October 5, 2006 6:52 AM
Quick Facts Of Critical Illness Insurance
Twenty per cent of critical illness claims are turned down. That means for every five people making this important claim, one will have it rejected at this crucially important time.
The whole reason behind taking out critical illness cover is that, in the event of you becoming critically ill (that is being diagnosed with one of the listed illnesses described in your policy documents) a payment will be made. The reasoning behind your decision to take out what some consider being an important part of your financial planning is sound. Critical illness can affect the whole family. You may have to pay out for child care, change your home or job or even train for a completely new career. Having taken out cover, should the unexpected happen, all eventualities are covered and you have gone as far as you can to minimise financial problems and get down to the important personal matters.
Unfortunately, in a number of cases, this is not so. Failure to disclose what may seem to you to be minor, unimportant illnesses in the past may give the insurers a reason to reject your claim. Fair or not, it’s completely legal! As far as the law stands, if you have failed to disclose information which the insurer was seeking, then the insurer is perfectly within their rights to terminate the cover.
If this happens to you, not only do you have to cope with the implications of the illness, but you have to either accept that your critical illness insurance plans have totally failed you. At this stage depending on the severity of the illness, you may feel overwhelmed by the situation and unable to face challenging the decision. If you do appeal against the decision and the Financial Ombudsman Service gets involved, they will make every attempt to establish whether you deliberately misled the insurers in order to gain cover or whether the questions on the original proposal form were vaguely or poorly written.
As soon as you make a claim on your critical illness policy, your insurer will instigate an extremely thorough check on your medical records. It appears that they can go back without a time limit and if they find anything, related to your illness or not, which you’ve failed to disclose to them, they may choose to refuse your claim. There is no such search or investigation carried out when you take out the policy and some people feel that this should be addressed.
It is virtually impossible to remember every minor illness. Can you really be expected to remember and record every visit to the doctor regarding things like headaches, eye pain, stiff neck, ear infections and depression? There were recent cases where claims were rejected for these reasons – a man had his claim for prostate cancer refused because of failure to disclose an earlier ear infection and a woman whose claim failed because she’d not disclosed an earlier problem with depression.
However, for four out of five people, the insurance works. It is important to disclose your full health history and not to attempt to cover anything up. Read the terms of the insurance thoroughly and miss nothing out. Used as intended, critical care cover is a valuable financial tool.
Plenty of help is available when choosing your critical illness cover. Log on to the internet and you’ll find on-line brokers who’ll be able to offer advice, a choice of quotes and the best possible terms.
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