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furious, any medical/legal people there?

(12 Posts)
hatstand Sat 23-Jul-05 09:41:12

not sure if anyone can help me...I am shaking with upset. I got a letter this morning from my life assurance company refusing my claim, following diagnosis with ms. The reason they have refused it was because on the original claim form I said no to the questions "have you ever had any problem with your eyes or vision" and "have you any physical defect or are you subject to any ailment or condition not already described". A few months before saying no to these questions I had visited the doctor cos I had mild loss of sensation in my legs. According to my medical records I also complained of "lazy vision" though I have no memory of this. The doctor told me it was "NOTHING" and it went away. I forgot about it. I never even thought about it. So I ticked "no" to those two questions (in good faith) and now they are refusing to pay out. I have to wait til Monday to find out how to appeal. But I'm going to. So my qs are - how do I go about getting my medical records - is there some ludicrous bureaucratic pocedure that needs giong through? If there is a difference between the patient's perception of what happened during a gp consultation, and what the gp wrote on your notes, how is this dealt with when it comes to things like insurance claims? And thirdly how relevant is the "utmost good faith" thing. The letter claims this is a legal concept ndthe basis of all claims - well I did act in "utmost good faith" - could this work in my favour?

anchovies Sat 23-Jul-05 09:51:49

Sorry to hear they are giving you hassle.

You can just request a copy of your notes in writing, I just had to pay for printing. Perhaps you should speak to your doctor re the consultation?

I am sure you will be ok once you appeal.

hatstand Sat 23-Jul-05 10:20:49

I have sussed what the reference to "lazy vision " was. When I went about my legs the GP asked me if I had any problems with my eyes. I replied that sometimes when I've been doing close work (reading, working at computer) and look up it takes a few seconds for me to refocus. I said this is in a "no but..." kind of way, It had never been a problem.

Bethron Sat 23-Jul-05 10:28:13

Message withdrawn

Bethron Sat 23-Jul-05 10:28:42

Message withdrawn

hatstand Sat 23-Jul-05 10:49:17

another even more technical q for any lawyer-type people - in the letter refusing my claim they say that if I had answered differently they would not have insured me on the same terms. If I were to ask them to prove this, is it a) feasible they might be bullshitting me and b) if they are bullshitting (ie if the answers would actually have made no difference) does that give me grounds for appeal?

CountessDracula Sat 23-Jul-05 10:51:36

hatstand my dh is a medical lawyer with insurance experience I will ask him when he gets back from walking the dog

SoupDragon Sat 23-Jul-05 10:54:08

I would imagine, Hatstand, that they may well have insisted on investigating those particular medical points more thoroughly before insuring you. eg I have had a benign tumour remved and also a couple of moples - my insurance required further confirnation of these events before they would insure me.

Ladymuck Sat 23-Jul-05 11:04:00

I'd make an appointment with your GP and go through your notes before even copying them. You should also ask to see copies of what he has given to the insurance company.

hatstand Sat 23-Jul-05 11:14:40

LM - I agree, I think that would be a good start. Have also just realised (rather belatedly and dimwittedly) that my bf ever (chief bridesmaid, known her since age 12 type bf) is a lawyer who acts for insurance companies on medical claims. I'm going to speak to her and ask her to look at all the papers for me.

CountessDracula Sat 23-Jul-05 11:39:51

Really Hatstand? Bet dh knows her, is a v small world.

hatstand Sat 23-Jul-05 12:23:02

she's a partner in a firm in Birmingham. still likely?

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