legal and general - non disclosure - non payout-YET!

[baboon]

Hello to all members. You might want to take a deep breath before you read on, so he we go I'll do my very best to explain as clearly as I possibly can.

 

Last year my father passed away unexpectedly through natural causes. Natural Pneumonia was the cause. My father was a fit and healthy man for his age, visiting the gym at least twice a week, but due to a viral infection he picked up his body wasn't strong enough to beat the throws of natural pneumonia.

 

Some five years previous my father undertook a life assurance policy which was to cover the outstanding amount on his mortgage, and nothing more. There was no financial gain to be made by my father. The policy was necessary due to my father having to re-mortgage his home due to the divorce of his wife, my mother.

 

On the death of my father a claim was placed on behalf of myself and my sisters. Legal and General took several months to come to the decision, their decision being refusal to pay on the grounds of non disclosure.

 

As the policy was deamed to be in it's early term, Legal and General requested further information be supplied with reference to the claim. My late father's doctor provided with my consent completed a medical questionnaire, which made a suggestion of health problems. L & G's query being an in-eligable entry made by a previous doctor which turned out to be an irrelevant entry with no bearing on Legal and General's decision to refuse the claim. Because of this request for further medical records L & G came across some entries which were relevant to my fathers application and their point of non-disclosure.

 

My father's marriage break down caused him some distress and at that time he visited a previous doctor who made a note in my father's medical records stating he couldn't cope, quiet a natural reaction to a marriage breakdown i would say! My father would have also required help via prescription do ease his stress, but only for a period of a week, he required no consultation or follow up. I have his previous doctor at the time of his marriage breakdown and his last doctor both verifying that my father was fit, healthy and of a sound state of mind, and that it is only normal for anyone experiencing divorce to naturally feel low and down. The doctors are both happy to testify against L & G's decision in writing. I hold full medical records of my father.

 

question:have you at any time had, or been advised to have, any medical investigation or consultation, advice, operation or treatment for any of the following:

 

f)any form of nervous or mental disorder, or have you ever required tranquillisers or anti depressants?

 

My father obviously thought that he didn't feel his 1 week stint on prescription medicine was relevant and certainly his feeling low period was only kind of natural, my father never received any consultation, advice, operation or treatment of the above stated apart from the prescription he took. My father was a very very hard working man who never took time off work for illness, and working meant paying for his premiums too. My father never expected to pass away and he certainly never passed away due to mental disorder!??!?!

 

I am currently in communication with two past doctors who are willing to support me in everyway possible. I understand that i should exhaust my free options, ie; dispute the decision of L & G, then if the refuse again to go to the Financial Ombusdman, then if that fails, rely on a court of law?

 

A year later Im getting to the stage now where battling on my own is feeling like forever and I would love to hear from anyone who was or is in the same position as me, just so I can seek some support and advice. Should i use a solicitor now? should i seek letters of support from his past employers to state his clear state of mind? should i question L & G professionalism? Did L & G ask for a full medical when he undertook his policy application, bearing in mind he was mid forties? Any little bit of input would be wonderful and I look forward to your responses.

 

Thanks for reading, I really do appreciate it

 

Baboon

[Bookworm]

Ombudsman. Get a final decision from the insurers, and straight to the Ombudsman. Don't waste any more time.

[baboon]

thank you bookworm, will me taking so long cause a problem? my father's estate has been lying dormant for some months now, so it's really only the last couple of months that have seen some activity (with reference to our claim).

[bazak1]

i agree totally with bookworm.

try them one last time for a "final" decision then get a very detailed letter, ( with supporting evidence from dr's new and previous etc ) off to the ombudsman.

are they saying your dear Father wasnt in sound mind?

are they also trying the " the person was ill at time of taking out cover" routine ( which can be a good get out clause if they suspect you of clinical fraud ).

i understand that this must be playing on your mind, but have faith, and challenge this ridiculous decision.

[mooreda]

I have my Life Insurance with Legal & General and when I took out the policy they wrote to my GP for my Medical Records anyway. They did as well for my wife. Double check through your records to make sure they did not do this in respect of your late fathers policy.

 

I'm really sorry they're trying to pull such a fast one - it's these sorts of things that give insurers such a bad name when trying to wriggle out of paying. Good luck with the Ombudsman although I understand they're pretty busy at the moment with Endowment and Bank Charges complaints - they're currently getting up to 5000 referrals a week as opposed to 1000 a couple of weeks ago.

[baboon]

thanks for your input it's really appreciated. Im not sure if L & G sourced my father's medical records on his application. I have never really questioned whether my father supplied his medical records before. I guess if they didn't I should be questioning why???

 

Thanks for your input every little helps me on my way.

 

thanks:)