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Life Insurance Claim declined
My dad took out life insurance. He declared that he was a diabetic. The special condition clause states that should he die as a result of diabetes within 24 months of the start date of the contract,we will be unable to lodge a claim against the policy. My dad died 18 months into the contract of a myocardial infarction (heart attack). The insurance company subsequently declined our claim, siting that his diabetes caused his heart attack.
No autopsy was performed to determine this. He was never previously hospitalised for heart conditions nor for his diabetes.
Did the insurance company make the correct decision even though no autopsy was conducted?
Legally, is there any good argument I can take to the insurance company?
No autopsy was performed to determine this. He was never previously hospitalised for heart conditions nor for his diabetes.
Did the insurance company make the correct decision even though no autopsy was conducted?
Legally, is there any good argument I can take to the insurance company?
Answers
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Have you got a cause of death in writing from hospital? Is it possible to get your Dad'd medical records to show no previous complications?
What evidence have the insurers got? I would demand to see it.
Get some legal advice, as Insurers will do whatever they can to not pay.
These is free and confidential..
http://www.communitylegaladvice.org.uk/ (funded by legal aid)
www.citizensadvice.org.uk
Good luck
What evidence have the insurers got? I would demand to see it.
Get some legal advice, as Insurers will do whatever they can to not pay.
These is free and confidential..
http://www.communitylegaladvice.org.uk/ (funded by legal aid)
www.citizensadvice.org.uk
Good luck
Firstly, are you based in the uk or usa....your term of autopsy indicates USA....in which case i do not know what the anser to your question will be...
If in the uk....and your dad had no hospital treatment or had seen a doctor for some time before his death, then I am sure that a post mortem would had been carried out...
On the subject of the life cover, if the heart attack was unrelated to diabetes, then the policy should pay out, unless specifically excluded on the policy document.
If you are in the uk, then you should complain and appeal to the life company in question. If you get no joy with them then you have the right to complain to the Financial Ombudsman Service.
http://www.financial-ombudsman.org.uk/consumer /complaints.htm
I fear that without a Post Mortem report proving that the cause fo death was unrelated to Diabetes then you may be fighting a losing battle. But for the sake of your dad, you should explore all avenues.
Good luck
If in the uk....and your dad had no hospital treatment or had seen a doctor for some time before his death, then I am sure that a post mortem would had been carried out...
On the subject of the life cover, if the heart attack was unrelated to diabetes, then the policy should pay out, unless specifically excluded on the policy document.
If you are in the uk, then you should complain and appeal to the life company in question. If you get no joy with them then you have the right to complain to the Financial Ombudsman Service.
http://www.financial-ombudsman.org.uk/consumer /complaints.htm
I fear that without a Post Mortem report proving that the cause fo death was unrelated to Diabetes then you may be fighting a losing battle. But for the sake of your dad, you should explore all avenues.
Good luck
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