The Wire: Spring 2021Case study – the value of critical illness protection

(Estimated read time 5 minutes)

Case study – the value of critical illness protection

Being diagnosed with a serious illness can be a life-changing experience. Not only do you have to deal with the emotional aspects of treatment and recuperation, but there may also be financial consequences.

You may lose valuable income, have to take an extended period off work, pay for care and even make adaptations to your home.

That’s why making sure the right critical illness protection is in place is so important. It’s something one of my clients discovered when he was diagnosed with a malignant melanoma in 2020.

Working with a client to ensure a protection claim was paid

Last summer, one of my clients was successfully treated for a malignant melanoma, a type of skin cancer.

Thankfully, he had insured himself against such an eventuality by taking out a life and critical illness policy with Skandia – now ReAssure – back in the 1980s.

At first, my client wasn’t sure he should claim, having received what turned out to be successful treatment. However, having checked that his policy covered the condition – it was the only type of skin cancer it did cover – I encouraged him to submit a claim. To assist, I provided a claim form and guided him through the claims process.

Sadly, this turned out not to be the most straightforward process. The main stumbling block was establishing my client’s “smoker” status and comparing his claim form with his original declarations when he took out the policy in the late 1980s.

Back in the 1980s, my client smoked small cigars, and declared as much on his application. In those days, an insurer classified you as a “non-smoker”, even if you smoked cigars.

Fast forward thirty years and, as this is no longer the case, there were question marks from ReAssure over the validity of the claim.

I knew my client was correct, and so I was persistent with the insurer. I liaised with ReAssure and the client’s GP and made repeated calls to ensure that the case remained live, and to progress it to a successful outcome for our client.

Eventually, through persistence, we did reach a positive conclusion. The insurer agreed to pay my client’s claim in full, and so he received the £424,000 payout he was entitled to under the terms of the cover.

Needless to say, this injection of capital at a time when he needed it has proved invaluable. It has removed any financial pressure he was under, allowing him to focus on his recovery. In many ways, it’s the perfect example of why protection is so important, and the huge benefits it can have when faced with a life-changing diagnosis.

I’ll leave the last word to my client:

“I recently made a claim under a critical illness policy. The insurer decided to take issue with some of the information which had been provided in the claim form, although the information had no bearing on the reason for the claim. 

“HFMC Wealth could not have done more for me in supporting me in my claim; as I see it, they ‘went in to bat’ for me and went beyond what I could have expected. 

“Thanks to their efforts and persistence, after several months the insurer relented and agreed to pay out under the policy. I can’t speak too highly of the people who were involved in bringing the matter to a successful close.”  

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