Medical Insurance Pre existing conditions

[di30]

Re: Medical Insurance Pre existing conditions

Hi Di

It would be advantageous to go through the terms & conditions of the policy before approaching the insurance co.
There may be a continuing onus clause for the OP to disclose asap anything which may alter the original terms of the agreement.
If so, that would have been the case when the diagnosis was made in 2007.

Hi
Yes good point charitynjw, missed all these posts sorry (mad house here today lol) x

[Angry Cat]

Re: Medical Insurance Pre existing conditions

I will throw this into the pot, for what it's worth:
http://www.webmd.boots.com/a-to-z-gu...kinsons-stages

The causes of Parkinsons are still not clear...it is possible that it can be genetic; passed on through family members plus other factors.

The General Consumer, is not clairvoyant, people do not wish to become unwell and not to recover. But in some cases this does happen and if you paid for PPI, inevitably one will experience problems claiming!

I've had massive PPI problems myself, having paid out on 5 different policies with 5 different Banks; they all failed because the product had been designed to make money for the firms.
But, not to provide the promised 'Peace of Mind' protection for the Consumer; me.

So far, 4 out 5 Banks have caved in but am still battling with one.

It is not possible to pre-meditate a long term illness.

[Angry Cat]

Re: Medical Insurance Pre existing conditions

.........They have failed you, and it's a lot to pay out each month, that have added up over the years, plus interest!

Absolutely, agree!

[Angry Cat]

Re: Medical Insurance Pre existing conditions

Hi Di, I will try again I will write to CEO ,many thanks.

That is: António Mota de Sousa Horta Osório.

Lloyds, have recently been in the press: bad news about not dealing with PPI claims correctly...!

skyways, will need to word his/her letter with care...

[des8]

Re: Medical Insurance Pre existing conditions

Hi, sorry to hear about your problems.
Whilst generally posters are querying Policy wording and general PPI problems, I'm more interested in seeing the actual wording of the proposal form and the answers given.
Halifax are claiming non disclosure, but if the questions weren't properly phrased, or the answers perhaps completed by the salesman for OP to sign they could be wrong.
Drafters of proposal forms and policy wordings aren't necessarily as good as they think, and they do make slips which get past their legal advisers.
If you haven't a copy of your proposal ask Halifax for a copy of the SIGNED proposal you made, and any promotional material used at the time, so it can be examined.

[Eloise01]

Re: Medical Insurance Pre existing conditions

Hi, sorry to hear about your problems.
Whilst generally posters are querying Policy wording and general PPI problems, I'm more interested in seeing the actual wording of the proposal form and the answers given.
Halifax are claiming non disclosure, but if the questions weren't properly phrased, or the answers perhaps completed by the salesman for OP to sign they could be wrong.
Drafters of proposal forms and policy wordings aren't necessarily as good as they think, and they do make slips which get past their legal advisers.

I agree. It's the totality of the contract that entered into and the circumstances under which it was entered into. In the case I quoted earlier relating to fixed term contracts there was clear evidence that the policy holder knew (they had a copy of the contract at the time the policy was taken out). The policy holder could not therefore be expected to know such contacts are excluded because it was buried in small print, whereas the policy holder accepted evidence of a contract which was fixed term as acceptable under the policy! The insurer hasn't necessarily covered all their bases. Maybe they have, but nothing is lost by trying.

[Turboman]

Re: Medical Insurance Pre existing conditions

Right--Back now

Lots of good posts and opinions on here--a good thread

HOWEVER-as a lot of you know--I (& my 'oppo Bill-k) only deal in fact

Soooo

before I go any further Skyways--please answer as below

• Is this a continual Medical Insurance Policy unconnected with the Loan or a PPI Policy tied to the loan?
• What was the exact date of the Loan?
• What were you attempting to claim for ---(ie hospitalization,unemployment , etc..)and exact date of claim?
• Please note ..the answer to above very important as if PPI-it would be only for 5 yrs and expired-so no chance of claiming or even not applicable to cancel as it would not be in existence

Sooo---I suspect the issue of the claim refusal is not applicable--so we have PPI Mis-selling where I need more info--ideally thro a SAR but for the time being

• Date of Loan and term of loan
• Scan of PPI Policy
• Scan of your Consumer Credit Agreement
• No of pymnts actually made so far? (bank stmts or Loan Statement)

Remove personal details of course-but if you dont know how to do it -send them to Simiantics@gmail.com where both me & Bill-k can view them

Turbs

[Bill-K]

