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Ben Jones
Ben Jones, UK Lawyer
Category: Law
Satisfied Customers: 50169
Experience:  Qualified Solicitor
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I have been on a long term health policy last two years.

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I have been on a long term health policy for the last two years. This policy is through my employers. Initially I was told that I would be receiving 75% of my salary. However the insurance company took off the amount I was receiving for earnings support allowance from the amount of benefit awarded to me whether I was in receipt of this or not. In April I was told that I was no longer entitled to this. The information I was sent did not specify this so now I have less money to live on. I have been in touch with both my company and the insurance company and been told that that is their policy. I have also been advised by my HR department that it is in the terms and conditions of the policy which I have never had. I am off work due to a work related incident. Do you think I have a case to pursue compensation.
Hello, my name is***** am a solicitor on this site and it is my pleasure to assist you with your question today. Do you agree that as per the terms of the policy your rights are as stated by the insurance company?
Customer: replied 2 years ago.
I have not read any terms or conditions related to this policy because I have not been given all the information. My company and the insurance compant set the terms and conditions. I have been given some information but neither the insurance company or my employers have told me and I seem to be finding out as we go along.
Customer: replied 2 years ago.
Hello Ben, I have had an email from the insurance company telling me that even if I don't receive any benefits they will still deduct it and I should get in touch with my employers and they told me that the insurance company told them this was their policy. Regards Eileen
Hello Eileen, as this is a discretionary benefit offered to you by the employer you would be bound by the terms that apply to the policy. They may not necessarily be favourable to you, but the employer is not actually obliged to offer such a benefit to its employees. They could have just left you on Statutory Sick Pay and that would be a very low amount of some £88.45 per week – that is the minimum requirement under law, anything on top of that is at their discretion. So if the terms and conditions of the benefits scheme is such that it allows the provider to deduct the amount of other benefits you receive regardless of whether you get them or not, they could do that. As long as you are being paid the statutory minimum amount I mentioned above, plus anything else you are actually entitled to receive under that policy. You would need to get the terms to see precisely what your entitlement is. It is pointless pursuing them for compensation if they are entitled to make these deductions. So make sure that you actually have the right to take any action first by confirming they were not allowed to make these deductions in the first place – you will have to check the policy terms to confirm that. Only then would you know if there is a case worth pursuing. I trust this has answered your query. I would be grateful if you could please take a second to leave a positive rating (selecting 3, 4 or 5 starts at the top of the page). If for any reason you are unhappy with my response or if you need me to clarify anything before you go - please get back to me on here and I will assist further as best as I can. Thank you
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