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JGM
JGM, Solicitor
Category: Law
Satisfied Customers: 11739
Experience:  30 years as a practising solicitor.
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I have a query about Life Insurance. We have a policy which

Customer Question

I have a query about Life Insurance. We have a policy which pays out on death or terminal illness. My husband has Motor Neurone Disease which is classed as a terminal illness. However Scottish Widows stipulate that death has to occur within 12 months of making the claim. This is impossible to assess and I'm not sure how our neurologist will answer. Is there a legal criteria for this situation or a way of appealing if the claim is refused?
Submitted: 1 year ago.
Category: Law
Expert:  JGM replied 1 year ago.

That doesn't make sense. If a policy is to pay out on diagnosis of a terminal illness then the contract of insurance can't be conditional on death occurring within 12 months because that would trigger the death provision in the policy. The policy has to define exactly what "terminal illness" means and all the consultant should be asked to confirm is a diagnosis of that illness. If the insurance company are being difficult you should go to the ombudsman or alrenatively just sue in the courts under the policy, i.e., for breach of contract. I hope that helps. Please leave a positive rating so that I am credited for my time.

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Customer: replied 1 year ago.
Thank you. I forgot to add that the policy expires at age 70 - which will be Sept. 30th 2017. Could this be a mitigating factor?
Expert:  JGM replied 1 year ago.

No, not if the policy was in force at the time of the claim. The claim is valid and in time from your narrative.