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Experiences with Insurance Companies

Discussion in 'Work, Finances and Disability Insurance' started by Sbag, Jun 16, 2018.

  1. Sbag

    Sbag Senior Member (Voting Rights)

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    Please be aware that this thread is not in the Members Only Section and therefore content is available to search engines.


    I have reported to the Financial Conduct Authority that companies are still including ME in mental health exclusions which goes against all the guidelines set by insurance bodies. As I didnt have a complaint specific to me they weren't that interested - will try and chase them on it.

    I had some good news this week - my claim that has been going on for the last 18 months was decided on last week and they approved it !!!!

    I had a mental health exclusion as I had depression when I took out the policy. They tried to refuse it saying that ME was a mental condition, then went through everything else they could - hadn't been ill for long enough (9yrs!), had been active in that time, could go back to work if I had more treatments (mindfulness, cbt and get give good results as shown in PACE trial), would not be permanent etc.

    I had to fight against each argument and even with reports from my consultant they just ignored them. Reports from their CMO fabricated information, I had to go through long SAR process to get these reports which they tried to withhold. Also had to have exam by their independent expert. I was expecting them to still refuse after this and had been to see my own indpendent expert as well. Hadnt even had this other report yet but i had sent another letter to them before they made decision, where I criticised their expert and his exam.

    Not sure whether this made the difference or if they just got fed up of me. The policy wasn't for a huge amount and they must have spent a lot working on it. I will get the rest of the notes from them under the SAR so hopefully will find out.

    I will put everything together so others can use but it will take a while as I am exhausted and body has crashed after the shock (not too bad but enough that i need a rest)

    Thank you to everyone that helped me on this with comments and answers to the questions I needed evidence for. Each letter I wrote seemed to be like a mini thesis especially with all the research I had to do in getting all of the information to throw at them. I never thought we would get to the end and get a positive decision without having to go through the ombudsman. It shows it's worth pursuing even against huge odds.
     
    Last edited by a moderator: Jun 18, 2018
    Hutan, andypants, MEMarge and 10 others like this.
  2. Annamaria

    Annamaria Senior Member (Voting Rights)

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    [UK]
    https://lexisweb.co.uk/cases/2017/october/miley-v-friends-life-ltd

    https://www.12kbw.co.uk/david-callow-successful-high-court-permanent-health-insurance-claim/

    Potential claimants should consider instructing solicitors and counsel who were successful in the above case.

    NB. I had bad experiences with solicitors Royds, now RoydsWithyKing, who advertise in ME charity journals. They instructed barrister Richard Colbey. When I expressed concerns, Royds told me that he had won many cases for them. It only emerged at the final conference that he had not taken a single case to a hearing. He held himself out as having experience of ME, but again at the final conference he revealed that he did not believe in the existence of post-exertional malaise. Whatever the deficiencies of NICE Clinical Guideline 53, it does include post-exertional malaise. He further said that claimants recover as soon as the stress of the court case is lifted. I don’t know what disease he assumed the case referred to, but I for one deteriorated and continue to be worse.
     
    TiredSam, janice, ukxmrv and 11 others like this.
  3. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    lambchambers dot co dot uk/who-can-help-you/barristers/richard-colbey

     
    janice likes this.
  4. Inara

    Inara Senior Member (Voting Rights)

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    I am very interested.

    And congratulations! I hope you'll be soon ok.
     
  5. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    I know this is an 'advert' for this lawyer but he gives potentially some useful information for Insurance claims re ME/CFS

    Andrew Kantor Helps Get Chronic Fatigue Syndrome Sufferers the Benefits They Deserve
     

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