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With the ABI confirming an increasing amount of Life Insurance claims being rejected, almost 230 million pounds over the last few years, people are concerned about their policies paying out.
Some of the reasons life insurance won’t pay out can range from non-disclosure to the policy having exclusions that don’t permit a successful pay-out.
Resolute Claims are a specialised consultancy firm that help customers appeal rejected Life Insurance decisions. Over the past twelve months they have noticed a marked increase in customers being refused a pay-out.
Once case involved a company that specifically excluded any death related to a pre-existing condition. One customer’s wife, who we helped, had a condition known as SLE (a form of Lupus) and because of this had multiple associated health conditions.
To the untrained eye these policies can seem like a good deal for people with multiple health conditions or substantial pre-existing conditions that exclude them from the normal insurance market. Unfortunately, as we have experienced, these policies are unlikely to pay-out.
In the above case our customers wife died of a heart attack, quite suddenly and unexpected. A post-mortem examination was conducted, and their heart attack was ruled to have been the result of heart disease. There was no past evidence that she had heart disease and there was no mention this was linked to her pre-existing medical condition of SLE.
However there is a documented link between SLE and cardiovascular disease, which the insurance company insisted proved there link between her pre-existing condition and cause of death.
This can really be disheartening and unfair as people are often comforted in the knowledge their loved ones will be provided for if they were to pass away. It’s extremely frustrating as policies like this would hardly ever pay-out if all it takes is a simple tangible link to medical research rather than the customer specific circumstances.
Resolute Claim’s medical team conducted some research and identified that almost 96% of causes of death would have been excluded from the policy (it would have only paid for accidental death). This is because SLE has been shown to have links to increase instances of cancer, lung disease, kidney disease, cardiovascular disease, dementia, infection and inflammatory illnesses. These conditions combined make up the overwhelming majority of causes of death in the UK.
Resolute Claims managed to successfully appeal this decision by stating that the exclusion was applied incorrectly and did not take into consideration the customers own circumstances. Instead relying solely on the medical and clinical studies carried out.
If you have a denied life insurance claim it can be difficult to know where to turn. When people complain about decisions there is a temptation to do this right away once the decision is made. It’s best to take some time and think about how you want to appeal the decision. You might want to Google, insurance claim rejected help, and see what support is available out there.
The most important thing to remember with a rejected life insurance claim is that you need to take an evidence-based approach. This is the same when appealing critical illness claim that can impact people just as much.
Resolute Claims are a specialist, FCA regulated company, that help people get the decisions they deserve and are able to put your best case forward.
If you need help need help with making an appeal, you can find more information on Resolute Claims here.
