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 | You and YoursΒ - Transcript Βι¶ΉΤΌΕΔ Radio 4 |
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| TX: 30.05.03 – ARE THE DISABILITY TESTS USED BY INSURANCE COMPANIES UNFAIR? |
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| PRESENTER – CAROLYN ATKINSON ATKINSON Can you walk 200 metres on a level surface without stopping or get in and out of a saloon car passenger seat? Alternatively can you pick up the phone and take a message or grip a pen with either hand? We're talking income protection policies and these are the type of tests used to assess whether someone is eligible for a pay out if they can't work. Thousands of people take out these plans every year in the hope that if a disease is diagnosed or they have an accident they'll be paid a monthly amount to replace their pay check. The belief is that if disaster strikes it'll mean the difference between financial security and a cash crisis. But a GP has contacted You and Yours because he's increasingly alarmed about how the insurance companies are assessing patients. His patient, Andrew Honeybell, has been turned down by Legal and General, despite having to stop work because of a muscle wasting disease which affects his heart. ANDREW HONEYBELL The disability I'm suffering from causes me a lot of severe muscle pain, I get numbness in my limbs, I get very short of breath and find the simplest of tasks really hard now. I've been diagnosed with a condition called polymyositis which I'm undergoing tests for still with a muscle consultant. I've been signed off by my GP due to this illness and I've put a claim in for Legal and General for my income protection policy which they've declined due to a test which they've now sent to the doctor which they call a six test which the doctor has to put the ability of doing these six things down on paper and because I can still walk, get in and out of a saloon car, answer a telephone, read a newspaper and pick up a pen and paper they're saying they will not pay this claim. PRESENTER Now Legal and General make it clear that in the documentation you were sent if as a result of illness or accident you're unable to carry out a number of specific tests they would pay up, did it not occur to you that you should find out what those specific tests were? ANDREW HONEYBELL Okay I did see that line in the key features document but obviously I thought if they were important enough issues they would be listed in the key features document. I've also checked on the Legal and General website and once again you can buy this product but no mention - it says about the six tests - but no mention of what the six tests are. PRESENTER And you didn't obviously pursue that to find out what they were? ANDREW HONEYBELL No not at the time. PRESENTER If you'd known what they were would you have gone ahead and taken out this policy? ANDREW HONEYBELL No, even if I had a serious disability that I lost my eyesight I could still answer a telephone, I could still walk, I could still bend and the policy wouldn't pay out. If I lost the use of my hands I could still walk, I could still take a message, I could still read a newspaper and I could still walk up the stairs and it still wouldn't pay out so why would anyone want to take a policy out with those features clearly listed in front of you? PRESENTER But Legal and General are saying they can pay for an independent medical examiner to re-look at your case and they can pay back all the payments you've made so you would not be out of pocket and they would also pay you interest - that's fair enough isn't it? ANDREW HONEYBELL Well if they pay me back my premiums and they haven't actually told me they were continue the policy and now I'm ill I'm not going to be able to get reinsured and why is it now we're talking to a radio station they're now saying that they're going to send an independent person in. I've written a complaint letter, I've spoke to them and they haven't offered to do any of this - they've offered to give me my money back yes but they haven't offered for an independent doctor to come and see me about my claim, it's only since I've now been speaking to journalists they're now willing to do that. PRESENTER What position are you in at the minute Andrew because you felt you took out this policy to cover just this sort of disastrous situation, how has it left you? ANDREW HONEYBELL We've been struggling for money, I'm living on my wife's earnings and basically the whole idea of this policy was to give me an income. My actual employment only pays me statutory sick pay, that was the whole idea of having a private policy to cover me in the event I was ill and because this hasn't happened I've now been made bankrupt and it's turned my life completely upside down and has caused me and my wife a lot of stress. PRESENTER Well Dr John Cormack is the GP who contacted us about this problem. CORMACK I can understand insurance companies wanting to make absolutely sure that they're paying out for genuine cases but in Andrew's case he's got clear biochemical evidence, he's got chemicals in his bloodstream that points to a diagnosis of myositis which is where you're very weak because your muscles aren't working properly. So it's not a grey area case at all, this is absolutely cut and dried - he'd love to work and he can't because he's so fatigued. PRESENTER So you think in - from your medical opinion that there is no way he can work at the moment and he does therefore qualify for this income protection? CORMACK I think he qualifies because his job is as an electrician so he has to travel long distances, drive long distances, there's a lot of heavy work, heavy lifting involved, there is just no way he could possibly work. PRESENTER Do you have general concerns about the way these policies are going because I do understand you have other patients which you think are in similar situations? CORMACK Yeah there's a couple of other patients and this is a practice with about 6,000 patients on its list, so if this sort of trend is reflected across the country then there may be a serious problem. And it seems that in the past people took out this sort of insurance so that if they got sick they could say well I may not enjoy being sick but at least my wife and kids will be looked after and that doesn't seem to be the case anymore, the companies are trying to nit-pick and say well you could lie in bed all day so you could be the television critic for the Guardian or something, pull yourself together. And really that's not a way to deal with this sort of case where you've got people who can't do their job, they really only can do that job, they're not trained for anything else. PRESENTER Dr John Cormack. Well on the line now is Isobel Berwick from the Financial Times. Isobel do you think that these polices, from what we've been hearing at least, are being oversold to people? BERWICK Definitely. I think part of the background is that these sort of policies are going to be regulated by law from 2005, which means that consumers will get a lot more protection. In the meantime they're being sold by the truckload and quite often to people who shouldn't be buying them. PRESENTER So basically at the moment people are sort of being enticed by how much money they'll get per month if some disaster happens but they're not actually reading the small print? BERWICK Exactly, I think they're being persuaded that they need these policies by advisors and bear in mind the advisors have to make a living and nobody's buying investments at the moment, so the kind of commission payments they'll get from selling income protection policies, for example, are going a long way to keeping these guys afloat in very bad times. PRESENTER But in Legal and General's defence, which is the one we've been talking about here, they are right to say that there are six tests that are set out fully in their policy document, that's provided once you've brought the policy, isn't that enough? BERWICK I don't think so, I think in reality most people don't read the very small print. I think if you're a customer you would want to see those six tests up front, as the man was saying, it seems unlikely that a policy would pay out and I think one should know this. And I think from 2005 that will be the case, it's just at the moment we have this problem. PRESENTER So it's a case of best practice. I mean we have another company here, it's a rival company to Legal and General who do list all the things that you will have to not be able to do if you get the money, do you think all these companies are going to be encouraged to follow this sort of best practice? BERWICK They will be forced to follow best practice by the Financial Services Authority, so there is hope in these cases but at the moment it's not helping the people caught in this situation. PRESENTER So what's your advice then, should people be very cautious about taking these out - I mean people do get pay outs on them so presumably for a lot of people they are still worth it? BERWICK I think there is a case for taking them out but be very wary if someone's trying to sell you this type of policy, they're earning a lot of commission and it may be that you're not in a position - you may not claim on it, if you perhaps wanted to save some money in a savings account and hang on until these policies are properly regulated that might be one way or you may be covered by your employer, a lot of people have six months income protection from work and that may not be clear and some people may take out additional policies unnecessarily. PRESENTER Okay Isobel Berwick from the Financial Times, thanks very much indeed. Back to the You and Yours homepage The Βι¶ΉΤΌΕΔ is not responsible for external websites |
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