Has your insurer let you down

“Heartless” – a word that sums up how one family whose story we cover on Sunday describes their insurer.

And it’s not hard to see their point. When Charlotte Maltese was murdered in 2005  her 70-year old mother was left in despair and destitute. Not only was Charlotte her only daughter but she had been her financial support, as she is not lucky enough to receive a state pension.

Friends hoped that a life insurance policy Charlotte had taken out with Norwich Union would help her out. But it turned her claim down flat, and they have been shocked and appalled by the insurer’s treatment ever since.

First she was told that she isn’t entitled to a payout under the terms of the policy. Technically Norwich Union’s right and if it had stopped there the family may have accepted defeat and walked away.

But what it did next is inexcusable.

It told the family that the policy would be invalidated anyway as Charlotte hadn’t told the truth when she had filled in the application form. A trawl through her medical records had revealed that she hadn’t disclosed a visit to her doctor for a smear test.

The impact was devastating. Here was an insurance company telling a mother that her daughter, who had been brutally murdered, was a liar.

It's not the first case of this type we’ve covered. Before Christmas the Sunday Times ran the story of Nicola James who was also turned down when she claimed on  a Norwich Union life policy after her husband’s unexpected death. It alleged that he had failed to declare full medical details when he applied for cover, but Nicola says that just isn’t true.

Then we detailed another tragic case - that of the Joads whose daughter died of vCJD, the human form of BSE.

In all of these situations the individuals involved felt they were dealing with companies that went out of their way to be obstructive: more concerned with box ticking and processing claims than helping them out in their time of need (the reason we take insurance out in the first place).

Pressure is beginning to build for a change in the law to stop insurers wriggling out of paying claims unfairly. The best thing that we can do is to continue to highlight cases were families feel they have been let down. So, if your insurance company has turned down a claim we would like to hear your story.

Comments

[John Blackmore]

I have no idea how well or badly Norwich Union treated the family in question. I have, however, 25 plus years of dealing with people applying for Life and Medical policies and would say that by and large own medical reporting is very unreliable.
The capacity to "overlook" quite important information is considerable.
I would advise anyone taking out ANY contact involving medical information to provide any and every detail. Also don't forget dangerous pastimes like horse riding.
To not do so means the contract may well be worthless.

[J D Harvey]

The NU has always been an aggressive organisation try being a competitor. But this time they have got it right in the Maltese case.Joint life policy taken out to protect a mortgage. Both parties have an insurable interest but this cannot pass to someone else. Her mother has no insurable interest whatsoever. The NU are very silly to bring in a health non-disclosure when they already have a cast iron case. If they cannot pay a legitimate claiment they could return all premiums paid equally to both life assured, but only as a gesture.

[M.Emblin]

Your article 1/4/07 refers.
Who received any commission from N.U.and became the paid agent of the lives assured and should have given advice and guidance.Were the two individuals living together or what was their status.Revert with the info. in case these enquiries can be taken any further.

[patricia davidson]

i read this story with considerable interest; we have a family in a similar situation - son was killed in a street fracas. The insurance company has been hounding the practice (SURGERY) to obtain (a) a report from us (b) copy of his medical records - they included his original signature to his application form, his partner's signature. The insurance company never asked us for any medical information prior to his death. We have no idea what he may have completed on his application form. Are we legally bound to resp9ond to the enquiries from the insurance company; it has always been our policy not to give any information after a patient has died, particularly where no information was sought by the insurance company at the time the insurance was taken out - ARE WE CORRECT IN THIS - can someone advise as to how this should proceed

PATRICIA DAVIDSON, GENERAL PRACTICE MANAGER, FALLS FAMILY DOCTORS

[Richard Pettet]

I had a problem with insurers in 2005. This was not a claim under a Life policy but a Travel Insurance policy (possibly the greatest source of complaints to insurers). Is this of any interest to you?

[Roger Murray]

Yes! I was let down badly by the Norwich Union with their Healthcare private medical insurance cover. I took out their private cover in 1994 and have been paying £266.32 every month with the trusting belief that I was comprehensively covered for health care.

Three years ago I was diagnosed with Asthma and not being over happy with the NHS treatment decided, for the very first time! to seek help from the Norwich Union and go private to see a specialist. Phoning the number provided on their Healthcare card, I seemed to get through to a foreign country and after a lot of difficulty finally got to speak to somebody. He wanted to know why I wanted to see a specialist. I explained it was for Asthma. He said he would check if Asthma was on his list. After a while he came back to say that as Asthma was listed as a chronic disease and as such, incurable, it was not eligible for cover on the policy. As simple and as cold as that!

