The Natural Health spirit

One of the most common enquiries we receive is from people looking for help claiming on their Total Permanent Disability cover, as part of their Critical Illness policy. We have seen a significant number of customers come through to our service frustrated by their insurance providers never-ending need for medical evidence and information.

Before we go any further, I will explain, in basic terms, what is Total Permanent Disability cover (TPD). Most often TPD cover is taken as an additional benefit through a life or Critical Illness policy, much like the waiver of premium option. It is designed to cover people that perhaps have not been diagnosed with a critical illness (as defined within their policy terms and conditions) such as cancer or a heart attack but are unable to work ‘permanently’ due to an illness. The cases we see are typically chronic pain and fatigue conditions like Fibromyalgia and ME/CFS (Chronic Fatigue Syndrome) and ‘lesser’ forms of cancer where a Rejected Critical Illness Insurance claim pay-out has not been triggered but due to treatment or combined health conditions returning to work is unlikely. TPD cover will pay-out a lump sum often to the value of your Life and Critical Illness policy.

As I said above the main reason customers come to us for TPD claims seem to around the amount of medical information required, time taken to assess the claim and the burden of proof of what ‘permanent’ is. When you submit a claim under your TDP policy an insurance company will normally write to your GP and/or consultant to confirm that a diagnosis has taken place. They will most likely also ask questions about what treatment you have received, what treatment has been planned/being considered and what the likelihood of your return to work. In an ideal world this would take place within a few weeks and the insurance company would make a quick and speedy decision on your claim.

The overwhelming majority of people we speak to do not experience this. The average length of time we report for ongoing claims before people come to us is around 6 months, with the insurance company seemingly asking for a never-ending list of information from GP, occupational therapists, and consultants.

A case we had several months ago had an insurance company reject a customer claim under the Total Permanent Disability due to them believing their condition was not ‘permanent’ enough. This client had multiple health concerns including mental health and Chronic pain/fatigue conditions. Their consultants confirmed they had attempted all treatments and despite their best efforts their symptoms failed to improve. The advised that they could not say for 100% they would not return to work, but it was more likely they would not. We were able to prove that on the balance of probabilities and given all treatment options had been exhausted without any improvement, that the likelihood of the client returning to work was minimal, therefore permanent.

It was not easy though as there is extraordinarily little on what permanent means? Can an insurance company wait 5/10/15years to finally consider your conditions permanent? It would seem that this is what some insurance companies are doing. An increasing number of insurance companies are not really interested in what the most likely option is they are looking for almost a cast iron guarantee that someone is unable to work again. This is often hard for consultants and doctors to give as a) You can never be 100% certain and b) when you are caring for someone with chronic mental health and pain/fatigue conditions you never want to give up hope of the possibility things might improve. Insurance companies seem to be using this to their advantage in rejecting claims or declining claims without giving any weight to the balance of probabilities. We have been successful in overturning a large amount of wrongly declined Total Permanent Disability claims by using ABI guidelines, legal framework, and previous FOS decisions as benchmarks.

Of course, every case is different and at Resolute Claims we aim to provide a fair and honest assessment of your situation. We offer a free check and assessment to every person who feels they have been wrongly had their Rejected insurance claim declined or has taken an incredible amount of time to assess. Even if you do not decide to use our services your can call us for support and where to go next.

Take Care

If you are thinking of making a claim on a Critical Illness Insurance policy, you can often be apprehensive. You might be worried about the process or something you left out about your medical history when you applied for the Non-disclosure insurance. We will go through the process here and what you might expect to see along with some handy tips and comments.

When you are making a claim, you can normally do this online of over the phone. They will ask some initial questions about the condition you have been diagnosed with along with some information about your GP and supervising consultant. The insurance company will normally give you a call to clarify some of your answers. Some insurance companies will ask you to confirm the information you provided when you applied for the insurance. Often this may be referred to as ‘fishing’. Insurance companies are only able to seek information that confirms an insured event occurs, meaning that they can not request or access information without reasonable concerns. An example may be that you took insurance out in 2011 and the insurance company ask when you stopped smoking. If you said on the application you stopped in 2007 but when the insurance company phone you say 2009, they may consider it reasonable to request information about your smoking habits at that time. This can delay your claim as GP’s can sometimes take 8 weeks to respond to request for medical information.

Furthermore, we have seen insurance providers obtain full medical records which they have then picked up more potential non-disclosures from. This is of course highly contentious, and we have successfully challenged insurance companies many times on this practice. In short, if you do not know or feel comfortable, just say you can not remember and advise them you will need to check your medical records. This should not slowdown or stop your claim.

