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Sorry, but your heart stopping for 20 minutes doesn't count as a critical illness ... that's what HSBC told Grenville - even though his insurance covered heart attacks
In January, father-of-two Grenville Stanbury’s heart stopped for 20 minutes.
The 62-year-old chartered surveyor collapsed in the middle of a local Chamber of Commerce meeting. Friends and colleagues battled to keep him alive before an ambulance crew arrived.
He then spent nine days in a coma. His wife and two daughters — one of whom was 30 weeks pregnant at the time — feared he might suffer brain damage.
Happily, Grenville is now back on his feet but he has been left unable to work and is not allowed to drive either.
Despite all this, his insurer, HSBC, wriggled out of a £40,000 claim on his critical-illness insurance policy by relying on small print to deny payment.
The bank rejected his claim because Grenville had suffered a cardiac arrest, rather than a heart attack. And they also said he couldn’t claim for being in a coma — because he was too old.
Grenville says: ‘I don’t think anyone would know that there is a difference between a heart attack and cardiac arrest or that you would need to check for that in the small print of a critical- illness policy.
‘I’ve paid into this policy for more than 15 years, thinking it would help me if I ever needed it, and I’ve just been fobbed off. If being dead for 20 minutes isn’t a critical illness, I don’t know what is.’
Life insurance is vitally important cover. It will pay a lump sum or an income to a loved one if you die.
You can get further cover that pays out if you are left critically ill. Grenville has spent around £10,000 on life insurance with critical illness since taking out the cover in 1999. The policy was bought through HSBC, but underwritten by Legal & General.
The specific clauses in his policy that have caught him out are those that exclude payouts for someone who has suffered a cardiac arrest. Heart attacks are covered, though.
The difference is that with a cardiac arrest, your heart actually stops. With an attack, the heart doesn’t stop — rather it has an irregular beat. Only around five per cent of people survive cardiac arrest if no one performs CPR.
Grenville thought he might also be able to claim for being in a coma as this is mentioned in the policy, too. But he discovered that cover for this ran out when he hit 60.
If it hadn’t been for the quick thinking of his friends and colleagues, when the cardiac arrest happened, he almost certainly would have died.
While one phoned an ambulance, another carried out CPR and a third ran next door to the local dentist to borrow a defibrillator.
While Grenville was in hospital recovering his wife, Susan, contacted HSBC to register the illness. At the time, doctors weren’t quite sure what had gone wrong. Grenville had none of the usual symptoms of a heart attack — there were no blockages in his artery, and he was not unfit or overweight.
The only thing out of the ordinary was some damage to his heart, caused by an undetected infection. Doctors concluded he’d had a cardiac arrest, and he was fitted with a defibrillator pacemaker to regulate his heart beat.
HSBC wrote to Grenville in April stating that he wasn’t covered. It said the insertion of a defibrillator may be classed as critical illness, but not when there had been cardiac arrest.
Grenville asked his insurer to look into his claim again but, in June, it refused for a second time.
After Money Mail contacted HSBC, it agreed to pay out in full.
A spokesman for HSBC says: ‘Unfortunately, Mr Stanbury’s illness is not covered in the critical- illness policy he took out.
‘But we recognise this is an exceptional case. It’s a very difficult time for him and we want to help so, as a goodwill gesture, we are offering the full sum of his policy.’
A spokesman for the Financial Ombudsman Service says: ‘We always try to stress the importance of understanding the policy that you take out.
‘If you feel your insurer isn’t being fair with you when it comes to specific details of any of your terms and conditions, like the difference between a cardiac arrest and a heart attack, then call us and we’ll see whether we can help.’
http://www.thisismoney.co.uk/money/news/article-3144776/Sorry-heart-stopping-20-minutes-doesn-t-count-critical-illness-s-HSBC-told-Grenville-insurance-covered-heart-attacks.html#ixzz3ednrUgyl
In January, father-of-two Grenville Stanbury’s heart stopped for 20 minutes.
The 62-year-old chartered surveyor collapsed in the middle of a local Chamber of Commerce meeting. Friends and colleagues battled to keep him alive before an ambulance crew arrived.
He then spent nine days in a coma. His wife and two daughters — one of whom was 30 weeks pregnant at the time — feared he might suffer brain damage.
