Client left uninsurable after GP report delayed 10 months

Lost form, admin failings and repeated adviser contact

Adam Saville
clock • 4 min read

Mr M wishes to take legal action against surgery after he suffered two strokes while waiting

A man - known as Mr M for legal reasons - who applied for life insurance has been left uninsurable after waiting almost a year for a GP surgery to return a medical report.

Unfortunately, the client, who was referred to a protection specialist by a financial adviser after being declined due to various heart issues, suffered two strokes at the end of a 10-month back and forth with the surgery which involved a lost form, administrational failings and repeated attempts from the adviser firm to get the report completed and returned by the GP.

Application

Back in August 2019, Mr M went through a research and application process with an adviser in order to protect a mortgage, however a report was requested due to his medical disclosures. This was posted to the surgery in question.

Four days later, the adviser called the surgery, which confirmed receipt of the report and confirmed it had been sent to the GP for completion. A number of calls were made to the surgery over the following three weeks and each time the adviser was told it was still with the GP.

In mid-September, the surgery confirmed that the report was part-completed however additional information was needed and that this had been requested from Mr M directly.

Lost form

Following contact from the adviser, Mr M visited the surgery at the beginning of October to provide the additional information, however on arrival he was told they had lost the form and that he needed to come back another day.

Two weeks later the surgery had located the forms and by November, the adviser firm had received confirmation that the client had signed a form giving his surgery permission to contact his previous doctor to gather additional information. The surgery received the information from Mr M's previous doctor two weeks later.

During the first week of January 2020, the adviser firm was informed that the report was still with the GP and that it should be completed in two weeks. A few weeks later, it was completed and with the admin team pending final stages, the surgery said at the time.

Client consent

Because the surgery believed the insurer consent form they had on file was not enough, the client was informed via a text by the adviser that he needed to go in and sign the report before it could be released.

To help speed up the process, the adviser firm emailed Mr M a consent form, which was eventually returned and forwarded to the surgery by mid-March 2020.

However, it wasn't until the middle of April that the adviser found out that the report was still outstanding. In mid-May the surgery claimed the report was still with the GP, however the GP did have the medical reports from his previous doctor, it said.

To the adviser's horror, during a call in mid-June, the receptionist said the report was never passed to the GP in the first place. "We asked for this to be dealt with urgently," the adviser told COVER. "At this point the report had been outstanding since August 2019."

In mid-June, after asking to speak directly with a manager at the surgery to find out what was happening, the adviser firm was told someone would call them back.

Mr M suffered two strokes a week later and he is now uninsurable due to his recent medical history, the adviser said.

'Extremely concerning'

David Mead, CEO, Future Proof said: "This case is extremely concerning. Whilst it is clear that some GP surgeries have come under increased pressure during recent months, others have been reporting a reduction in workloads, and have consequently been able to turn around insurance medical reports faster than normal.

"We have always been concerned about the potential consequences of unnecessary delays in obtaining reports from surgeries. This particular client will now be unable to obtain cover and his family are now exposed to a risk that was entirely avoidable.

"Our recent experience is a higher percentage of cases than normal are requiring additional medical evidence. If this is a trend across the industry, the problem will be exacerbated." 

Legal action

According to British Medical Association (BMA) guidelines, GP reports report should be returned within 20 working days of receipt of the request, sometimes sooner in exceptional circumstances.

Medical reports for life assurance purposes are covered by the Access to Medical Reports Act 1988. Read the guidance here.

Mead added: "It has arguably never been more important for the insurance industry and the BMA to urgently work together to ensure situations like this are avoided. We're delighted to hear about the new guidelines published by the BMA stating that these reports should be returned to the insurers within 20 working days."

Mr M's wife, who is a lawyer, now wishes to take legal action against the surgery, due to negligence.

As the case is potentially subject to legal proceedings we have removed all identifiable data related to all parties involved.

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