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

[TUTTSI]

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

Miss FM, Charlies argument may well be compelling but unless full evidence from the insurers is disclosed to the family as set out in my previous thread then I would definately say they should pay out what he is due under the policy which Nic took out. If they nullify that the policy is nul and void after evidence is proven then they should at least return the premiums to the family which Nic has paid over the years this would at least be some compensation. I am sure if someone started a fund to raise money for this family then I am sure that it would with all the signature obtained be quite substantial. This fund I guess could only be started by a lawyer to ensure that the money is properly kept and gioven to the family in trust for the family of Nic.

Have been following this thread for some time - it is truly heartbreaking.

Obviously first impulse = sign petition, there is an injustice here

But Charlie 505's argument is compelling - can't help thinking that the best we could all do is

- chip in for the family (it's easy to sign a petition, more money-where-mouth is to lob over a tenner or so, particularly for those who can afford it) Is there anyone here in the position to set up a charity for the family?

- lobby parliament to change the law (it does look as if the insurers are acting within the letter of the law from the evidence above and are obliged to defend) and make the petition aimed at parliament to change the law on insurer's smallprint etc..

- give the insurers the option to be the good guys and make an ex gratia payment to the family - they can easily afford the sum they would have been liable for - even over or above - but will not be willing (or allowed by their lawyers) to admit liability, for the reasons that Charlie has given. If they can be seen to be the good guys rather than the ones resisting being railroaded into submission they might be more generous = more constructive result for family

[MissFM]

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

Sorry Tuttsi - Obviously I have that wrong - but I did think the insurers couldn't say that (about the pins and needles) unless they had it on the form (ie in writing). Am not being heartless or arguing that the family shouldn't have the money - of course have complete sympathy with family and none with insurers - everyone does, it's completely obvious. It's just a matter of where the law lies - thinking of a stategy that will actually work for the family AND how to change such a stupid law (to help future families in this situation of which there will be many).
As regards charitable trust - presumably it would have to be a lawyer or suchlike.

[TUTTSI]

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

Miss FM, I believe the crux of this matter has been blown out in the open because the insurers probably have not shown the evidence to the family, that is my gut instict other than that I agree with Charlies argument that a wrongful disclosure does make any policy nul and void. I also firmly believe that the insurers could have called for the GP's notes before taking on the risk and had they have done this Nic would have either of had an increased policy premium or they would not have granted cover in the first place.

The insurers now have a responsibility to the family for remedy if found to be that Nic failed to answer an outright question. This being the case even if it is an ex gratia payment ( at least equivalent to the premiums which Nic paid and which they have collected the payments) they cannot have it both ways iIMHO. I understand that he took the policy out 3+ years ago so probably paid a substantial amount. Probably not as much as they should have paid out but if Nic did make that fatal mistake sometimes it is not disclosed because it may have been something that happened once and he did not realise it was relevant. I have never known that particular question to be asked outright. The question probably may have said something like... have you visited your doctor in say the last 12 months......and to give a description of why he attended the GP. How easy is it for anyone to forget something that probably was not relevant or minor at that time to forget one thing. Also, they are trying to say that he was a drinker when he was under the limit on alchahol. This is why I firmly believe that they have to disclose to Nic's family the form in which he signed to ensure what was requested exactly and how he answered it.

My husband recently went for some extra life cover and they called for the doctors notes + screening on the phone by an independant medical organisation, the insurers loaded the policy because they said he had rhematoid athritus....he went to the doctors to find out if that was on his record because he was not aware of this and the GP confirmed that he definately has not this condition they have since taken the loading off. This is why I am saying the insurers get their wires mixed up sometimes and you have to be one step ahead of them.

