Consumer wins critical illness claim
January 24, 2008
A woman who suffered a brain haemorrhage last year and had to have brain surgery performed has finally won her claim for a critical illness payout after the insurance company tried to convince her that she was not eligible to claim because she had failed to disclose vital information. The nurse, aged fifty five, had a critical illness policy with Abbey National, and this had been passed over to Phoenix as part of the sale of this part of the Abbey National business.
After she had been to hospital following the haemorrhage, but prior to having the surgery, she contact her insurance company to claim the value of the policy, which was £40,000, as this covered her for a brain haemorrhage. However, just prior to having to go back to hospital and have brain surgery that carried a 25% risk of fatality, she received a letter from the insurance firm claiming that she had failed to disclose a period of stress some years earlier and this made her ineligible.
She stated: ‘Before my craniotomy on the 28th of September I received a letter saying my policy was nil and void. They said I had not disclosed that I had an episode of stress in 1997, when I was off work for three weeks. I have researched this and stress or depression does not cause brain aneurysms. I felt totally let down by Phoenix because I really believed that I had informed them of all my illnesses when I applied.’
An official from Phoenix told This is Money: ‘The Abbey National application form has a clear warning that clients should tell it about anything which could affect its decision to accept the proposal for insurance. Taking into account her occupation as a nurse, there is clear non disclosure. Her occupational knowledge would not allow any ambiguity as to how to answer the health questions with any required information.’
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