Is your health insurance not paying out for a critical illness?
If your insurance is reluctant to pay out for a critical illness, we may be able to help.
What is Critical Illness Insurance?
Critical illness insurance gives financial protection in the event that you are no longer able to work or carry out your normal day-to-day activities due to a long-term illness or disabilities.
Critical illness policies provide cover for specific conditions, and nearly all policies also provide cover for “Total and Permanent Disability” (TPD). The TPD section of the policy is often the section that chronic pain sufferers will use to make a claim. There are three different definitions of TPD as follows:
- Own Occupation – if you are permanently unable to do your Own Occupation
- Any Occupations – if you are permanently unable to do Any Occupation
- Work Tasks/Living Tasks – if you are unable to do a certain number of specific tasks that are listed in the policy
It is very important to check on your policy Schedule which definition of TPD applies to you
It is not uncommon for insurance companies to be reluctant to pay out on policies of this nature, even though the criteria needed to fulfil the payout are straightforward. However, when the illness in question is a chronic pain condition such as fibromyalgia, ME or CFS, they tend to be even more cautious about paying out and will often insist that their customers try all avenues of treatment before agreeing that they have fulfilled the criteria for an insurance payout.
Similarly, where one has an ill-health pension, it can prove difficult to receive the pension when the illness in question is a chronic pain condition. However, Brian Barr Solicitors are experts in critical illness and ill health retirement claims and can help you by obtaining the evidence you need to prove to the insurance company that you meet their criteria for a payout.
What is Considered a Critical Illness?
Every critical illness policy will have its own definition as to what qualifies as a critical illness, and which illnesses are covered by critical illness insurance, so it is important to carefully check your insurance documents before claiming. However, the most common critical illnesses and disabilities include:
- Heart Attack
- Brain Injury
However, when a claim is made as a result of a chronic pain condition such as fibromyalgia or CRPS, it can be difficult to prove that these conditions will prevent you from working, so it can be more difficult to receive a payout from your insurance company or pension provider. But that is where we come in.
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How We Can Help With Critical Illness Insurance Claims
At Brian Barr, we will go out of our way to help you get the money you are owed from your critical illness insurance policy. We can help you recover the value of your policy and will take a percentage to cover our fees.
We have a panel of independent medical experts in all disciplines who will be able to assist us in getting you the right result and get you the money you’re owed.
44 year old nursery nurse LB from Basingstoke developed the chronic widespread pain condition fibromyalgia and it stopped her working. LB was not fit enough to return to work and she was dismissed on ill health grounds two years after the accident.
I recently received a letter from an Oncology Engineer who was off as a result of a number of illnesses. My answer to him elaborates on the sort of support you can expect from your employer when suffering from critical illness:
Mrs GL of Norwich was injured in lifting incidents at work in June and September 2004. She suffered a back injury which became chronic and she developed fibromyalgia. Mrs GL claimed under her Accident Protection policy. She was unable to work after the second accident and claimed under the Permanent Total Disablement Section of the policy. She had to establish that she had sustained accidental bodily injury which within twelve months resulted solely and independently of any cause in death, permanent disability or hospitalisation.
44 year old LB from Basingstoke, Hampshire had been a nursery nurse for 22 years until she developed Fibromyalgia. This stopped her working in January 2005. She suffered a constellation of nasty symptoms which made it impossible for her to pursue her demanding employment.
Call us today on 0161 737 9248
We can help you
As experienced brain injury solicitors we will go out of our way to ensure you receive the compensation you deserve.
We can also provide access to medical experts, rehabilitation services and therapies to ensure you have all the aids, equipment and assistance to help you to recover from your brain injury.