Happily, Grenville is now back on his feet but he has been left unable to work and is not allowed to drive either.
Despite all this, his insurer, HSBC, wriggled out of a £40,000 claim on his critical-illness insurance policy by relying on small print to deny payment.
The bank rejected his claim because Grenville had suffered a cardiac arrest, rather than a heart attack. And they also said he couldn’t claim for being in a coma — because he was too old.
Grenville says: ‘I don’t think anyone would know that there is a difference between a heart attack and cardiac arrest or that you would need to check for that in the small print of a critical- illness policy.
‘I’ve paid into this policy for more than 15 years, thinking it would help me if I ever needed it, and I’ve just been fobbed off. If being dead for 20 minutes isn’t a critical illness, I don’t know what is.’
Life insurance is vitally important cover. It will pay a lump sum or an income to a loved one if you die.
You can get further cover that pays out if you are left critically ill. Grenville has spent around £10,000 on life insurance with critical illness since taking out the cover in 1999. The policy was bought through HSBC, but underwritten by Legal & General.
The specific clauses in his policy that have caught him out are those that exclude payouts for someone who has suffered a cardiac arrest. Heart attacks are covered, though.
The difference is that with a cardiac arrest, your heart actually stops. With an attack, the heart doesn’t stop — rather it has an irregular beat. Only around five per cent of people survive cardiac arrest if no one performs CPR.
Grenville thought he might also be able to claim for being in a coma as this is mentioned in the policy, too. But he discovered that cover for this ran out when he hit 60.
If it hadn’t been for the quick thinking of his friends and colleagues, when the cardiac arrest happened, he almost certainly would have died.
While one phoned an ambulance, another carried out CPR and a third ran next door to the local dentist to borrow a defibrillator.
While Grenville was in hospital recovering his wife, Susan, contacted HSBC to register the illness. At the time, doctors weren’t quite sure what had gone wrong. Grenville had none of the usual symptoms of a heart attack — there were no blockages in his artery, and he was not unfit or overweight.
The only thing out of the ordinary was some damage to his heart, caused by an undetected infection. Doctors concluded he’d had a cardiac arrest, and he was fitted with a defibrillator pacemaker to regulate his heart beat.
HSBC wrote to Grenville in April stating that he wasn’t covered. It said the insertion of a defibrillator may be classed as critical illness, but not when there had been cardiac arrest.
Grenville asked his insurer to look into his claim again but, in June, it refused for a second time.
After Money Mail contacted HSBC, it agreed to pay out in full.
A spokesman for HSBC says: ‘Unfortunately, Mr Stanbury’s illness is not covered in the critical- illness policy he took out.
‘But we recognise this is an exceptional case. It’s a very difficult time for him and we want to help so, as a goodwill gesture, we are offering the full sum of his policy.’
A spokesman for the Financial Ombudsman Service says: ‘We always try to stress the importance of understanding the policy that you take out.
‘If you feel your insurer isn’t being fair with you when it comes to specific details of any of your terms and conditions, like the difference between a cardiac arrest and a heart attack, then call us and we’ll see whether we can help.’
http://www.thisismoney.co.uk/money/news/article-3144776/Sorry-heart-stopping-20-minutes-doesn-t-count-critical-illness-s-HSBC-told-Grenville-insurance-covered-heart-attacks.html#ixzz3ednrUgyl
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would have swerved hsbc full stop after the scandal that broke earlier this year.
do think most insurance companies are like this though. always small print knowing a lot wont read through the endless pages. needs tighter regulation but im sure mp's wont bother as they are loaded up on shares so it no doubt hits them in the pocket ton introduce such measures. |
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They love taking the fees and there seem to be plenty of stories of them trying to wriggle out of it. Funny how they seem to cough up when some publication get's involved!
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Critical illness policies have long had a bad reputation for finding ways to avoid paying out for the wrong sort of heart attack or the wrong type of cancer.
Their primary use is to help make a good living for people working in financial services. |
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I used to sell life cover and criticl illness independently. The difference between providers cover is enormous and I never sold a L&G critical illness policy which if I remember they were one of the cheapest obviously HSBC will have been tied to this product.
I would advise anybody with critical illness cover to check it thoroughly and maybe get a free adviser to go through it with you. |