Has a company treated you unfairly? Our consumer champion, Katie Morley, is here to help Our reader’s doctor has written to L&G to say he thought it would be unjust not pay out, but L&G won’t budge Has a company treated you unfairly? Our consumer champion, Katie Morley, is here to help. For how to contact her click here. Dear Katie,
On Jan 25 this year, my husband died from a heart attack. He was only 53. This year has been the most dreadful time for me. I have been so stressed that I thought I was having a heart attack myself. My hair has been falling out in clumps, and on top of all this, the pandemic meant I couldn’t see family and friends for months. However, they advised me to write to you, as you may be able to help with a problem I am having with my husband’s life insurance.
We had a policy with Legal & General that we took out in 2012 and then renewed in 2018. Two days after my husband’s death, a friend of mine informed L&G as I was too upset to make the call.
In June, I complained as the claim was taking too long and I had heard nothing. In August, it finally responded, turning down my claim. On the application form, which my husband filled in through a broker, he answered the question: “How long ago was your blood pressure last taken by a doctor or nurse?” My husband answered: “Three months ago.” Then it asked what was his last blood pressure reading when taken by a nurse or doctor. My husband answered “124 / 86”, which is high.
Unfortunately, my husband’s surgery can’t find any blood pressure reading for my husband in the three-month period in question. The last they could find was 18 months before the questionnaire was filled out. My husband knew he had high blood pressure and was on various medications, so I find it hard to believe he did not have his blood pressure taken for that long. My husband had nothing to hide. His doctor has written to L&G to say he thought it would be unjust if the claim was not paid, but L&G won’t budge.
I was deeply sorry to hear that you had lost your husband at such a young age, and so suddenly. I cannot imagine what a terrible year this must have been. The last thing you needed was hassle over this life insurance policy, but as it was refusing to pay out the £85,000 you were expecting, you had no choice but to fight the decision. When you wrote to me, I sensed you were at the end of your tether.
Determined to get to the bottom of the discrepancy, I asked L&G to reopen your case urgently. First, I wanted to explore the possibility that your husband did have his blood pressure checked by a doctor within the stated three-month time frame, but that for whatever reason, it was not logged.
L&G had full access to your husband’s medical records, so I asked it whether your husband had been to any appointments within the specified three-month window. No, it told me – the last appointment was recorded 18 months before the life insurance medical questionnaire was filled out. Had he filled the form accurately with this information, he would have been asked to undergo a heath check before being granted cover, it said.
As such, it was not prepared to pay out. Instead it offered to put you back in the position you would have been in had the policy been bought correctly, by refunding all the premiums. I phoned you to talk you through the decision, asking you to rack your brain to think of another possible explanation for the discrepancy. Like you, I was sure your husband had not tried to pull the wool deliberately to get cover. I felt there must be an innocent explanation for this.
I asked you whether your husband might have had his blood pressure taken in another setting? As he knew he had high blood pressure and was on medication for it, I’d be surprised if he had gone 18 months without a reading.
Yes, you said. At your local LloydsPharmacy. He used to go there regularly to use the communal blood pressure machine, which was free to use. So could this have been the reading he was referring to on the form? I think it is a definite possibility. But I’m afraid that even if it were, it would make no difference to L&G’s decision. This is because the reading would have been taken by your husband himself.