PIA

 

Éclarification of your position with regard to a distinction between a straight endowment policy and a policy that is essentially an endowment with an attached insurance (critical illness) element.

 

Édisavow or not responsibility for regulation of such a combination product?

 

Émay have broad implications. If you do not regulate such a product then who does?

 

ABI

 

Éregard to any responsibility you may have for the regulation of a critical illness insurance attachment to an endowment policy under your Code of Practice.

 

Épolicy I described is seriously flawed.

 

Éessentially worthless in that any part of the attached insurance is just about impossible to effect a successful claim.

 

ÉLords debated and concluded that a diagnosis MUST predate the definition of a pre-existing condition.

 

Éan unknown condition can be excluded from cover after it becomes known (Abbey Life)Éthe possibility alone of the existence at an earlier time of an unknown and undiagnosed condition is sufficient ground to refuse admission of a claimÉ

 

Éobservations will remain non-attributable until after a diagnosis. Indications are just that. An indication of something until a diagnosis makes it possible to unequivocally assign an indication as a real symptom to a recognised condition.

 

ÉÒassociated symptomsÓ is sufficient description (Abbey Life) to fully describe such indications to predate the condition to a suitable time.

 

Éno diagnosis: no pre-existing condition can applyÉthe claim was refusedÉmedical history gives access to all symptoms, allegedly attributable or otherwiseÉan undiagnosed condition cannot have symptoms unless in hindsight.

 

Éusing the certainty of a future diagnosis of an unknown condition to justify claim rejectionÉethic is perverse and dangerous.

 

Érequest your position on this situationÉimplications of this arrangement are far reaching and need serious public discussion.

 

Abbey Life

 

á                    What are associated symptoms? Define them.

 

á                    How was the pre-existing condition a certainty by October 1995 (actual diagnosis November 1996)?

 

á                    Who made the recommendation to reject my claim and how is/was that person medically qualified to do so?

 

ÉLords concluded a diagnosis MUST predate the definition of a pre-existing conditionÉ

 

Épossibility alone of the existence at an earlier time of an unknown and undiagnosed condition is sufficient ground to refuse admission of a claim at a later time when that condition has manifested and can be diagnosed.

 

Back to The Arguments

 

Contents