View more on these topics

IFA’s fight finally wins critical claim

An IFA’s year-long fight for her client has resulted in £220,000 finally being awarded in a critical-illness claim which had been rejected twice.

Square Mile Wealth managing director Jane Robinson pushed for the payout for a client who permanently lost the use of both legs after a fall. She is questioning whether the ABI’s consultation on tightening CI definitions will improve claims, particularly for “grey claims”.

Norwich Union rejected Ben Hooper’s claim under total and permanent disability claim criteria. Robinson argued it should have been assessed under paralysis/paraplegia but a second reassessment under paralysis/paraplegia was declined when a consultant’s examination revealed that Hooper had some muscular movement.

Another appeal resulted in payment once NU accepted he would never regain the use of his legs. NU says the case was a complex one which did not fit into any of its criteria.

Robinson says: “The ABI consultation means tiered definitions will provide even more subjectivity. I think it is the moral obligation for an adv- iser to fight as much as poss- ible for a client in the spirit of best advice.”

Hooper says: “Under any other circumstances, I would have accepted the original rejection. It is only because of Jane that we decided to challenge them.”

An NU spokesman says: “Due to the complexity of this particular claim, the critical-illness policy provided a number of potential routes to claim.”

Recommended

‘Boutique’ battle is breaking out

Multi-manager T Bailey is delighted that the Credit Suisse incubator fund is endorsing its own views on the benefits of holding boutique funds but is critical of its “artificial restrictions” which exclude larger, more established funds.

Aifa’s View: High stakes

Aifa’s Stakes in the Ground initiative has come about in response to members’ continuing worries over retrospective action by the FSA and Financial Ombudsman Service, where there is a risk of current regulatory standards being applied to assess actions that were taken against a different economic and regulatory backdrop.

Newsletter

News and expert analysis straight to your inbox

Sign up

Comments

    Leave a comment

    Close

    Why register with Money Marketing ?

    Providing trusted insight for professional advisers.  Since 1985 Money Marketing has helped promote and analyse the financial adviser community in the UK and continues to be the trusted industry brand for independent insight and advice.

    News & analysis delivered directly to your inbox
    Register today to receive our range of news alerts including daily and weekly briefings

    Money Marketing Events
    Be the first to hear about our industry leading conferences, awards, roundtables and more.

    Research and insight
    Take part in and see the results of Money Marketing's flagship investigations into industry trends.

    Have your say
    Only registered users can post comments. As the voice of the adviser community, our content generates robust debate. Sign up today and make your voice heard.

    Register now

    Having problems?

    Contact us on +44 (0)20 7292 3712

    Lines are open Monday to Friday 9:00am -5.00pm

    Email: customerservices@moneymarketing.com