Danielle’s story

CRITICAL ILLNESS INSURANCE CLAIM

The insurer had outlined to Danielle’s husband that her condition was “too rare” and therefore was not covered under the policy. This was extremely upsetting news for them given how significant the money would have been in supporting Danielle and her family during her recovery and beyond. Following a meeting with Danielle and her husband, Stewarts reviewed the insurance policy and contacted the insurer on Danielle’s behalf to discuss the situation.

Stewarts identified that a claim could be commenced under a separate part of the policy that provided for payment where illness resulted in total permanent disability (TPD). Claims for TPD can be notoriously difficult. However, after obtaining additional evidence and liaising with the insurer, they altered their position and accepted the claim. As a result, a pay-out of more than £91,000 was secured for Danielle. The client’s husband described this as “a life-changing amount … with which we were able to pay off our mortgage”.

TRAVEL INSURANCE CLAIM

In early 2020, Danielle experienced further frustration with making a claim, this time under their travel insurance policy. She again turned to the Pro Bono team at Stewarts for support. Danielle and her husband had booked to take their children on a “trip of a lifetime” to Florida, which would be the first trip they had been able to take since Danielle had been unwell. However, shortly before the trip, they had to cancel the trip when one of their daughters’ displayed symptoms of Covid-19. In light of emerging government guidance regarding isolating, Danielle had been concerned about whether they should go and called NHS 111 who advised they should not travel.

Danielle attempted to claim the cost of the holiday from the travel insurer but was informed that, as she could not provide evidence of the advice she received from NHS 111, the insurer would not accept the claim. Much to Danielle’s dismay, upon contacting NHS 111 it appeared the recording of the call had been lost. Danielle’s husband described their despair: “My wife and I tried to fight the insurer’s stance until we felt we had reached a point where we had exhausted all our options. Out of desperation, we once again contacted Stewarts.”

Understandably, Danielle and her husband felt like the insurer was penalising them for responsibly following the government’s Covid-19 guidance. They had appealed the insurer’s decision to the Financial Ombudsman Service to no avail. Stewarts immediately contacted both the insurer and the Ombudsman to argue that this response was not reasonable and supplied additional evidence that the call to NHS 111 had been placed that day. On reviewing the complaint, the Ombudsman agreed with Stewarts, agreeing that Danielle should not be held accountable for the call recording being unavailable. It was clear they had sought the advice from NHS 111 that resulted in the cancellation of the trip.

Following the decision, the insurer immediately contacted Danielle to confirm they would now be paying out for the full holiday costs (over £4,000). Now Danielle and her husband have recovered the money, they hope to take their trip to Florida together as a family once it is safe to do so.

IN THEIR OWN WORDS

Danielle’s husband had the following to say about their experience of the Pro Bono team:

“In summary, my wife and I would like very much to take this opportunity to say just how very grateful we are to Stewarts. Please keep doing what you’re doing, you make a huge difference to everyday people’s circumstances often when they and their families are at their lowest ebb. You give people like my wife, and I hope at times when it feels like we have no right to be hopeful.”