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Ben Jones
Ben Jones, UK Lawyer
Category: Law
Satisfied Customers: 44896
Experience:  Qualified Solicitor - Please start your question with 'For Ben Jones'
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We took out sickness accident and redundancy insurance for

Customer Question

We took out sickness accident and redundancy insurance for my husband for five years starting Feb 2009. He was made redundant on 24.12.13 and we made a claim. The advisor said we would get the full twelve months payments and they would ring every month to ensure he was not working and still claiming Job Seekers Allowance.

Today he has had a partial payment. The insurers say this is because the policy has come to an end. Our view is that the event that was insured against - ie redundancy, occurred during the term and we should therefore expect to gain the full benefit whicn was £1000 a month for twelve months. Are we right? If not we feel the policy was completely miss-sold to us and the insurers have witheld information that had we known we may have made other decisions such as him taking up offers of independent work. The insurers say they are reviewing the file and will contact us again on Monday. What should we do next?

Thank you very much.
Submitted: 2 years ago.
Category: Law
Expert:  Ben Jones replied 2 years ago.

Ben Jones :

Hello, my name is Ben and it is my pleasure to assist you with your question today. His entitlement to these benefit would depend entirely on the wording of the policy which he had taken out. Have yo checked to see specifically what he was entitled to, especially in the event the policy had come to an end?

JACUSTOMER-ifm33l3t- :

No we haven't yet but will dig out all of the documents we have. However, my view is that if you have a car accident the day before a car policy ends you insurer still deals with the claim. I would hope the same principle would apply.

Ben Jones :

that would not necessarily be the case because the insurance you have covers periodic payments over a period of time, whereas a car insurance would generally issue a lump sum for an accident that has occurred whilst the policy was in force. But of you can check the wording and let me know that would be great

JACUSTOMER-ifm33l3t- :

Also, we feel we were not properly informed if these were indeed the terms. And nobody has told us until today. We knfrkmed them abojt the redundancy notice backin the Autumn.

JACUSTOMER-ifm33l3t- :

So is there potentially a case about miss-selling?

Ben Jones :

Misselling is an issue that would depend on the facts of what happened, what you were told, etc. It would be impossible for someone to go over every single term and eventuality with a policy so it would depend on what you were actually told at the time, what you asked in terms of cover and so on. As I was not present at the time of the sale I cannot comment if you were missold the policy

Ben Jones :

But if you can check the term and get back to me then that would be a starting point

JACUSTOMER-ifm33l3t- :

But if they review the file and can clearly see that this has not been discussed with us then we could make that case?

Ben Jones :

that is a potential yes, but before you start thinking about making a misseling claim it is best to use all fee resources that are available to you - obviously to start with you have the formal complaints process with the insurance company which you can use all the way to the end, if that does not wok then you have the Ombudsman at your disposal which will provide an independent overview of what has happened and can issue a binding decision

JACUSTOMER-ifm33l3t- :

My husband is getting the documents out now which should make things easier!

Ben Jones :

ok if you can have a look and respond here I will take a look, I am due in some meetings this afternoon so may not be able to reply immediately but will get back to you this afternoon

JACUSTOMER-ifm33l3t- :

Once we have had more information from them on Monday we have said that we will raise a complaint if we feel we need to.

JACUSTOMER-ifm33l3t- :

I will do some reading and let you know.

Ben Jones :

Thank you

JACUSTOMER-ifm33l3t- :

Thanks.

Ben Jones :

Just respond on here when you want, i will be notified

JACUSTOMER-ifm33l3t- :

Do I just keep this window open? Not used this site before!

Ben Jones :

you do not have to, you can just save the webpage and come back to it whenever you like

JACUSTOMER-ifm33l3t- :

OK. Thanks.

Ben Jones :

No problem

JACUSTOMER-ifm33l3t- :

Hello again Ben. We can't put our hands on absolutely all the documents but have the main terms and conditions of the policy. We can't see anything in there about payments stopping when the policy ends. There is a list of circumstances under whicn they won't pasuch as in the initial mknth

JACUSTOMER-ifm33l3t- :

Month's waiting period and if you resign, are dismissed, sent to prison etc. I am happy to say none of these apply to my husband!

JACUSTOMER-ifm33l3t- :

Sorry for typing errors. Working on a tablet with limited success. Hope you get the gist of it !

Ben Jones :

Hello again, do you perhaps have the policy wording I can take a look at, then I would know what I am advising on specifically

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