Re: Medical Insurance Pre existing conditions

• Is this a continual Medical Insurance Policy unconnected with the Loan or a PPI Policy tied to the loan?
• What was the exact date of the Loan?
• What were you attempting to claim for ---(ie hospitalization,unemployment , etc..)and exact date of claim?
• Please note ..the answer to above very important as if PPI-it would be only for 5 yrs and expired-so no chance of claiming or even not applicable to cancel as it would not be in existence

• Scan of your Consumer Credit Agreement
• No of pymnts actually made so far? (bank stmts or Loan Statement

• Good point about the 5 year PPI policy term, Turbo. I think it is very Important to determine for sure exactly what the policy term is/was. If Halifax have not used policy expiry as the reason for refusal, but leapt on the pre-existing condition clause instead - it seems to indicate that the policy may still have been in force at the time of the claim.
  
  Sorry for the delay in posting here, as I didn't log on until just now, but I've scanned through this thread, and there are some interesting and very good posts IMHO. Sure, if it's mis-sold PPI, then I might have some advice on that - but if it is a matter of trying to make a claim stick on a medical insurance policy - or a PPI policy for that matter - then I bow to the knowledge of those who know about such things as contract law, etc. - and that is the good people who have posted here so far.
  
  What I would personally suggest, though, is that Skyways does as suggested by several posters, and does NOT cancel the policy as yet. At present, s/he has 2 chances:-
  1. Continue pressing with the claim on under the policy, until it is clear that there is no point in continuing. This still provides the chance of an insurance policy payout.
  2. If no success with 1 above, THEN cancel the policy, and launch a claim for mis-selling. And even if step 1 produces success, still consider a claim for mis-selling - but only AFTER the insurance has paid out. Any such payout would be deducted from any mis-selling refund.
  
  If s/he cancels now, then step 1 is binned - possibly prematurely. So - I think step 1 should be thoroughly investigated and exhausted first. As Turbo suggests - it could even be a dead duck already - but I think we really need to be sure, to be sure, beGorrah !
  
  Another thing to weigh up is perhaps the difference between a policy payout and a mis-selling refund. I'm not sure that it's likely, but it's possible that a mis-selling refund might work out at more than a policy payout. Turbo and I can do some number-crunching for this separately, as he has mentioned above.

[Turboman]

Re: Medical Insurance Pre existing conditions

Thanks Bill--was writing this as you were posting too)

Right..following on..got more time now--will comment on a few of items mentioned in posts in my next post after this but (as I feel we will be only dealing with mis-selling rather than refusing a claim (after policy out of time) :

First of all ..lets remind ourselves re the principles of PPI Policies invoked at time of taking out a loan--also see my thread here
http://www.legalbeagles.info/forums/...n-Amortization

• On loans greater than 5 years--the PPI only covers the first 5 years.
• On loans (say) 2,3,4 years--the PPI policy just covers the term of the loan agreement.
• The PPI cover always ends with the termination of the Loan Agreement.--being early settlement or consolidation
  
• On termination of a loan early-or request for cancellation of PPI Policy before 5 yrs--the lender usually refunds part of the PPI upfront sum according to a specified chart(for that Lender) which varies the % refund dependent on how many years have elapsed and relative to the total term.
• This PPI Refund will be apparent from the closing statement.
• Claims for mis-selling are reduced by the above PPI Refund amount if given.
• At outset of a loan--the PPI Single Premium Payment is added to the Amount of the Cash Loan Advance and the total amount amortized over the loan term..ie--to produce a regular identical monthly payment to pay off the total loan over the term)
• However--the PPI Policy would terminate after the term if less than 5 yrs or on 5 yrs if loan was for 5 years or greater
• This results in a situation which confuses a lot of people--namely that the PPI Policy is null & void at 5 yrs..yet the monthly premium still contains a PPI element--to 10,20,30 yrs etc (otherwise the mthly payment for the first 5 yrs would be much bigger)

[Eloise01]

Re: Medical Insurance Pre existing conditions

Some brilliant advice there from Di30, Turboman, and Bill-K. I wonder whether you think that this may be an apt situation for some "no win - no fee" advice on whether the contract is enforceable? Although I do have some qualms about some CFA (in my area of law, anyway!), it would be a relatively fast method of securing several legal opinions on the viability of a case without any cost to the OP. And given that CFA is based on the probabilities of winning, if they read the documents and talk to the OP and think they have little chance, at least the OP knows to scotch that option?

