My husband has been declined a critical illness claim after a discovery of “non-disclosure” and have “avoided” the policy. We are utterly devastated by this news and wondering if anyone has any experience in appealing this. I have been on Financial Ombudsman site to gain advice and i do think we have a good right of appeal. However we are flabbergasted that we are in this position as we believe that the “non-disclosure” was completely innocent due to the wording and our understanding of the questions.
My husband had 2 episodes of “vertigo” which he saw the GP for one in 2009 and again 6 months later in 2010.
These episodes were when his head was tilted back when in a seated position (dentist chair) and it would spin for a few seconds before resolving. The GP said it was inner ear issue given exercises and no further follow up was required, and he never returned to the GP for this as it didn’t affect him. Which is why it then was forgotten on declaration 2.5yrs later when taking out premium. As on declaration it was asked if ever suffered from dizziness or loss of balance to which we answered no as effectively he didn’t, as he did not have balance or dizziness when standing or moving about.
Insurance company have said that if they had known about this then he would not of been offered insurance at all, as it was a clear indicator of MS which I don’t believe to be true.
They want to refund all premiums
We’ve begun the appeal with the insurance company themselves and now have to wait for their final decision before we can go to the FOS
I’d like some help and advice of how or who best to go to that could help get our point across,
It never affected him daily, or even regularly enough for us to have remembered this symptom on taking out insurance
His trade was such that he was forever climbing stairs and lifting so it never affected his balance nor dizziness when moving his head to standing
Even if we had said yes to the declaration, on further questions I believe he would of been given insurance based on the GP saying it was a crystals in the inner ear and to do exercises and no further follow up as even with the second visit they said to do the exercises.
this is an extremely stressful and emotional situation and I don’t want to get the appeal wrong
Thank you in advance