What is Total Permanent Disability insurance:
Total Permanent Disability Insurance (or TPD) is normally an additional benefit added to Critical Illness Insurance. It covers you if you are permanently unable to work or carryout certain daily living activities again. It would normally pay-out the full sum assured if successful.
How to claim:
You will often have to prove your disability is permanent and have little chance of improving before your insurance provider will consider a claim. The insurance company will write to your GP and Consultant to get medical reports. This can often take several months. Once the insurer has enough information, they will be able to decide on the outcome.
Issues people face:
The most common issue we see is the amount of medical information the insurance provider has requested. Most medical conditions that are “permanent” will require ongoing treatment and some insurance providers will say that your condition cannot be classed as permanent until you have finished treatment. Other insurance providers will ask medical professionals for an unrealistic amount of certainty in relation to your condition being permanent rather than what is “likely.”
On other occasions we have come across people whose policy states they must not be able to carry out “any” occupation rather than their own occupation. An example might be a builder but could still, theoretically, work in an admin role.
At Resolute Claims our we are seeing ever increased numbers of Total Permanent Disability Claims. We are successful at fighting claims where people have been stuck in a never-ending loop of providing medical information or been rejected due to not meeting the policy terms and conditions.
Case Study:
A Client came to us to discuss her Total Permanent Disability Claim. She had been diagnosed with Fibromyalgia three years before making a claim, the claim had been ongoing for almost 18 months prior coming to seeking help. As with any declined insurance claim it’s important to have all the information to hand, This means we look at a variety of information which includes policy details, regulatory guidelines and medical information and opinions.
We were able to establish, that on the balance of probabilities, that the policy terms had been met, which resulted in a pay-out for the customer.
If you, or someone you know, thinks they had an insurance claim rejected unfairly, it’s important they seek advice. They can get visit the Financial Ombudsman Service or can speak to one of our advisers for fee information and guidance around appealing a declined insurance decision.
