Can I be sued for using his insurance?!?! HELP!

[BlairW]

So it's a bit complicated so please bare with me!

My now ex-partner (not married, but living together for over 10 years) covered me as part of his work private medical insurance scheme when he started with with current company years ago.

Roughly a year before we split up, I was given a major health diagnosis (not cancer) but now need regular scans, bloods, consultant reviews etc +/-medications depending on multiple factors.

When we split, my ex partner acknowledged the fault was his and that he would continue to cover me on his private policy 'for as long as I needed'. I did tell him that this could be lifelong and he looked uncomfortable (probably guilty conscious) but seemed to agree.

Fast forward a few months... the amicable nature of the break up went up in flames when I said I wanted to buy him out of the house as my mortgage had been approved. He went crackers - threats, stole legal documents from the house whilst I was at work, intimidated me near the house dressed in black.... basically long story short - the courts got involved and it has taken years and cost a bloody fortune!

The house is now mine and my next series of scans/bloods are due. In a court statement he gave during the proceedings, he stated that he cancelled me off his private policy shortly after I qualified for the mortgage several years ago.... but... and this is the legal issue.... he hasn't. My policy is very much still active and has been since he initially covered me many years ago.

I've spoken to the private provider but they are unable to do anything including remove me from the policy, as only the main policyholder can make any amendments.

Will I get in trouble legally if I still use the policy? Could he someone claim against me?

I have looked at going with another provider but they won't cover pre-existing conditions, and the same private company will transfer me to my own personal policy within 3 months of him cancelling me off his policy if/when that happens.

No because he's on some specific corporate scheme - so it's not the standard one as it's delivered via his employer

Your speaking to the wrong people. Some desk jockey at the insurance company dont know the ins & outs of your relationship. They just know you are (or were) named on the policy.

I bet if you spoke to his employers they'd be telling you a different story.

I don't understand why you are taking the risk. He will find out, you will be removed, you will have to find an alternative then.

Why not just do it now and avoid all the worry about being sued or made to pay everything retrospectively?

You are not together any longer. Don't use the fact someone made an error to benefit from something you are actually not entitled to any longer.

As I said before, almost all phi policies require adults to be living at the same address.
If you have called the insurance company, advised that you are living at the address you live at now and that they've confirmed you are covered still then there is nothing else you can do other than just be aware cover can be withdrawn at short notice.

Your response implies that you've not actually told them all the situation ie you no longer live together. The risk you run here is not that they sue you.. ypu can't be sued for not complying with terms they refuse to give you. But they could refuse to insure you.

So I've been having regular treatment throughout the last few years so if he is getting statements about that, he hasn't acknowledged them.

I can't get the T&Cs as its only available as the policyholder as its a work based private scheme (corporate package) and I work in a different organisation so its not like I can enquire and get the same deal.

I'm fine with covering myself if he does remove me - I have a good job and the company will give me up to 3 months grace period. I won't receive a notification if he does cancel me, so I check the portal roughly once a month to check I'm still covered for peace of mind.

I don't think you've read all the posts but I can't remove myself from the policy!

I've asked and been told that the only person who can amend the policy is my ex-partner.

I can't start an entirely new policy because my diagnosis won't be covered so I have to wait for him to cancel me and then transition to my own version of that same policy. The company will give me a 3 month grace period when this happens but the diagnosis will still be covered as its a continuation in their eyes and therefore not excluded as a pre-existing condition. Does that make sense?

Speak.to.his.employer.

Aren't you better off just emailing him and saying look, I'm still on your policy and I can't start my own until you remove me so either remove me or I'll continue to claim on your policy until you do.

I definitely have told them the relationship had broken down and he had moved out several years ago. They said they have no rights to amend and/or remove someone - only the policyholder

AS someone else said, there is no way the insurance company can sue you for breaching terms if they will not provide them.

So long as you asked for the terms and they declined, and told them you reside separately and they said that is fine, you are good to go.

You could record such an exchange on a dictaphone and note the date / time, get the call centre operatives name to cover yourself.

The policy holder will be his company, not him. You need to tell them that you are no longer in a relationship and are not living together.

As it was him who moved out, could be he has not changed the address.

This.

Then if you've been totally up front and informed them of the situation and they've said they're still covering you, there is no risk of being sued !

If you can afford it then why not take yourself off the policy now and pay the £4k?

I have a Restraining Order in place... if I email him I will breach it and it will give him a legal defence that I re-established contact.

No - I will not contact his employers. If he ever found out, he would go mental!

Is he really going to kick off ? At my work I'd be the one in trouble as my policy only covers my partner and I'd get in massive trouble for allowing someone to remain covered because I hadn't informed HR I was no longer in a relationship.

Because, as stated in that post, the condition would be excluded as it would be a pre-existing condition.

I mean, the most obvious thing to do is to contact him (in writing) and tell him. I get he’s a dickhead, but I suspect he will be more angry if you contact his employer then if you contact him!

I suspect the taxable benefit value of the policy is more expensive for him as a family policy than just a policy with him on it, so it possibly isn’t right to say that there is no financial impact for him.

I would also email the insurance company to put it in writing, so they can’t deny what you have told them.

Then just crack on until something changes.

Hope your treatment is going ok. Good luck.

Oh Yes!!!

He would go mental. He can't take any accountability for his own actions and directs it at me, hence the NMO/restraining order.

But as the protection order is due to lapse soon as all the legal proceedings for the house ended last month, I don't want to rock the boat.

Stop using the policy.

He told you that you have been removed in a court setting - take him at his word.

If you needed a restraining order you need to break all ties with him.

Either use the nhs, pay yourself or take out your own insurance. Stating it will cost more is irrelevant. You are no longer in a relationship and he has said he removed you. There are no grounds for you continuing to use the policy.

What I can’t understand is that if he cancels you and you start a policy with this company you will be covered but if you just say I want my own policy now it is a pre existing condition , it makes no sense .

Yeah, I'd want it in writing that they were happy to do this, likelihood is even if they do the premium will be very high, insurance companies don't like to loose.

OPs ongoing claim is probably hiking ex partners employers premium!

She’d be with the same company though. For example for pet insurance. Say you have a policy that covers your dog who develops a chronic condition. If you move to a new insurer they’d exclude that condition but you could change your policy with the existing insurer and get continuous cover.

OP can’t have her own policy with the insurer as already covered but if she goes elsewhere the pre-existing condition won’t be covered. OP you’ve explained the situation to the insurers . I’d message him asking to be taken off and save that message.

So I can't get cover privately until he cancels the policy and NHS is atleast a 18 month waiting list just for initial consultant review. I can't leave my condition unmonitored for that long as it could permanently impact my vision and several other things but my vision is the big one for me as I would lose my career.

So at present I have a policy number with the provider. My diagnosis coded under that policy number so as long as I keep the policy number (whether thats via his corporate scheme or personally funded), the condition is covered.

Any new policy would generate a new policy number - so the diagnosis would then pre-date the creation of this number thus it won't be covered as its considered a pre-existing condition.

As my ex-partner was someone with a strong moral code, when he said he would cover me for as long as it was needed I believed him. It's only since seeing the witness statement that I've suddenly become doubtful and worried as he stated he removed me 2 years ago.