I have been off work for over 6 months and have made a claim on my income protection policy . Now the company are refusing claim as they say MS is hereditary and as I originally ticked box which stated there was NOT hereditary illness in family they say I made a false declaration . MS is not proven to having a responsible gene at this point in time. Any suggestions to deal with insurance company would be gratefully received .
I would print off the relevant pages from this website or from the MS Trust which state that MS is not hereditary and send that back to them with a note to say you are contacting the Insurance Ombudsman with the same information regarding your claim. That should move things along. Having a parent/close family member does increase your chances of getting MS but only by a small percentage - it’s not a dead cert.
Tracey
I’m also pretty sure it’s not hereditary so like Tracey says, print off the relevant and send it back to them.
If they don’t pay out then complain, and if they still reject it, go to the FOS (financial ombudsman service), they’ll include details when they respond to your complaint if it comes to that - good luck
Sonia x
How can they state something that has never been proven. ln fact ‘how dare they’. lts up to them to prove this - not you.
Yes - as Tracey has put - so well - take the relevant info to the lnsurance Ombudsman and get them to sort it out. Also, the MSSociety would most likely help as well.
All insurance companies always try to wriggle out of paying up - lts always up to us to make sure they do not get away with it.
Good advice.
Alison
No, definitely NOT hereditary. However, as Tracey says, family history does increase the risk, so they might still argue it was a “material fact” you had an obligation to disclose, as it might have affected your premiums, or their decision to insure you at all.
Unfortunately in these cases, the burden is usually on the insured party to declare anything known that might affect the odds - whether or not they specifically asked the question! So it may not necessarily be a watertight response to say: “But I was never asked that! I was asked: ‘hereditary’, and it wasn’t!”
All you can do is try.
Incidentally, I don’t think the increased risk is quite as slight as all that. I think, with an affected first degree relative, lifetime risk goes from about 1 in 800 to as high as 1 in 20. So still a 19 in 20 chance of NOT getting it, but certainly enough of a difference to give insurers a concern. They certainly might argue they wouldn’t have insured you if they’d known.
Not terribly helpful, I know, but the way it is. As I say, you can only try…
Tina
x
Thank you everyone for your suggestions and links . Apparently it is the underwriters that are quibbling about MS being hereditary or not . The claim department is happy to pay out . Of course I can’t speak to the underwriter involved …I have challenged him or her via the claims dept. to produce a scientific paper that states it is at this point in time hereditary . They won’t find one ! Perhaps in time they will find a gene . My sister brother and I are part of a research project at Addenbrookes hospital in Cambridge to identify a gene for MS . Spread the word to families with two or more MS sufferers in to ask their GP to refer them to be involved .
If it’s underwriting quibbling then they should be able to produce ‘their’ evidence, keep challenging them! Good luck - Sonia x
A long day of phone calls but worth it …the insurance company have agreed to withdraw the hereditary aspect as a reason not to agree the claim . They are relooking at the claim . Should have an answer in the next couple of days . Fingers crossed and thank you all for your help . You’ve been GREAT .
That’s great news. Keep us updated. I’ll keep my fingers crossed for you.
You have reminded me that I also agreed to be part of the research at Addenbrooke’s. I had forgotten about it. I remember signing a consent form, having lots of extra bloods taken and receiving an information sheet. I have no family history that I know about of MS and it is important research to try to identify why some people develop MS and some don’t. There’s been a lot on the boards recently about genetic research and I had forgotten all about this. This proves that they are conducting research into it. I believe the researchers never know the identity of the subjects who are part of the research programme.
Tracey x