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Insurers Won’t Pay Out For My Critical Illness Insurance Policy

Question:

I have bad Fibromyalgia and not been able to work for twelve months.  I have a Critical Illness Insurance Policy but the insurers will not pay out.  They say that Fibromyalgia is not one of the named illnesses in the policy.  Can I claim?

Answer:

Fibromyalgia may not be a named illness, but these policies usually pay out for total permanent incapacity or disablement.  Whilst nobody wants your Fibromyalgia to be totally or permanently incapacitating, the test is not always as demanding as it sounds.  Generally it means that you will probably not be able to follow either your own occupation or any occupation (depending on the definition in the policy) until your normal retirement date.  If you feel that you satisfy that criteria you will have a good arguable claim for a full payment under the policy.  You will, however, probably need the support of a Consultant who will say not only that you have Fibromyalgia, but you probably will not be able to work again.

A word of warning.  All these policies are different.  It really depends on how the policy defines total and permanent incapacity/disablement whether you come within the definition.  If you are in any doubt, a good solicitor should be able to help you interpret the policy, although obviously he will need to know how bad your Fibromyalgia is and whether or not you can do the various tasks unaided which may form the basis of the definition.

The above question originally appeared in Fibromyalgia Family Magazine

We do not endorse any research, studies or sources mentioned within our blogs and comments. Furthermore, we do not endorse any medical advice provided, and would strongly recommend anyone seeking medical advice to contact their local healthcare provider.

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