this is why we would ask the person claiming to provide bank statements for the period in question. Upon receipt of the statements, we would also need the person claiming to provide explanations or additional evidence for any credits into the account. With this in mind in order to validate your claim this information must be made available. I hope this clarifies your query and you can now understand why we needed to request this information from you and I apologise if this causes you any inconvenience.

 

In your letter you have stated that the business and bank account is in joint names with your wife. According to the bank statement you have supplied this is solely in your name. Therefore to enable me to continue with the assessment of this claim, I will still require evidence to support the credits into the account on the ...............................................................................

 

Thank you for your assistance in this matter and I look forward to hearing from you shortly

 

With the last letter I sent them, I included a photocopy of our cheque book with both names on it- apparantly this isnt proof! So I faxed them a letter from our business manager stating the account was opened as a partnership in april 2005. I have fax confirmation - they deny receipt of this and ask me to send it special delivery.

I did speak to a helpful young lady there yesterday who has offered to get me copy of phone call transcript free of charge.

Lisa Church, Senior Claims Administrator, apparently tried to call me 3 times on 30th jan (strangely no missed calls on my mobile - the only number they have) she was supposed to call me yesterday - surprise surpise - no phone call!!!

 

Anyway - rant over

 

Can anyone advise me how to reply this time. Thank you so much everyone for your time and your help

regards Sue x

[suecrill]

I WON

Pinnacle paid by BACs into our account today

Thank you so much to everyone on here who helped me and empowered me to fight

My contribution to this site will be dealt with this weekend

And a huge thank you to reidnet, nightmarefor banks and mooreda It would never happened without your help

Sorry I have been missing for a while, my daughter was in labour for 6 day and finally delivered my lovely little granddaughter on Friday morning

Thanks again everyone

Regards

Sue

[reidnet]

Well done Granny Sue..lol Glad we were able to help, I hope things will start to get better for your OH now that they have sorted this mess out.

 

Take care

 

Ian

[Nightmare4banks]

Hi Suecrill,

 

Congrats on winning as you more than deserve it and God bless the birth of the little one - Grandma!lol!

[reidnet]

Hi Nightmare4banks..

 

I think we maybe better hide before Granny Sue comes after us for calling her Granny..lol

[suecrill]

I will Grannie Sue the pair of you if you dont behave - lol

It doesnt matter what anyone says this week i am on a massive high - beating Pinnacle and securing at least 1 year of peace of mind and I~ have a little baby granddaughter who is simply gorgeous (just like her granny - lol)

Will feel even better when I have seen off abbey and all the rest of the credit cards and debt chasers who have hounded me for the past 8 months

and after 1 year I can claim total disablement from pinacle if brian cant go back to work

Empowered isnt the word !!!!!!!! A big cheer for CAG and all of you who helped me

 

Luv Nannie Sue !!!!