[Turboman]

Re: Medical Insurance Pre existing conditions

Not sure where you going on this Eloise

• Jan 2007-Docs notes re possible tremor , Parkinsons etc..
• Feb/2007-Loan with PPI taken (we think until confirmed)
• Oct/2007-Consultant referral-possibly Parkinsons
• Dec/2007-Confirmed Parkinsons
• Feb/2013-OP paid off due to ill health
• Mar/2013-OP claimed and told not covered due to pre existing

Sooo---OP tried to claim after 6 years of taking PPI which was only valid for 5 year policy anyway

Sooo---I believe all we should be concentrating on is "mis-selling"--which is bread & butter on here--lol

..or am I missing something Eloise01 & Bill??


Turbs

Some brilliant advice there from Di30, Turboman, and Bill-K. I wonder whether you think that this may be an apt situation for some "no win - no fee" advice on whether the contract is enforceable? Although I do have some qualms about some CFA (in my area of law, anyway!), it would be a relatively fast method of securing several legal opinions on the viability of a case without any cost to the OP. And given that CFA is based on the probabilities of winning, if they read the documents and talk to the OP and think they have little chance, at least the OP knows to scotch that option?

[Eloise01]

Re: Medical Insurance Pre existing conditions

Heh- I haven't a clue about PPI. It's a "new world" to me. I was just looking from the position of legal logic! So I don't understand the "five year" thing - I assumed that if they had refused to pay out on the basis of the condition not being disclosed when it was taken out, rather than because the policy no longer applied because it would not pay out anyway, no matter what, that that would be what they said! I am sure you are right about the five year thing though - although it's a bloody swindle if the loan is for longer! Are you telling me that if I take out PPI on a ten year loan I can lose my job after six years and they won't pay out??? (You can tell I never had a PPI policy, can't you?)

[Turboman]

Re: Medical Insurance Pre existing conditions

Afraid so Eloise01--after 5 yrs you are expected to get a new PPI-Type policy from somewhere

A point that I should add-(got Barclaycard PPI Policy in front of me ) is that pre-existing medical conditions don't invalidate the policy--merely claims on THAT pre existing condition are not accepted

You will soon get to grips with PPI Eloise01

Sums are what I do--Di does procedures & care--Bill does tactics......but we mix & match & hope others chip in to help us when they can

Heh- I haven't a clue about PPI. It's a "new world" to me. I was just looking from the position of legal logic! So I don't understand the "five year" thing - I assumed that if they had refused to pay out on the basis of the condition not being disclosed when it was taken out, rather than because the policy no longer applied because it would not pay out anyway, no matter what, that that would be what they said! I am sure you are right about the five year thing though - although it's a bloody swindle if the loan is for longer! Are you telling me that if I take out PPI on a ten year loan I can lose my job after six years and they won't pay out??? (You can tell I never had a PPI policy, can't you?)

[Bill-K]

Re: Medical Insurance Pre existing conditions

Sorry if I wasn't clear enough, Turbo. I'm suggesting that we make 100% sure exactly what this insurance is, and how long it ran for. It's looking likely that it may be PPI, and that Skyways claimed on it after the cover had expired - but we don't yet know this for a fact, and I think we need to establish that before we abandon any pursuit of a claim under the policy.

What I would personally suggest, though, is that Skyways does as suggested by several posters, and does NOT cancel the policy as yet. At present, s/he has 2 chances:-
1. Continue pressing with the claim on under the policy, until it is clear that there is no point in continuing. This still provides the chance of an insurance policy payout.
2. If no success with 1 above, THEN cancel the policy, and launch a claim for mis-selling. And even if step 1 produces success, still consider a claim for mis-selling - but only AFTER the insurance has paid out. Any such payout would be deducted from any mis-selling refund.

If s/he cancels now, then step 1 is binned - possibly prematurely. So - I think step 1 should be thoroughly investigated and exhausted first. As Turbo suggests - it could even be a dead duck already - but I think we really need to be sure, to be sure, beGorrah !

Are you telling me that if I take out PPI on a ten year loan I can lose my job after six years and they won't pay out???

Yes, that's exactly right, Eloise. The PPI premium is charged as a one-off lump-sum payment at the start of the loan, and is added to the loan amount (or Principal). The loan for the PPI premium then runs alongside the cash advance loan for the whole term of the loan (maybe 25 years or more) - but the insurance itself is only effective for a few years - usually 5 years or less !!!

[Turboman]

Re: Medical Insurance Pre existing conditions

Yes--agree Bill-lets see the CCA--we need facts-black & white

re-reading the posts....

really good points raised Eloise01,Di30,Bill,Chaz,AngryCat,Inca,des8,Puff

Perfect thread with lots of input & different suggestions