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Hello everyone!
This is my first time posting, so apologies if it's on the wrong board or something.
I'm in the middle of a bit of dispute with Pru over serious illness/disability cover claim and I'd love some advice on my position in this dispute.
Around a year after paying into my policy, I was diagnosed with M.E. I informed the company and was told it wasn't covered by their serious illness/disability cover. Upon looking at their conditions T&Cs, I noticed M.E was excluded under the Muscular Disorders section, but at present, the World Health Organisation defines it as a Neurological Disorder. Of course they didn't accept that, and because they were so rude, I took the matter to the Financial Ombudsman who ruled they give me £200 compensation and assess me under Neuro disorders.
Their assessment forms were to be completed by treating specialist, and because I was on waiting list to go back to ME clinic, I gave the form to my GP to complete as she was the one seeing me most often. She filled in the forms and carried out the "functional activities tests" for me. From what she completed, it look very much like I was eligible from their "functional activities test".
When I got a response, they told me that they couldn't be sure that my disabilities were permanent and wouldn't pay out. They asked for a report from a Specialist Neurologist (since I was claiming under Neurological disorders). I told them that when I had asked to be referred on previously, my old GP told me that due to the lack of information on the condition, I'd "sit at the bottom of the waiting list" for ages.
So it's a NO from them, despite the fact they haven't contacted the consultant who treated me at the ME clinic and they expect me to demand to see a Specialist Neurologist.
There's no cure for ME, just treatment of symptoms, so I'm frustrated as how they don't see that as some sort of permanence. I'm sorry for the long rant, but could anyone advise me on the situation and my position? I've referred back to Financial Ombudsman, but would love your opinion.
Thanks in advance,
Louise
This is my first time posting, so apologies if it's on the wrong board or something.
I'm in the middle of a bit of dispute with Pru over serious illness/disability cover claim and I'd love some advice on my position in this dispute.
Around a year after paying into my policy, I was diagnosed with M.E. I informed the company and was told it wasn't covered by their serious illness/disability cover. Upon looking at their conditions T&Cs, I noticed M.E was excluded under the Muscular Disorders section, but at present, the World Health Organisation defines it as a Neurological Disorder. Of course they didn't accept that, and because they were so rude, I took the matter to the Financial Ombudsman who ruled they give me £200 compensation and assess me under Neuro disorders.
Their assessment forms were to be completed by treating specialist, and because I was on waiting list to go back to ME clinic, I gave the form to my GP to complete as she was the one seeing me most often. She filled in the forms and carried out the "functional activities tests" for me. From what she completed, it look very much like I was eligible from their "functional activities test".
When I got a response, they told me that they couldn't be sure that my disabilities were permanent and wouldn't pay out. They asked for a report from a Specialist Neurologist (since I was claiming under Neurological disorders). I told them that when I had asked to be referred on previously, my old GP told me that due to the lack of information on the condition, I'd "sit at the bottom of the waiting list" for ages.
So it's a NO from them, despite the fact they haven't contacted the consultant who treated me at the ME clinic and they expect me to demand to see a Specialist Neurologist.
There's no cure for ME, just treatment of symptoms, so I'm frustrated as how they don't see that as some sort of permanence. I'm sorry for the long rant, but could anyone advise me on the situation and my position? I've referred back to Financial Ombudsman, but would love your opinion.
Thanks in advance,
Louise
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