Under what situations would a claim be refused?

We are please to tell you that claims are rarely refused. If a claim is refused it is usually for one of the following reasons:

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Type of cover
Life Insurance       Mortgage Life Insurance
 
Cover Level (£)

Number of years
Do you want:  
Critical illness cover
Family income benefit
 

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The following might help you decide how much cover you need.
How much would you need to repay your mortgage, overdraft, loans or any credit card balances? The freedom that comes from being debt free does wonders for recovery
How long should you insure for?
20 to 25 years is most common but it really depends on how much you can afford and your personal circumstances.
Can You Include Your Children On A Critical Illness Policy?
Yes. Most insurers will automatically include children on your policy.
Will a claim for critical illness affect any State Benefits?
No, it should not affect your claim for State Benefits.
What happens if your condition deteriorates after making a claim on your Critical Illness policy?
As far as your insurance is concerned, it makes no difference. Your policy has already paid out and your ex- insurer has no further interest in your health.
A period before cover becomes effective
Sometimes on a Critical Illness policy there may be a period straight after starting a policy during which time a claim cannot be made.

Non listed Illnesses
With a Critical Illness policy, claims are limited to the illnesses specified on the documents that accompany your Application form and policy documents. If your illness is not listed then you do not have a claim.

Extreme sports or hobbies
The insurance company will want to know if you follow any activities that can be dangerous. For example motor sport, skydiving, parachuting, climbing, caving, diving etc.

These activities can be treated in different ways. Sometimes the insurer will load your premium (known as “rating”) otherwise they will simply exclude any claim that arises as a result of that activity.

If you follow an extreme sport then let the brokers know when they telephone so they can find the best insurance company for you.

Emigration
If you are planning to emigrate, let your insurance company know as some insurers will not meet a claim if you are living permanently outside the UK. Of course, there would be no problem if you were just holidaying, temporarily working or visiting abroad.

Other Claims that will be excluded
All insurers will void any claim if:

  • you fail to take reasonable steps to seek medical advice or if you do not follow the medical advice that has been given to you,
  • you drink alcohol to excess or are involved in solvent abuse or take drugs (other than under medical direction),
  • you inflict injury on yourself,
  • your injury arises as a result of war, invasion, riot or civil disturbance,
  • you fail to disclose on your Application anything that may be relevant to your future health.

Frequently Asked Questions related to the above topic.
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