My mother in law died on 03/106/12 of breast cancer, and had 2 life policies, 1 for the mortgage, taken out in 1995 and one for life cover taken out in 2005. She filed a claim in April 2012 under the terminal illness provision. Her insurers are now refusing to pay out claiming non disclosure. There was an incident in 2000 where excess alcohol and tablets were consumed, but no history before or repeat afterwards. On the application which was sold door to door the questions "were you ever treated in hospital for mental illness" was answered "No", purley because the family are adamant and this could be verified by the GP that she was never diagnosed with a mental illness. How should we approach the insurance company, as in reality these questions should have been asked by them whilst she was still alive.
Please remember to RATE my answer by using the smiley faces OK SERVICE, GOOD SERVICE OR EXCELLENT SERVICE. If you seek clarification please ask.
The first thing that I suggest you do is try and obtain a copy of your Mother-In-Law's medical records.
Once you have done this, you will then have something to approach the Insurance Company with.
Your case is dependent upon the wording of the policy and whether the questions asked of your mother-in-law were clear enough.
The question quite simply was "Were you ever treated in hospital for a mental illness?" Which was answered no becuase she was not, she was treated for a one off incident
Once you have armed yourself with the medical report, you should contact the Insurance Company and challenge their decision to not pay. You should suggest that the wording was unclear and that the GP's records substantiate your claim and suggest that they reconsider.
If they do not re-consider, you will have the threaten them with legal proceedings. If the threat of proceedings does not work, you will have to take the next step and issue proceedings against the insurance company.
If that the question, and there is no record of any mental illness in her medical records, I would be of the opinon that you would have a strong case to argue.
I hope this answers your question. If so, kindly click ACCEPT.
If you wish to discuss, please feel free to ask further questions.
They continue to write to the doctors seeking information and the surgery have commented that they have alkready sent the information which was recently requested again. This claim was lodged in April 2102 and they are still not giving any clear indication other than "they have concerns around non-diclosure". This is causing significant additional distress to this family, is ther anything further I can do to speed this up now, as I feel it is absolutely ridiculous and disgraceful it has gone on this long
Hi, the only thing you can do to speed this up is threaten the, with legal proceedings.
If they still refuse to pay, you will have to sue them.
I would suggest that the executors of your mother-in-law's estate instruct solicitors to conduct the proceedings.
DISCLAIMER: Answers from Experts on JustAnswer are not substitutes for the advice of an attorney. JustAnswer is a public forum and questions and responses are not private or confidential or protected by the attorney-client privilege. The Expert above is not your attorney, and the response above is not legal advice. You should not read this response to propose specific action or address specific circumstances, but only to give you a sense of general principles of law that might affect the situation you describe. Application of these general principles to particular circumstances must be done by a lawyer who has spoken with you in confidence, learned all relevant information, and explored various options. Before acting on these general principles, you should hire a lawyer licensed to practice law in the jurisdiction to which your question pertains.
The responses above are from individual Experts, not JustAnswer. The site and services are provided “as is”. To view the verified credential of an Expert, click on the “Verified” symbol in the Expert’s profile. This site is not for emergency questions which should be directed immediately by telephone or in-person to qualified professionals. Please carefully read the Terms of Service (last updated February 8, 2012).