I wanted to know if anyone had made a successful claim on their insurance for critical illness cover for their mortgage? My claim must be made within 26 weeks of diagnosis and must have current continuous motor or sensory impairment for 6 months.
Hi Lou I no longer had a mortgage (long story) but still had the critical illness policy as I’m a single parent. I successfully claimed on mine last year although mine didn’t specify that I had to claim within a certain time after diagnosis. My policy said I needed to have moderate neurological symptoms for a continuous period of 3 months. The insurers obtained reports from my GP and my neurologist and the claim was settled within about 3 months. The main thing your claim will depend on is whether you fully disclosed any medical conditions and/or family history at the time you made the application for insurance. Good luck Tracey
yes my insurance payed up no problem at all. good luck with yours
My insurance also paid up no issues at all. However they have cancelled my policy after paying for a considerable amount of time on my mortgage and will not cover me for anything on my illness. So best read the fine print. Good luck! Strudders
Hiya, we claimed on our critical illness policy and they were fab, all done and dusted within about 2 months. We has to claim within so many days of a diagnosis and they wrote to my neuro for confirmation and that was it. Good luck with yours.
This is atrocious. LP’s can prove nothing! It’s entirely possible to have serious, debilitating MS and not have any signs in your LP. My neuro knows that so why don’t your insurers?
I have crit ill insurance, too, and they regard MS as a crit ill. Mine was for mortgage cover and I no longer have a mortgage, too, but still pay the insurance. I was thinking of binning it but boy, am I glad I didn’t. I want a Dx!
This is not anything to do with your question; just in case they argue this point.
Insurance companies have a department named ‘How to wriggle out of claims’ and this is for future reference just in case. They may say something like ‘you had a cold in 1988, reported to the GP, this was obviously the start of your MS and you should have known.’
MS patient wins cash battle with insurer
A woman with multiple sclerosis has won a legal battle with an insurance firm that refused to pay out under critical illness policies after she was diagnosed with the illness.
The exact worth of Valerie Cuthbertson’s Court of Session victory over Friends Provident has still to be finalised, but she should receive about a £50,000 lump sum and a weekly payment of £139.
The court heard that the firm had used questionable methods in its search for evidence to invalidate the policies and had latched on to entries in Ms Cuthbertson’s medical records. She had not disclosed a handful of appointments with her doctor in the application forms for the insurance, but the judge ruled that she had no reason to believe those were of any importance.
Ms Cuthbertson said: “It has been a long time, five and a half years, but I felt I had to take it all the way because they were wrong. I felt I had a really good case, and I think for anybody else going through this sort of thing, they will take heart from this.”
Ms Cuthbertson, 39, a theatre manager from Glasgow, took out the cover in 1994. Nearly two years later, she was diagnosed with MS but did not appreciate that the policies covered her condition and made no claim.
Then, in 1999, a representative of Friends Provident called on her to review her financial affairs. He arranged for a claim form to be sent to her and Ms Cuthbertson submitted it.
Friends Provident obtained a report from her consultant neurologist, who confirmed an unequivocal diagnosis of MS. A request was then made to her GP for sight of her medical records.
In his judgment yesterday, Lord Eassie said: "The letter referred to the notes being required to help [the firm’s] chief medical officer in the assessment of the claim and stated that they would be given ‘careful and sympathetic consideration’.
“However … [the firm] had already obtained all the information they required to satisfy themselves that [Ms Cuthbertson] had multiple sclerosis, and the only purpose of recovering the GP records was to see whether … there was any entry which might give grounds for avoiding or invalidating the policy under which the claim was being made.”
Friends Provident did reject the claim on the ground that Ms Cuthbertson had failed to disclose her full medical history.
In its defences, Friends Provident cited five consultations with the GP which, it claimed, ought to have been disclosed. Those took place between 1990 and 1994 and involved complaints about eye pain, an ear problem and tingling in a leg.
Ms Cuthbertson’s neurologist said that, with the benefit of hindsight, and knowing her now to have MS, it might be possible “to discern in some of the entries a possible indication that she was developing the unfortunate disorder”. However, he would not have expected a GP to have been alerted to the possible significance of the incidents.
Lord Eassie said: “I am satisfied that, at the time of answering the matters raised in the application forms, she did not think that the consultations with her GP were of any materiality.”
Source: The Scotsman ©2006 Scotsman.com
Although it is not a precedence in the UK because of EU laws a judge will take this into consideration.
Good luck, as you have done claim; suck it and see.
I doubt that would ever happen Sophie. Think of it from the insurance company’s point of view…symptoms of MS may not actually be MS. MS can be difficult to diagnose as we know because the symptoms can fit any number of other conditions like Tumour or other Cord compression, Stroke, Acute Disseminated EncephaloMyelitis (ADEM), Lyme disease, Sub-Acute Sclerosing Panencephalitis, Neurosyphilis, Progressive Multifocal Leukoencephalopathy, Systemic Lupus Erythematosus, Cerebral Arteritis, Complicated Migraine, Diabetes, Hypothyroidism, Myasthenia Gravis, Acute Transverse Myelitis, Herpes Simplex Encephalitis, Polyarteritis nodosa, Sjogren syndrome, Behcet’s syndrome, Sarcoidosis, Paraneoplastic syndromes, neuromyelitis optica (Devic’s syndrome), HIV-associated myelopathy, Adrenomyeloneuropathy, other Myelopathy, Spinocerebellar syndromes, Hereditary Spastic Paraparesis, Guillian Barre Syndrome, Polymyositis, Benign Paroxysmal Positional Vertigo, Parkinson’s Disease, Cerebral Haemorrhage, Amyotrophic Lateral Sclerosis (ALS), Mononeuritis, Huntington’s Disease, Post-Infectious Encephalitis, Arteriovenous Malformations, Arachnoid Cysts, Arnold-Chiari Malformations, Cervical Spondylosis and many more, depression, migraine and the familiar trapped nerve. ( I copied this list, I didn’t remember it!)
So the strict diagnostic criteria is there for a reason because they can’t have policies paying out just on a set of symptoms that may not actually be a critical illness after all.