Sorry Tuttsi - Obviously I have that wrong - but I did think the insurers couldn't say that (about the pins and needles) unless they had it on the form (ie in writing). Am not being heartless or arguing that the family shouldn't have the money - of course have complete sympathy with family and none with insurers - everyone does, it's completely obvious. It's just a matter of where the law lies - thinking of a stategy that will actually work for the family AND how to change such a stupid law (to help future families in this situation of which there will be many).
As regards charitable trust - presumably it would have to be a lawyer or suchlike.

[MissFM]

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

Absolutely agree to all of the above, Tuttsi.

According to Charlie, the insurers will have to pay back all the premiums if they are allowed to declare the policy void (or have I yet again misunderstood). It's not going to be enough for the family to manage without him (Nic). You can't fairly call it compensation because no amount of money can compensate.

My proposition is - are there not more constructive (and more likely to succeed, though less crowd pleasing) ways of addressing this situation? As you have described very clearly above, the whole insurance business needs a complete overhaul and it needs to be more transparent, fairer and most particularly more accurate and efficient. If a family's livelihood may come down to a clerical error - and there seem to be so many - the whole system needs revision and that is down to government and law-making.

I seem to be annoying everybody on every thread I am trying to make a contribution to at the moment so will just p..s off now.

[TUTTSI]

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

Miss FM -There is no problems making contributions to threads but if a mistake occurs then of course someone has to put you right so that the original poster does not get the wrong information. It takes years of being on forums to learn about the tecniques in giving the right advice. I often do not post on bailiff threads as I am not so conversant with them.

Yes you are also right that there should be a complete overhaul on Insurances generally because mistakes can make the difference between being paid out or having a policy voided and causing distress to families as in Nic's case.

Just to bring to everyone's attention from Satuturday the European Courts have ruled that all male insurance premiums either for car or life insurances are to be reduced by 10% and womens increased by 10% or so my husband has just explained to me. Therefore the new policy which he was just about to take out now has to be reduced again it appears. No wonder the insurers were in a hurry to get him to sign on the dotted line. http://www.bbc.co.uk/news/business-12606610

Absolutely agree to all of the above, Tuttsi.

According to Charlie, the insurers will have to pay back all the premiums if they are allowed to declare the policy void (or have I yet again misunderstood). It's not going to be enough for the family to manage without him (Nic). You can't fairly call it compensation because no amount of money can compensate.

My proposition is - are there not more constructive (and more likely to succeed, though less crowd pleasing) ways of addressing this situation? As you have described very clearly above, the whole insurance business needs a complete overhaul and it needs to be more transparent, fairer and most particularly more accurate and efficient. If a family's livelihood may come down to a clerical error - and there seem to be so many - the whole system needs revision and that is down to government and law-making.

I seem to be annoying everybody on every thread I am trying to make a contribution to at the moment so will just p..s off now.

[MissFM]

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

thanks Tutts and I do understand and yes heard about the insurance thingy which is another ridiculousness :clgblinkie171:

[Bill-K]

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

We often feel as though we are 'under attack' in these forums - particularly where we may seem to have a 'minority' view. Charlie gets my respect for putting across the insurers' side of the argument, and without him there may have been no discussion here at all. I think we seem to agree that the Law must be upheld - and that the Law may need to be updated (and has now been, I believe).

Miss FM's suggestion of an 'ex gratia' payment seems like a worthy one to me. I dare say that none of us here really know ALL of the facts, and we respond emotively - when the business of insurance is - and should be - free from such pressure. As Tuttsi has said, the insurers have a duty to fairly and properly assess the risk when selling insurance. Was that duty fulfilled ? They know how to gain (lawful) access to information which the likes of you and I have no access to. If they did not do this, then they have failed in their duty to their (prospective) customers, IMHO.

I originally held the opinion that we cannot be expected to declare every sneeze and fart we have ever had - and I still hold that opinion. However - if there were questions in the application which specifically related to 'pins & needles,' then I may change my opinion - but this needs to be made VERY clear, as far as I'm concerned. It doesn't seem to be that clear here as yet. Does the 'fart count' question feature in the application ? Bowel Cancer is another prominent insurance risk, I believe.