The next stage is for the insurance company to write to your GP and specialist. They will often ask questions along the lines of, when did you first start experiencing symptoms, when did you first attend the GP, what treatment are you undergoing along with copies of histology reports etc. Remember the ABI guidelines, only to ask questions that confirmed the insured event happened? Well, most insurance companies also ask slightly underhanded questions like, ‘has the client ever been asked to cut down on their alcohol consumption’, ‘has the client ever smoked’, ‘what was their last three height and weight readings’. Sometimes the answer to these questions can lead to a Critical Illness policy being rejected or rated. We have seen instances where insurance companies request full medical records straight away. The Financial Ombudsman’s longstanding view it that a claim against a policy is not an opportunity to underwrite the policy again.

Of course, there are instances where the insurance company have a right to ask those questions if they have reasonable grounds to suspect non-disclosure. An example might be someone diagnosed with alcohol related liver cancer which is normally a result of many years of alcohol abuse. This is reasonable grounds for the insurance company to confirm your drinking habits.

Once the information has been received by the insurance provider, they will decide on your claim. Sometimes though they may request more information from your medical providers to confirm possible non-disclosures or for clarification on your diagnosis.

The whole process should take no more than 8 weeks.

The decision an insurance company can take are:

• Pay the claim in full.
• Partially pay the claim (some non-disclosures will result in this)
• Cancel the policy and refund the premiums (non-disclosure that would have resulted in the initial application being declined)
• Cancel the policy with no refund of premiums (where there has been a wilful non-disclosure)

Resolute Claims can help people who are experiencing difficulties in making a claim on their Critical Illness Cover. We offer an 70% reduced fee where customers are looking for help claiming on their insurance (rather than our full fee for overturning a rejected Critical Illness claims). We will answer all the questions for you and ensure that your insurance provider acts fairly. Even if you would like to chat through your concerns we are here to help with free information and guidance.

Are you experiencing frequent unfavorable health signs and symptoms like neck and back pain, hassles, or even stress? Discomfort medicines may simply do so a lot, and they will not correct your complication.

Exploring a chiropractic doctor, like us below at Dr. Katinka, may have the ability to aid you get over some or every one of your signs and symptoms. A chiropractic change describes a chiropractic specialist physically readjusting the vertebrae in your spine.

This type of procedure can possess a myriad of favorable advantages without the tension or even invasiveness of surgery or various other extra rigorous strategies. Is a chiropractic correction right for you? To help you address that, our team are visiting take you with some of the best benefits of getting a chiropractic correction.

1. High Blood Pressure

A research study published in the Individual Journal of High blood pressure showed that a chiropractic care modification could offer folks experiencing hypertension the very same effect as taking certain hypertension medicines.

This study additionally revealed that the results of the modification will continue to persist for 6 months after the modification. High blood pressure medications can easily possess adverse negative effects including: – Fatigue. – Nausea. – Vertigo. – Anxiety. – Weight-loss.

If an adjustment may offer identical, or even the exact same, impact as these kinds of medicines, it might be one thing to take into consideration. Modifications have actually been presented to help clients experiencing coming from low blood stream tension.

2. A Chiropractic Care Modification Can Aid With Neck

This advantage is actually most likely one of the most known when it involves mosting likely to the chiropractic practitioner. 80% of all Americans experience some kind of lesser pain in the back in their lifetime.

Medications as well as surgical operations are actually alternatives for this form of pain, yet those may be unsafe, costly, as well as ineffective. A modification from chiropractic practitioner companies may significantly lessen your spine and back pain via a non-invasive strategy.

Chiropractic care therapy is actually additionally more affordable than other techniques of pain in the back monitoring. You’ll have the ability to spare on your own coming from both light as well as constant ache while likewise reducing your medical costs.

3. Scoliosis.

Scoliosis is a health condition where there is actually an abnormal curve of the spine. This can easily lead to ache, unusual posture, a decrease in your stable of movement, and also issue breathing. Many scoliosis patients have few options for therapy.

A chiropractic care change has been presented to assist deal with scoliosis clients. Chiropractic care procedure blended with bodily treatment can aid alleviate and also avoid the progression of scoliosis. The performance of this particular therapy alternative differs from client to patient, however it is a practical possibility.

4. Sciatica Pain.

Sciatica pertains to ache that radiates coming from your lower pull back your lower legs because of a ruined or pressed sciatic nerves. This form of constant ache can easily bring about over-medicating and constant discomfort.

Chiropractic therapy can easily assist eliminate stress on the sciatic nerves that is inducing your sciatic nerve pain. Studies present that individuals getting modifications decreased the number of discomfort days they possessed. They also experienced a decrease in the seriousness of their discomfort.

5. Problem Alleviation.

Each strain and also migraine headaches can be caused by neck and back pain as well as spine problems.

Back imbalance may induce muscle mass stress and also ache which may cause both pressure headaches in addition to migraine headache headaches. Besides neck and back pain, frustration is the best health problem that chiropractics physician address.

There end 200 researches examining the benefits and also effectiveness of chiropractic care modifications for frustration comfort.