Has anyone claimed on life insurance policy of any kind regarding lupus?

I have a decreasing mortgage cover policy with Zurich which has been in place for almost 10 years. I recently contacted them to see if they would pay out regarding my diagnosis SLE with class 4 nephritis. They refused as SLE is not listed on my documentation as it was not generally recocnised when the policy was taken out. The same policy with Zurich today however, or any other life ins company for that matter, will pay out for SLE. Has anyone else experienced or challenged this. I think its greatly unfair as people dont generally review life ins policys each year to see if there are new diseases they could be covered for. Basically if id took out this policy 6 months ago, fine, they would pay out, but because ive had it and paid into it for 10 years, they wont.

4 Replies

oldestnewest
  • Did you have this when you took out the mortgage!!!

  • Didnt have lupus when i took out the mortgage, only diagnosed 8 months ago. Had the decreasing cover policy for 10 years or so, my point being that lupus has only recently been added to the list of critical illnesses, so the wording in my policy doesnt mention it, however if you were to take out the identical policy today it would cover and pay out for SLE.

  • If they can avoid paying anyone for anything they will, is my experience - I'd take legal advice.

  • Hi there

    Insurers regularly review the conditions they provide under their critical illness benefits. As this can mean that they have to 'reprice' the policy, this generally means that what one policyholder paid for one set of conditions will differ to another, and so they can't apply any new definitions (in your case SLE) retrospectively. Also, during such reviews, they may also remove conditions covered under previous policies - again, they wouldn't then go back and remove those benefits from existing policyholders.

    When you took out the policy were you given advice by a financial adviser? If so, one may have reasonably expected he or she to regularly review your policy to ensure it is fit for purpose, both in terms of the conditions it covers and the price you pay for it.

    The other thing to explore, although Zurich should have already don't this on your behalf, is whether you meet any other definition under the policy, such as Kidney Failure, Total and Permanent Disabilit, Loss of Independent Existence and so on, depending on what benefits you have covered.

    The other option you have is to go to the Financial Ombudsman Service.

    I hope this helps.

You may also like...