When Paul Webb, a father of one, was told he might have less than 12 months to live, he took some solace in the fact that he had life insurance with terminal illness coverage.
The £200,000 payment will allow him to work less and spend more time with his ten-year-old son.
But when the 47-year-old came to claim, his insurance company Legal & General refused to pay – because there was a chance Paul could live longer.
The insurance giant, which made £2.1 billion in profits in 2018, has admitted it suffers from a terminal illness but said it could live up to five years if it had a lung transplant.
Article: Single dad Paul Webb refused a payment from his life insurance company after he was told he might have less than 12 months to live
Paul is on the transplant list, but there’s no guarantee he’ll survive long enough to get one.
Today Money Mail can reveal how Paul is just one of many desperate insurance clients forced to struggle for payments in their darkest hours.
Our investigation found that life and travel insurance companies were repeatedly reprimanded by the financial ombudsman after wrongfully ignoring sensitive allegations.
The findings come just months after Money Mail reported how Aviva denied critical illness payments to parents Stephen Jackson and Stephen Huddleston because they suffered cardiac arrest, not a heart attack.
Paul has paid £20 a month for life insurance with Legal & General since November 2015. Under the terms of the policy, the insurer will pay £201,448 if he dies or if he is diagnosed with a terminal illness who has a life expectancy of less than 12 months.
The former Navy submariner was told he had between two and three years to live after being diagnosed with interstitial lung disease in September of last year.
But after his condition deteriorated, the account manager from Oldham was now told he might have less than 12 months to live.
However, when Paul attempted to claim on his life insurance policy, Legal & General dismissed his claim. In a letter, the insurance company said: ‘We do not contest the severity of your illness. However, the opinion of the doctors who treat you is that your life expectancy initially was 1-2 years without a lung transplant, and you were given priority for an early lung transplant.
She added, ‘While we realize that not everyone on the transplant waiting list will be successful, we need to keep in mind that there is a possibility of a transplant.
“So the doctors who treat you, our medical officer and the third medical expert are all unable to confirm an expected life expectancy of less than 12 months at this time.”
Legal and General said Paul could live up to five years if he had a lung transplant. Paul is on the transplant list, but there’s no guarantee he’ll survive long enough to get one
There are currently more than 330 people on the national list for lung transplantation, according to NHS Blood and Transplant.
The latest figures show that within a year, 65 people had either died while waiting or been crossed off the list because they were too ill. Interstitial lung disease is difficult to predict, a respiratory specialist told Paul in a letter.
And he acknowledged that while Paul’s prognosis could be between a year and two, it might take a chest injury just to see that drop to less than 12 months.
Three months when you only have a 12 is a long time and patients should never be treated this way
After Money Mail intervened, Legal & General agreed to pay – three months after Paul had attempted the claim. ‘He was sickeningly handled,’ says Paul, who is still on the transplant list.
I feel like Legal & General was using a lung transplant as an exit condition. Three months when you only have a 12 is a long time and patients should never be treated this way.
The ombudsman has ruled in favor of more than 150 clients who were initially denied insurance payments after the death of a loved one since April 2013. Experts say decisions must be made about what is fair and reasonable.
L&G says its policy requires its therapist and medical officer to agree that life expectancy is less than 12 months.
Esure was forced to pay out a widower’s home insurance claim in 2014 after he argued his wife’s death — following a violent attack in public — did not meet its policy definition of “assault in the street.”
One woman was denied compensation under a critical illness benefit because she allowed her husband’s life support to be taken off 13 days after he had a stroke in order to donate his organs.
ReAssure Ltd said had he survived the 28 days it would have been entitled to compensation, but was asked to pay in 2013.
Travel insurance company Mapfer was forced to pay up in 2015 after it denied a couple whose young nephew died the day before their holiday — because he wasn’t considered a “close relative” under the policy.
“Slandering how many weeks people have left to live or looking for reasons not to pay, rather than how best to support people in this impossible situation, is unacceptable,” says Martyn James, of complaints website Resolver.
Legal and General says it has “every sympathy” for Paul, but its policy requires his therapist and medical officer to agree that his life expectancy is less than 12 months.
A spokesperson adds: ‘If a customer is on a waiting list that will extend their life beyond 12 months, the circumstances will not normally meet the terms of our policy definition.
If the treating specialist and our medical officer agree that an individual’s condition is changing, they may agree on a life expectancy of less than 12 months.
A spokesperson for the Confederation of British Insurers says: ‘Almost all (97 per cent) of life insurance, critical illness and income protection claims are paid out, with insurers paying nearly £14m a day on these policies to help families cope. very financially. sad time.
How to find the best life insurance
Protecting your family when you die — or if you become seriously ill — is one of the first things financial advisors often recommend.
It is important when purchasing life insurance that you make sure that you are getting the right high quality policy at the best price.
There are three main types of cover life: term level, term of tapering, and term of life.
The first pays a set amount if she dies before a set date, the second slowly reduces payments and is often used in line with the terms of the mortgage, and the third pays whenever she dies.
Read more about the different types of life and protection insurance here.
The cost of life insurance can vary widely due to the way commission is calculated on policies.
For many years, This is Money has recommended that the cheapest way to get a policy is with a broker called Cavendish Online. They charge a one-off fee of £25 and then 100 per cent of the commission you earn is reinvested in policies to lower premiums.
This is Money has now joined forces with Cavendish Online to offer this service to our readers.
> Learn more about life insurance and find out the cost of insurance here
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