Current Timescales making a Critical Illness Claim

Since the middle of 2020 Resolute Claims have received hundreds of phone calls from people advising their critical illness claim has been rejected. People making a claim on their Critical Illness policies have experienced huge delays in making a claim with more than half the people we speak to waiting more than four months to get a decision, often then rejecting the critical illness claim.

Part of this can be due to the pandemic. As GP’s and consultants have been busy battling the current health crisis the time taken for reports to be sent back is taking ever longer. This means insurance companies cannot decide the outcome of a claim until they have confirmed your diagnosis or prognosis. This should hopefully get better as we slowly return to normal.

On the other hand, we see a large number of claims where insurance companies are continuously going back to medical experts for more information about their health. In the cases Resolute Claims have supported we often ask the insurance company why they have requested this information. We are often told it is part of the standard process, well if that was the case why isn’t it standard to request this at the start of the claims process?

From the cases we have seen it seems that insurance companies are requiring an ever-greater burden of proof to approve a successful claim. Once recent case, where we had successfully appealed a declined critical illness decision, the insurance company dismissed two medical experts’ opinions in favour of something they had reviewed in a medical blog in the United States. This was an extraordinarily complex case where the details of the illness was very technical. It was never referred to their Chief Medical Officer and the decision was made by a claim’s adviser. It is often quite disheartening to see people struggle with ill health or bereavement only for the insurance provider to look for every possible avenue to reject the claim.

If you feel or if you know anyone else who feels they have been unfairly treated by an insurance provider and had an insurance claim declined while making a claim on their Critical Illness/Life Insurance/ Income Protection policy then Resolute Claims are here to help. You can call us (at local rate) on 0333 050 8792.