Insurer refused to pay Life Insurance Claim
After the tragic death of our young client’s father an Insurance Company denied a claim made on his life insurance policy on the grounds of non- disclosure. (As featured in the Guardian)
The business told our client that her father had not disclosed medical information on his application form and as a result they were not obliged to make any payment, however, they would make an ‘extra gratia’ payment representing a fraction of the sum due. At the time, our client was grieving and heavily pregnant and not in a position to question the insurance company. A declaration was obtained confirming the sum was accepted in full and final settlement of any claim under the policy.
Almost a year later she found our details from the internet and came to us, she could not accept that her father would have made any error on the application form, knowing he was meticulous in this regard.
After carefully scrutinising the medical records we were able to find hard evidence to support our client’s position. Nonetheless, the business continued to argue non-disclosure and lack of jurisdiction for the Financial Ombudsman (suggesting because the money had been accepted in ‘full and final’ settlement the fairness or their decision could not be questioned).
After a 2 year battle we successfully obtained what was rightfully our client’s and demonstrate that the claim had not been dealt with fairly. In addition to the £150,000 limit the Ombudsman can award we were able to get the Insurance Company to pay out the full sum under the policy with 8% interest for the 3 years in which they had not paid.