An IFA is writing to insurers for clarification on how many critical illness claims they turn down because the policyholder has not suffered chest pain during a heart attack.
Alan Lakey, partner at Highclere Financial Services, is concerned Scottish Provident is the only insurer which does not demand evidence of chest pain during a critical illness (CI) claim for a heart attack.
He says all the other insurers adopt the Association of British Insurers’ (ABI) model definition for a heart attack, which states the death of a portion of heart muscle must result, among other things, in ‘typical chest pain’.
Lakey says it is “worrying” so many insurers use this wording in their CI policies because around one quarter of heart attacks are ‘silent’ with no chest pain or, indeed, no pain anywhere.
Many heart attacks may also result in a pain in the arm, rather than in the chest.
Lakey says he can understand the logic of the definition, as it aims to ensure the policyholder has actually suffered a heart attack rather than angina or indigestion.
But he believes clarification is needed over how many claims are turned down and he is concerned some insurers may be acting subjectively in upholding one claim and not another.
As a result, Lakey is writing to insurers to find out how many claims they turn down because of a lack of chest pain, and he says the answer could be an important consideration in product choice.
If insurers say they have not turned anyone down because it is clear when a heart attack has occurred, Lakey states this will “throw the argument in favour of Scottish Provident out the window”.
Russ Whitworth, claims and underwriting director at Legal & General, says: “Our aim is to pay all valid claims. If a heart attack is evidenced either by ECH changes or other biochemical markers and we are convinced it has happened, then absolutely we would pay the claim.”
If you have any comments you would like to add to this story or would like to speak to its author about a similar subject, telephone Emily Perryman on 020 7968 4554 or email [email protected].IFAonline
Joined as head of strategy, multi asset, in June
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