Judge rules allegations of non-disclosures of GP visits 'were insignificant'
More rejected claimants are expected to take their insurers to court after a recent non-disclosure case was overturned by the Ombudsman.
Protection specialists have aired concern after multiple sclerosis (MS) sufferer Valerie Cuthbertson, who complained to the Ombudsman about Friends Provident not paying out her critical illness (CI) insurance, had a judge rule in her favour saying Friends Provident's allegations of non-disclosures of GP visits, "were insignificant in the view of medical witnesses".
Richard Verdin, sales and marketing director at Direct Life & Pension Services, believes this precedent will also spur other unsuccessful policyholders to challenge their providers.
He said: "I expect more declined claimants will challenge insurers' decisions through the courts in the future. People are generally becoming more inclined to take on big companies over what are, after all, large sums of money."
However, Mark Locke, public relations manager at Aegon UK, played down the significance of the case.
He said: "This case could be very significant for past claims, but this sort of situation will probably become less common as the disclosure process is more thorough now. Over the past few years, the industry has made some key changes to tightening up the process where people disclose medical information."
Friends Provident, which is expected to appeal in July, rebuffed the significance of the case.
Sebastian Kadritzke, retail media relations at Friends Provident, said: "At present, we do not see that the decision in the Cuthbertson case has any implications on other cases or on our policies. Until our lawyers have completed their study of the judgment and we receive their full advice it is inappropriate for us to comment further. We would also point out that this case was decided under the Scottish Law and has no implications outside Scotland."
Kadritzke added: "Our application processes comply, and in many ways exceed, the standards suggested by the Association of British Insurers (ABI). And when considering claims involving non-disclosure, we similarly comply with the standards and approach agreed between the ABI and the Financial Ombudsman Service."
Cuthbertson bought CI insurance from Friends Provident in 1994. She was diagnosed with MS in 1996, but it was only in 1999 that she realised the policy covered her for her condition and she tried to make a claim.
However, Cuthbertson had not disclosed to the insurer details of two visits to her GP in 1990, to check on what she and her GP had thought was insignificant eye pain. Her medical notes showed these consultations and Friends Provident rejected the claim due to non-disclosure.