My point is that - if the right questions were asked, then what were they - and what were the answers ?

Sure - if a full medical was not considered necessary, then was this because the insurer failed to ask the right questions ? Or because the prospective customer failed to disclose every single health 'blip' they have ever had ? I'm still not happy that the onus seems to be upon the prospect to provide what the insurer needs, when the insurer does not make their needs clear.

[Charlie505]

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

I am sorry if this comes up twice – I seem to have lost an earlier version of my comments - and apologies also for some lengthy comments ...

Some very interesting points are being made here by Tuttsi, Puffrose, Miss FM and Bill-K – including Tuttsi’s introduction of the European judgment on gender neutrality. Hopefully I can make some helpful observations...

Like all businesses insurers must give shareholders a return on capital invested greater than they could get from sticking their money in the bank. Those shareholders are not generally cigar smoking fat cats – they are often pension funds investing your money and mine, so it is in all our interests that companies make reasonable profits. Insurers make a margin between premiums and claims and what they want is stability and predictability. They don’t mind paying claims and they are very good a predicting their incidence – but only if they stick to objective criteria, due process and law. Otherwise the basis on which the industry has served the public for centuries can’t be maintained.

It has suggested that the insurers haven’t been open with the family about the evidence. Actually we don’t know what has been said. What we do know is that medical evidence is given by a GP in strict confidence as dictated by medical ethics, and it is not within the insurer’s gift to decide to make it public.
Was it the insurer’s duty to get full medical evidence in this case? A GP’s report or a medical examination are requested if a sum insured is of a particular size, or if something is revealed on the application that needs checking out. Insurers try to keep medical reports to a minimum – firstly because it slows down an application by weeks and annoys customers, and secondly because it is expensive (I think a GP report is now about £100 a throw) and whilst the insurer pays the GP, all costs ultimately land on the shoulders of customers.

Should the law be changed / should there be an ‘overhaul’? Well it’s already happening – the Bill has been passed by Parliament and will take effect in 2013. Traditionally insurance contracts have been ‘contracts of ‘utmost good faith’. The customer has all the relevant information about the risk while the insurer is working blind – so the responsibility is placed on the customer to tell the insurer everything it should know before it enters into the contract. Times move on and it is now considered too much of a burden of responsibility for customers – so in future they will only have to answer straight questions. This means that insurance application forms will probably have to get longer.

To put things in perspective, for life insurance about 98%-99% of claims get paid. For Critical Illness it is about 92% . that may be better than many would expect – and certainly a major improvement has occurred in recent years, but there is still more to do. Some declined claims will be due to attempted fraud, some will be because the claim isn’t covered, and some (probably too many) are down to genuine error or carelessness. Apart from the individual issues, the Nic Hughes case causes the many people who have no cover at all (I think about 40% of the population) to believe that insurance companies declining a claim is the norm rather than the exception. Everyone wants insurance to be seen as something that ‘does what it says on the tin’ and that means continuing to work to reduce the chance of errors. This isn’t a straightforward as it might seem - more accuracy means more questions, more paper (and let’s face it insurance is inherently boring to most people). People want to be told everything, but they also don’t want to spend time reading what they are sent.

Puffrose has asked why the insurer won’t meet the family. I don’t know – from broad experience of this sort of media situation, the family has everything to gain, and the insurer everything to lose. The media are fickle – they are only interested in new stories and the campaign may run out of steam if it doesn’t keep providing new stories. A meeting with the insurer would provide renewed momentum to the campaign, but the insurer would know they would be walking into a media event which is being used as an alternative to due process by the campaigners. I can see why the campaign is calling for a meeting and equally I can see why the insurer isn’t taking the bait. I don't mean that to sound unsympathetic - just realistic.

