Jump to content
Sign in to follow this  
Benthejockey

PW legal eagles

Recommended Posts

Insurance company fun and games. I ******** my wrist back in march. Made a claim off my insurance who said it was a preexisting condition and wasnt insursable. My policy stated preexisting injury NOT preexisting pain which is what I had. I responded with a letter pointing out the conditions and why they should pay out and theyve subsequently responded with a letter saying they will reassess my claim if I accept a new condition on my insurance back dated to the beginning of my policy or theyll cancel my insurance and refund my premiums. I think that's a bit off. I am going to see citizens advice but I thought I'd use the PW citizens advice burea as well.

Share this post


Link to post
Share on other sites

Is there an independent insurance watchdog, such as Insurance ombudsman you could appeal to?

Share this post


Link to post
Share on other sites

I have used the Ombudsman in the past and they are more than helpful. Got my claim paid and compensation as when told to pay me they sent a lesser amount. When I reported this to the Ombudsman they were on the phone immediately to the insurers who said it was a clerical error caused by a new clerk in the office and the new check was issued that day. 

Make sure that you have all your evidence ready and they will start proceedings. Its not a quick process as they have to give the insurers time to present their case for not paying, the Ombudsman will then take a reasonable balanced view. Costs nothing. Go for it and good luck.

Share this post


Link to post
Share on other sites

This is my game - If you've broken your wrist before it will apply as a pre-existing condition (Depending on the wording of the clause) as it will technically be a weaker joint than one that wasn't previously broken. What's the new condition they are asking to apply? 

Happy to help via PM if that assists

Share this post


Link to post
Share on other sites

He didn't say he had broken his wrist before he said " I ******** my wrist back in march." could have just been a strain injury.

Share this post


Link to post
Share on other sites

@Fatcatsplatjust sent you a PM.

Hurting it in march is what lead me to discover it was stuffed. Without hurting it to the extent I did I wouldnt have gone and got it looked at and just coped with a sore wrist.

Share this post


Link to post
Share on other sites
37 minutes ago, Benthejockey said:

@Fatcatsplatjust sent you a PM.

Hurting it in march is what lead me to discover it was stuffed. Without hurting it to the extent I did I wouldnt have gone and got it looked at and just coped with a sore wrist.

If I understand it right? If you were to twist your ankle as a six year old, at twenty you take out health insurance........then aged fifty you break the same ankle, the insurance company will refuse to pay out on you policy because you didn't disclose you twisted that ankle when you were six?

Share this post


Link to post
Share on other sites
6 hours ago, panoma1 said:

If I understand it right? If you were to twist your ankle as a six year old, at twenty you take out health insurance........then aged fifty you break the same ankle, the insurance company will refuse to pay out on you policy because you didn't disclose you twisted that ankle when you were six?

Depends on the wording of the pre-existing conditions exclusion clause - Some will be time barred, some open as per:

Unless otherwise declared and agreed by the Underwriters no benefit will be payable for any condition for which the Insured Person has sought advice, diagnosis, treatment or counselling or of which the Insured Person was or should reasonably have been aware at inception of this Insurance or for which the Insured Person has been treated at any time prior to inception. 

Or

PRE-EXISTING CONDITION means a condition for which:  (1) medical advice or treatment was recommended by or received from a Physician during the 3-year period preceding the Effective Date of this coverage; or (2) symptoms were present during the 3-year period preceding the Effective Date of this coverage that would cause a reasonably prudent person to seek advice or treatment from a Physician.

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...
Sign in to follow this  

  • Recently Browsing   0 members

    No registered users viewing this page.

×
×
  • Create New...