Help us make Friends Life pay out Nic Hughes' critical illness policy

[Charlie505]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

This Act is the first change to the law on non-disclosure since 1906. Insurers have improved paractice over the years, and there is an industry code in place already which has much the same effect as the Act - but the law needed to be updated. It applies to all personal insurances - car,home,life,annuities, and critical illness.

Your insurer will now have to ask you specific questions to get information about your circumstances when you buy insurance. The Act will protect you if you unknowingly give wrong/incomplete information - and your insurer can't decline a claim due to non-disclosure unless you carelessly or deliberately lied or misrepresented.

However insurers can still decline a claim if you deliberately, recklessly or carelessly gave incorrect or incomplete information when answering questions so you still have a duty to answer questions correctly. (If unsure you should get advice). The Act describes what 'careless' or 'reckless' and expects you to take reasonable care to avoid misrepresenting your circumstances when answering questions.

It is possible that this may be relevant to the NH case - but perhaps not in his favour. It is aleged that he was asked a straight and material question which he did not answer correctly - if this was careless then he did not fulfil his obligations under the Act. The Act will not apply retrospectively and FOS do not have to follow the requirements of the law in their adjudication (amazingly!) but it may have some bearing on the FOS consideration of the case.

[Hurricane Puffrose]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

any update..have they done the decent thing yet??

[Charlie505]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

The case is with FOS Puff, and will have to wait its turn -timescales are usually weeks or months rather than days.

As for 'the decent thing' we won't agree - but I would not be surprised if the insurer were to have offered something on an interim (and confidential) basis. Only the family will know whether that is so, but whilst recognising that they are in dispute and going through due process, it would nevertheless be decent under the circumstances.

[Hurricane Puffrose]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

As i said, have they done the decent thing yet??

Its disgusting, he was covered for cancer, passed from cancer, he paid his way and now they are backing out of the agreement??

Thats like having a car insurance policy fully comp and them not paying because you didnt disclose a flat tyre!

[ploddertom]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

Mentioned in the Money Section of the Telegraph today. Didn't get chance to read it all but it seemed to suggest he wasn't quite honest about the questions he was asked.

[ploddertom]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

Here's the link http://www.telegraph.co.uk/finance/p...loopholes.html

[bluebottle]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

I know there have been cases where the insurer has not been exactly clear as to what information they required and judges have the unenviable task of deciding whether the proposer is in the wrong or whether the insurer is being unreasonable. I would not like to be one of those judges. During my time as a policeman, I came across insured persons who acted dishonestly and unreasonably, but, equally, I came across insurers who behaved just as dishonestly and unreasonably. Yes, the insurance industry has had to clean its act up, usually, by imposing legislation on them. However, the playing field is still tilted too much in favour of the insurer. The insurance industry has gotten away with far too much for far too long. That has to change, whether the insurance industry likes it or not.

[Inca]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

Charlie won't be surprised to hear I still think it stinks....and I welcome the FOS investigation and hope on everything I hold Holy they uphold the Hughes familys claim.
It does indeed beg the question 'Why would Nic lie?'

[bluebottle]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

If he didn't know he had cancer when he completed the proposal, the insurer is, in my view, behaving unreasonably. Claiming that he must have known smacks of desperation. Let the insurer PROVE he knew he had cancer when he completed the proposal. If they can't or won't, make them pay the claim, in full, and then hit them with some form of punitive measure that will make them think twice before doing anything similar in the future. Something has to be done and if punitive measures against insurers is the way forward, so be it.

[Inca]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

What the insurers are saying BB,,is that Nic didn't disclose he had spoken to his GP about 'pins and needles' ( no diagnosis,no treatment) and that his GP had mentioned on his notes that he had mentioned Nic cutting down on booze.

The GP has come out and said publicly that both incidents were NOT issues,,and that there was no disclosure to make in his opinion,but FL won't pay up.

[Hurricane Puffrose]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

Basically FL havent anticipated the backlash, and they need to pay up.

There is no need for this case to go to the financial ombudsman as there is no case to answer, the poor man passed from a insured illness, the "undiagnosed symptoms" were neither here nor there as they could have been a trapped nerve etc, and I defy you to go s a doctor and not be told to stop drinking, smoking or to lose weight!

