# Income protection claim denied - appealing to fso



## Cilroife (22 Jul 2016)

Hi all

I had an income protection policy with a few yrs.

Hen I made the application I ha ad a hip condition diagnosed and had had surgery. This was disclosed on my application and and an exclusion applied to that hip.

I have now been out of work for 1 yr due to another illness and surgery. I made a claim on the policy after 3 Mts when I knew that I wouldn't be well enough to go back to work as quickly as I thought.

They denied my application because of none disclosure and voided my policy.

The points they made were the following

1 . On the application form they asked if I had ever sure ref with back pain or a back issue. I had said no. But the asked for all my GP notes going back 5 yrs. and found that I had referred pain from my hip issue toward my back. To me or my GP this was nothing to do with my back it was hip related and I obviously didn't consider myself to have back issue of pain.


2. The 2nd issue was that they had asked if I ever suffered with stress anxiet depression. And I had t. But they had found 1 time when my brother was seriously and suddenly ill I had gone to my GP exhausted and very upset. My GP was away and I saw a locum who didn't know me. She ? On her notes maybe depression. I took time off work - I was back at the gp days later already feeling better.


My GP had written a letter denying their claims of none disclosure and said their interpretation of her notes was incorrect.

I did not have back issues. And the stress I experience was normal stress due to family issues and not anything she had medicated me for or referred me for treatment for.


I apple alex the desision to the company friends first and they said they reached the same conclusion

I am not off work for any of those two reason.

They have not asked me to be reviewed by any independent medical person.

They have just interrupted my GP notes incorrectly and based their desision on that.

I am awaiting this all in writing from them and am going to appeal to the FSO but I wonder does anyone have any input, advise or opinions ?


I find it had to accept that they are basing my " none disclosure" on interrupting my GP note differently than she did and then I was knew about myself.

Thanks


----------



## Gerry Canning (25 Jul 2016)

Cilroife,

Too much of this income protection is a racket.
Keep everything in writing .
Write to Friends First and reappeal and or ask for their final letter on not upholding your claim.
Then go via The FSO .
From what you state you have a reasonable case ,but bear in mind the FSO is in my opinion a (creature) of the financial industry.
General.
Friends First and their ilk have to check are claims bona-fide , what they do not have to do is trawl to find spurious non-payment issues.


----------



## Cilroife (25 Jul 2016)

Gerry Canning said:


> Friends First and their ilk have to check are claims bona-fide , what they do not have to do is trawl to find spurious non-payment issues.




Thanks for yor input - I don't understand this point?


----------



## Gerry Canning (26 Jul 2016)

Cilroife.
I appreciate that Friends First need to check that claims are genuine and that customers are not over claiming.
In your case (from what you write) they are trying to find a reason to not pay out , in that your doctor has answered their concerns, yet they will not listen..
In your case it looks like Friens !st have chosen to take the line that your medical history is a good nuff reason to not pay out.
It looks like in your case Friends1st are just looking for an excuse to NOT pay.

In too many cases the Friends 1st of this world make sure they FIND non-payment reasons.
Hope this explains better.


----------



## Cilroife (26 Jul 2016)

Gerry Canning said:


> Cilroife.
> I appreciate that Friends First need to check that claims are genuine and that customers are not over claiming.
> In your case (from what you write) they are trying to find a reason to not pay out , in that your doctor has answered their concerns, yet they will not listen..
> In your case it looks like Friens !st have chosen to take the line that your medical history is a good nuff reason to not pay out.
> ...


Thanks so much does explain better. 

Do you know if anyone ever get solicitors involve in cases like this or in help with financil services ombudsman application/ process


----------



## Gerry Canning (27 Jul 2016)

You can do but I would on what you say go via FSO .Be sure to keep/record everything and DO not take calls from Friends First, leave FSO to fight it out and have patience ..


----------