What seems to be at the heart of many comments is the question of responsibility – who should take responsibility in this situation. It is suggested that the insurer has ‘left the family in the lurch’. Well they certainly have if they are refusing to pay out on a valid contract. But if the contract is null and void, they have no responsibility – apart from the return of the premiums wrongly paid into it. What we struggle with is that if the insurer isn’t responsible – it means that the individual is. Or ...we say as a good society that we all step up. The word we use for this doesn’t sit comfortably on our lips but it is the foundation of a caring community – charity.

We are fortunate enough to live in a thriving democracy and under the rule of law. When there are disputes in contract, we have recourse to law – and if we can’t afford it there is state aid. In financial services the Financial Ombudsman Service has been set up as a lower cost alternative for dispute resolution – the insurer always pays the cost of the investigation whether it wins or loses. And customers can write to their MP who will normally intercede with a company on a constituent’s behalf. However some people will want to walk past these approaches and exercise their democratic right to protest. However when you take up digital pitchforks if you are not careful you find yourself with travelling companions who don’t know where to draw the line between peaceful protest and actions that sully the reputation of your cause.

Finally on Tuttsi’s European point - this is about a European Court of Justice ruling which took effect on December 21^st. It decrees that insurers cannot differentiate between men and women in the rates they charge. The court action was started by the Belgian equivalent of Which? magazine, called ‘Test Achats’ on the basis that the Treaty of Rome prevents gender discrimination in the EU. So women can’t be charged less for car insurance because they have fewer accidents, or charged less for life insurance because they live longer. And men can’t get a better deal on annuities because they die earlier. Early results suggest the difference will be significantly less than the 10% suggested above but it will vary from insurer to insurer because it will depend on the balance of male and female customers that each has on its books. The insurance industry in the UK fought it for years because it goes against the principle of setting premiums based on the risk presented by an individual’s circumstances - but some European countries just don’t see things the same way.
With financial services regulation increasingly coming from Europe now over the head of our own UK regulators, this might be the shape of things to come.

Sorry for such a long post.

[Hurricane Puffrose]

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

Sorry to harp on but the fat remains, the man paid in to have his family supported in the event of something happening to him, he paid in good faith to a company to protect his family.
The company has let him and his family down, in grand style, and the shareholders will have no profits to buy the old bubbly with if people (like myself) vote with their feet and go elsewhere.

The family have asked for a meeting with their solicitor present, which has been flatly refused by the insurer, and yet the Insurer wants us to comply with them!

The pins and needles have absolutely nothing to do with his condition, I have carpel tunnel syndrome, I get pins and needles and shaking through my arms, would this invalidate any claim I had because I didn't tell them I had it when claiming for a life threatening illness?

I for one will continue to invite people to sign the petition in this man's memory.. people first profits later!

[Inca]

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

The diagnosis of Multiple Sclerosis depends on more than 'I've got pins and needles'. This whole saga STINKS IMO. I can't remember everything I've chatted to my Dr about or mentioned in passing (and she has tapped it into my notes for future reference IN CASE it becomes an issue). Nic died of DIAGNOSED AND DECLARED CANCER and therefore his policy,in my opinion,was and is valid.

[Charlie505]

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

Sorry to harp on but the fat remains, the man paid in to have his family supported in the event of something happening to him, he paid in good faith to a company to protect his family.
The company has let him and his family down, in grand style, and the shareholders will have no profits to buy the old bubbly with if people (like myself) vote with their feet and go elsewhere.

The family have asked for a meeting with their solicitor present, which has been flatly refused by the insurer, and yet the Insurer wants us to comply with them!

The pins and needles have absolutely nothing to do with his condition, I have carpel tunnel syndrome, I get pins and needles and shaking through my arms, would this invalidate any claim I had because I didn't tell them I had it when claiming for a life threatening illness?

I for one will continue to invite people to sign the petition in this man's memory.. people first profits later!

