The Times
…published an extract of
the Lords' debate concerning pre-existing conditions to an illness regarding
insurance…that no such pre-existing condition can exist until after a diagnosis
of that condition.
The Abbey Life principle
to critical illness insurance is that a condition can be retrospectively
excluded when expedient…
…claim failed due to
"associated symptoms" which have never been declared…the alleged
unqualified symptoms predated January 1996
to place my claim outside cover…diagnosis almost one full year inside the
cover.
Abbey Life propose that
I do not have any right to know why my claim failed.
…claim process allowed
for scrutiny of the medical history…selection of appropriate symptoms that might
be connected to an undiagnosed brain tumour…retrospectively after the tumour's
existence is known.
…unilateral partial
deafness was probably an "associated symptom" to ‘prove’ a tumour…and
to ‘prove’ specifically a meningioma. Ménière’s disease or
cochlear damage or many things - in the absence of an MRI can also result in
deafness.
Significantly, the
informed opinion of consultants was guided by the scan. This was not until November
1996 and so proves that Abbey Life could not possibly have
any justification whatsoever to claim that prior knowledge was available
by September 1995.
…major loophole in this
type of product is that the Personal Investment Authority
does not regulate the insurance part of the policy - only the investment part
itself - and the Association of British Insurers
seems powerless or just reluctant to make definitive comment in an
insurance matter.
The Office of Fair
Trading (OFT) has a full report…considering its content with regard
to critical illness insurance.
The General
Medical Council stance was one of total disinterest…the Chief Medical
Officer (CMO) retired during my protracted complaint and was not necessarily
involved with the claim refusal…claims' underwriters have some delegated
authority to make medical decisions…illusion that qualified medical opinion is
used to arrive at such a decision…the CMO is in "possession" of
information does not mean that he was involved in the use of that information
to make a decision himself.