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Critical Illness Cover Insurance

Recent stories in the force down have another time lambasted the insurers over dangerous illness insurance. The core difficulty is that a dangerous illness claim is not as straightforward as, for case in point, a claim beneath life insurance. With life insurance it’s going to be firm for the insurance company to quarrel that you’re not dead!

By their very natural world, dangerous illness claims are much more complicated. The insurer will need to please itself that the claim is validated in three key areas previous to it meets the claim: –

Has the sickness been properly diagnosed?
Is the long-established illness included in the agenda of insured critical illnesses enclosed by the policy?

Did the policyholder entirely reveal their medical history and current state of health on their innovative application form?


On the first point, it’s clearly in the policyholder’s attention to verify the medical diagnosis – so there’s hardly ever ever any disagreement between the insurance company and the policyholder on that issue. It’s the after that two areas which the insurer needs to authenticate, where conflicts seem arise.

With constant growth in the medical knowledge, from occasion to time there can be some situations where corroboration waterfall into a grey area – a policyholder will argue that their exact illness is insured while the insurer will quarrel that it isn’t. Insurance companies are conscious of this difficulty and they often change the wording in their policies in an effort to clarify the range of the cover and eliminate areas for dispute. Nevertheless, disputes do happen all too regularly and sparks fly when a policyholder thinks his sickness is covered but the insurer disagrees.

Mr. Welch’s court case have to stand as a clear aide memoir to everybody that applications for insurance must for all time be totally accurate and finished in good faith. We be familiar with that in some cases this may still leave room for dispute (and Mr. Welch’s case may be an example), but if a candidate fails to complete the forms accurately, they are taking the huge risk and any claim they make could be rejected.

Rightly or incorrectly, the journalists have a history of philanthropic the insurance companies a hard time, casting them as cruel big business. This serves to reinforce the public’s emotion that insurance companies are deceitful and not to be trusted – especially it seems, in respect of critical illness insurance. This outlook is reinforced by the fact that approximately 20-25% of dangerous illness claims are rejected (although this negative response rate does vary between insurers). This issue is something that insurers must approach to grips with – it’s bad for clients and undermines self-assurance in insurance – and that must be awful for the development of the insurance industry.

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