Puffrose, I realise you feel strongly about this but you are saying things here that are wrong or based on conjecture. The family are not being asked to 'comply' with the insurer - the Ombudsman is there for them. It is there to resolve disputes of this type, and if the family don't want to refer the case to the Ombudsman you really have to ask why not. The courts or Ombudsman are for those seeking justice - the internet are for those who just want to get their way.

Of course the family have asked for a meeting, and of course it has been refused. It is a campaigning approach that avoids using the processes of justice available to them. It is hardly surprising the solicitor would be present - but this would be the same solicitor who appears not to be telling them that they have a strong enough case to seek justice through normal avenues.

The pins and needles had nothing to do with Nic's cancer - but as I have explained they have everything to do with a decision an insurer makes to enter a contract in the first place. It's the law. Your 'in good faith' point is actually a legal term (uberrima fides) and if Nic didn't disclose a fact material to the decision to enter the contract, that legal principle was not satisfied.

I am sorry to hear you have carpal tunnel syndrome. I have seen many such cases and understand the condition. I have meralgia paraesthetica which also gives me pins and needles. I always disclose mine when I apply for insurance. Your carpal tunnel syndrome is obviously not life threatening (but it would be relevant for health/disability cover). However (and this really is the critical point Puffrose) the insurer would not know whether your pins and needles were carpal tunnel, or due to something more sinister unless given the opportunity to check that diagnosis with the GP. They can't do that if you don't tell them. If in doubt, disclose - and certainly don't tell an insurer you haven't experienced a symptom if you have already consulted your doctor about it.

As for people and profits in business - it isn't an either/or. You can't have one without the other.

[Charlie505]

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

The diagnosis of Multiple Sclerosis depends on more than 'I've got pins and needles'. This whole saga STINKS IMO. I can't remember everything I've chatted to my Dr about or mentioned in passing (and she has tapped it into my notes for future reference IN CASE it becomes an issue). Nic died of DIAGNOSED AND DECLARED CANCER and therefore his policy,in my opinion,was and is valid.

Inca, You make a valid point when you say that people can't remember everything they said to a doctor - but on the other hand if 'oh, I forgot to say' was a valid excuse then it would be exploited, and it would become impossible to get insurance for anything at a reasonable price. The question of MS is something I mentioned to illustrate the point that pins and needles can be symptomatic of a serious condition; of course there are other tests that would need to be done to confirm such a diagnosis - but the insurer can't find out if they haven't been told.

To put this in a very stark way - if you were being asked to bet your own money on a person's life expectancy, would you want to be told before you took the bet that they had been consulting their doctor about pins and needles? Of course you would - particularly if the law gave you that right (as it does).

[Inca]

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

A GP cannot diagnose MS,there is a battery of tests that have to be done,(and re-done in a lot of cases) MRI's,CAT scans,Lumber punctures,EEG's etc and these all take time and precious resources so I very much doubt that isolated 'pins and needles' cause many GP's to send their patients trotting off to Neurologists.A simple trapped nerve (and I'm not in any way being derogatory to anyone who has one,they are bl**dy painful) can mimic the effects of MS.

[TUTTSI]

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

As you might be aware Inca my Mum had MS and as time progressed she was numb from the waist down together with pins and needles and she also had to have a lumbar puncture - it was horrible as a little girl with mum and she was in a state when she came out from this test very bloody. Really MS is not the nicest of of diseases it is an inflamation of the nervouse system. xxxx < hugs.... to you you Inca as I know what you are going through trust me. xx

A GP cannot diagnose MS,there is a battery of tests that have to be done,(and re-done in a lot of cases) MRI's,CAT scans,Lumber punctures,EEG's etc and these all take time and precious resources so I very much doubt that isolated 'pins and needles' cause many GP's to send their patients trotting off to Neurologists.A simple trapped nerve (and I'm not in any way being derogatory to anyone who has one,they are bl**dy painful) can mimic the effects of MS.

[Hurricane Puffrose]

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

just out of interest.. which insurer do you work for?