Total Permanent Disability (TPD)
We see a great number of Total Permanent Disability (TPD) cases. Whilst TPD is covered by most critical illness policies, somewhere in the region of 40% of TPD-related claims are declined by insurers.
Broadly, TPD has been taken to mean that the person is too ill to work. Insurers, however, have devised different ways to assess TPD according to the person's inability to carry out their "own", a "suited" or "any" occupation, or, if not in work, a number of specified daily living activities or functional tests.
In declining these claims Insurers will often argue the prescribed definition has not been met in that: ‘the condition is not permanent’, ‘all treatment options have not been explored’, ‘the diagnosis is not clear’, or their ‘chief medical officer has a different opinion to your treating specialist/GP’.
More Wins for BTW
We have most recently acted for Miss S, who due to debilitating depression was unable to continue in her career as a teacher. For a period of 2 years her insurance company denied that the requisite definition had been met. They argued that Miss S had not tried all the treatment options and as such her condition could not be classed as permanent. Miss S came to us for advice. We were pleased to secure a full payment for Miss S with interest.
We have successfully dealt with many similar claims for conditions such as chronic arthritis and chronic fatigue syndrome /myalic encephaloyelitis.
Meet Jan Our Top Insurance Denial Claims Expert
Jan is a leading insurance denial claims specialist. She represents injured, disabled and bereaved families with compassion and sensitivity. With extensive experience in handling these matters, she has now become one of the UK's leading solicitors dealing with critical illness denial and life insurance claims.
Having gained front line experience in representing clients who've had claims on their critical illness or life insurance refused, Jan first became involved in this area when her own partner was diagnosed with terminal cancer and his critical Illness claim was denied. Despite difficult personal circumstances, she fought the decision of her insurers and the claim was won in record time. Jan has passion for representing others in the same position. She has now assisted a large number of clients who have had their claims denied with great success.
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