Critical Illness Insurance The Press Are Giving Insurers A Hard Time.
Recent stories in the press have again lambasted the insurers over critical illness insurance. The core problem is that a critical illness claim is not as straightforward as, for example, a claim under life insurance. With life insurance it’s going to be hard for the insurance company to argue that you’re not dead!
By their very nature, critical illness claims are much more complicated. The insurer will need to satisfy itself that the claim is validated in three key areas before it meets the claim: –
Has the illness been correctly diagnosed?
Is the confirmed illness included in the schedule of insured critical illnesses covered by the policy?
Did the policyholder fully disclose their medical history and current state of health on their original application form?
On the first point, it’s obviously in the policyholder’s interest to verify the medical diagnosis – so there’s rarely ever any conflict between the insurance company and the policyholder on that issue. It’s the next two areas which the insurer needs to...
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