…published an extract of the Lords' debate concerning pre-existing conditions to an illness regarding insurance…that no such pre-existing condition can exist until after a diagnosis of that condition.
The Abbey Life principle to critical illness insurance is that a condition can be retrospectively excluded when expedient…
…claim failed due to "associated symptoms" which have never been declared…the alleged unqualified symptoms predated January 1996 to place my claim outside cover…diagnosis almost one full year inside the cover.
Abbey Life propose that I do not have any right to know why my claim failed.
…claim process allowed for scrutiny of the medical history…selection of appropriate symptoms that might be connected to an undiagnosed brain tumour…retrospectively after the tumour's existence is known.
…unilateral partial deafness was probably an "associated symptom" to ‘prove’ a tumour…and to ‘prove’ specifically a meningioma. Ménière’s disease or cochlear damage or many things - in the absence of an MRI can also result in deafness.
Significantly, the informed opinion of consultants was guided by the scan. This was not until November 1996 and so proves that Abbey Life could not possibly have any justification whatsoever to claim that prior knowledge was available by September 1995.
…major loophole in this type of product is that the Personal Investment Authority does not regulate the insurance part of the policy - only the investment part itself - and the Association of British Insurers seems powerless or just reluctant to make definitive comment in an insurance matter.
The Office of Fair Trading (OFT) has a full report…considering its content with regard to critical illness insurance.
The General Medical Council stance was one of total disinterest…the Chief Medical Officer (CMO) retired during my protracted complaint and was not necessarily involved with the claim refusal…claims' underwriters have some delegated authority to make medical decisions…illusion that qualified medical opinion is used to arrive at such a decision…the CMO is in "possession" of information does not mean that he was involved in the use of that information to make a decision himself.