Simply case of people power here, people can and DO vote with their feet.. and from what I have been readingin on twitter, many (myself included) have.

[bluebottle]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

What the insurers are saying BB,,is that Nic didn't disclose he had spoken to his GP about 'pins and needles' ( no diagnosis,no treatment) and that his GP had mentioned on his notes that he had mentioned Nic cutting down on booze.

The GP has come out and said publicly that both incidents were NOT issues,,and that there was no disclosure to make in his opinion,but FL won't pay up.

Sounds to me like a case of an insurer trying it on to see if they can get away with it. If the insurer is claiming Nic did or didn't do something, let THEM prove it. However, publicly claiming a seriously-ill person is being dishonest in order to bolster or legitimise an insurer's attempt to repudiate a claim is beneath contempt.

[Charlie505]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

We still have the same arguments being made - and I am afraid that in my view, the same misconceptions being held:

1. If you want to make a comparison with car insurance this case would be like saying you had a Fiesta when in fact you had a Porsche, then expecting the insurer to pay up for a carpark bump because it had nothing to do with the type of car. The fact is that if you don't tell the truth on your application you haven't 'paid your way' - you have paid less than you should have, and left other policyholders to pay more as a result. It is not OK.
2. The Act hasn't forced insurers to do anything - it mirrors an industry code of conduct that they voluntarily set themselves some time ago, (and which was followed in the NH case). However it does make the situation even more clear to both insurers and applicants what their respsctive responsbilities are. That is a good thing.
3. The question NH was asked was very clear and (alegedly) he failed to answer it correctly. At worst that may have been dishonest (Why would he? - good question, but people do it on a daily basis because they think it won't come back to haunt them), but more probably it was just careless.
4. Numbness/tingling is not trivial - it is a classic symptom of an illness that would have rendered NH uninsurable for this policy until and unless it was investigated and found not to be present. This is the crux of the insurer's argument -NH wouldn't even have had the policy if he had answered the question correctly.
5. This was not an 'I can't remember every cough and stubbed toe' situation - alegedly NH had been sufficiently concerned about this numbness to have consulted his doctor about it not long before taking out the insurance. If it was a reasonable misunderstanding then it might be different, but I am not sure even his supporters are arguing that.
5. If there is anyone who thinks that you can fail to tell the truth to an insurer and that it will be OK if the reason for a claim was unrelated, I would urge them to look at their motor, home contents, life, medical or any other insurance they have - because they don't work that way - can't work that way, and never will work that way - its the mathematics of risk. You can't deny having a heart problem and expect to be covered if you are hit by a bus.
5. 92% of claims on Critical Illess policies are paid. The balance tend to be about conditions not covered by the policy. Situations like the NH case are rare.

However it is possible that NH's family will win their case at FOS - and if so they will have done so by fair and due process. It is a free, impartial and binding (on the insurer) adjudication servce. It is good that NH's supporters realised belatedly that attempting to circumvent due process with a digital mob was not going to work.

Why might they win the FOS case? Well it won't be for any of the reasons the campaigners put forward, because they aren't very strong ones. We don't know the full facts, but IF it turns out that at the point of the claim for cancer the insurer requested medical evidence without probable cause (i.e. if they were just looking for something (valid or otherwise) on which to decline the claim) then FOS could well consider that to have been unfair.

In which case - they would agree with Inca - and I would also concede - that 'it stinks'. We'll have to see.

[Hurricane Puffrose]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

the more people vote with their feet out of principle the more Nik has helped to change the law.

It would have been a lot less stressfull for all, and better PR by far, for the insurers to pay up and honour what they promised Nik. They are dragging their feet and need to do the decent thing asap, which is simply pay what they owe.

[bluebottle]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

Parasthesia (Pins and Needles) is symptomatic of a number of conditions, not just MS. I have Fibromyalgia and parasthesia is part and parcel of the condition. Unless FL have credible medical evidence that would substantiate their arguments, IMHO, they are skating on thin ice and writing the most public corporate suicide note ever.