I saw red, thinking of the many thousands of pounds I had paid out on this policy and cancelled it there and then.

Norwich Union clearly state on their Healthcare promotional matter the following....

Access to high quality medical facilities and care.

Extensive cover for something as minor as an in-growing toenail to out-patient diagnosis such as ex-rays and treatment for cancer.

Unlike some insurers, we’ll cover you for all eligible claims-however long your treatment takes, with no overall claim or age limit.

I think the key word here is eligible! They say...‘We’ll cover you for all eligible claims! Which is ambiguous to say the least. I was never told when I took out the policy, what was and what wasn’t eligible, and, how do you know when you take out such a policy, what you are going to get in the way of diseases?

Asthma is now one of the most common diseases in the UK, yet it is not considered as eligible on their policy. What a get out!

There must be hundreds of thousands trusting people out there religiously paying hefty monthly payments to Norwich Union with the misguided belief that they are comprehensively covered for their healthcare, when they are simply not!

Norwich Union are very clever knowing full well that they are aiming at a ready made market which is getting more and more disillusioned with the NHS. Many in their late seventies, like me, who are not very good at reading the small print.

It is criminal to think that such a large and respected company who so many people trust, should be exploiting such a vulnerable and unsuspecting sector of the population, and getting away with it!

Roger Murray.

[Helen Kasher]

Hi, I was diagnosed with breast cancer in April 2005 and had a claim on our critical illness policy with Norwich Union rejected due to alleged non disclosure of post natal depression lasting more than 3 months (we continue to dispute this).The ombudsman has also rejected our claim and we are left with nothing and also with no life insurance policy to protect us. I have 2 young children and have had my life insurance withdrawn at a time when I need financial security most. We are currently moving house to clear our mortgage and reduce financial pressure as a direct result of the failures of this policy.

[Lisa Rudkin]

My husband died suddenly aged 39 and NU declined to pay out on his life insurance due to a 'material nondisclosure', although my husband's cause of death was unrelated to this information.I am left with 4 little children and a large mortgage. I am financially unable to challenge this decision, unfair as I believe it is. I am frustrated at the mercenary attitude of NU and would be very interested to know how many life insurance policies they specifically decline to honour.I also would like to know if a class action has been considered by families such as that mentioned in your article?

[Dr.K. Trivedi]

Dear Sir/Madam, 9.7.07

THE EQUITABLE LIFE ASSURANCE SOCIETY
SCHEME NO. WO109

I paid £8/month for 8 years for my pension. After retiring they are paying me only £1/month. It is disgraceful.
I hope to hear.
Yours Sincerely
Dr Trivedi

[Stanley Mazur]

After a robbery the NU decided that I had failed to inform them of my wifes financial help in setting up the business calling it the withholding of material information.
I have found out that they believe my wife and I robbed my shop and six years on I am still in and out of court. It was their agent who told me there was no need to mention my wifes financial input.

[Brian Marsden]

We bought our daughter a car for her 18th. We insured it with Swinton. As another car was insured with them I phoned the branch I had dealt with previously, but didn't think the quote was competitive. So I tried several internet quotes with different scenarios. None was any better.

Out of the blue I received a phone call from their call centre. After 20 minutes - including being called back and being placed on hold - I was made an offer I couldn't refuse. I had made it clear that I would not be eligible for an NCD as I had one on another car. he confirmed that there was no NCD on offer.

A few days later the confirmation letter arrived. Would I please call in at my local office to "confirm my eligibility for a NCD". I just took the front page. (Later it mentioned a one year NCD which I assumed was an introductory offer.) That was a mistake. The battleaxe I spoke to then printed off "proof" that I had been offered 5 years' NCD. The clear implication was that I had either obtained a quote under false pretences, or was some sort of imbecile with a very short memory span. I returned the next day with the full documentation. After an hour of fruitless discussion, I was finally told that she would get back to me when they had had a chance to hear the recorded transcript of the original offer. Three days later she phoned again. There was no trace of the recording. Therefore would I please return the certificate of insurance and pay an additional £400 for the "next best" quote.

In other words, (1) they had provided me with cover on the bases of the accurate information I had provided; (2) their computer system had somehow mixed up the internet quotes I refused with the actual quote I accepted; (3) they had managed to lose the recorded transcript. As of course this was all my fault, I must now pay an additional £400.

I refused, and have heard nothing since. The case continues...