‘I earn six figures as a KC, but insurer refused to pay out my full salary when I nearly died’

KC
KC

Dear Katie,

I was taken seriously ill in November 2023 and had to go to three hospitals in two weeks due to thrombosis on my abdomen and lung.

It was life threatening, and if it had not been for the vigilance of my GP I could have died. The NHS hospital I was treated at did an amazing job, but it was a very frightening experience.

I am a barrister and KC so I am self employed as a sole trader. I have been unable to work since this experience and my doctors have signed me off until they know I have recovered sufficiently to undertake very complicated and stressful work at the Bar.

I have always taken insurance quite seriously and took out an income replacement policy with Reassure. This was designed to pay me a salary in the event I could not work for some reason, however the amount it has offered to pay out does not reflect my true earnings.

Due to the nature of my job, and the effect the pandemic had on the courts, my salary has fluctuated greatly over the past five years. I feel Phoenix Group, which has taken over the policy, has calculated what it should pay me as a monthly replacement income in a way that rather conveniently suits it, but at my expense.

I do not understand why Phoenix is dragging its feet, but every day they ask for some other obscure piece of information despite already having received all my medical reports. Despite me applying early for the cover they did not start the process until late January. I have had to put up with sneery and sarcastic comments and no agreement to decide this matter in a sensible time frame.

A proper payout would make a significant difference to my financial position and allow me to recover and go back to work. In truth I feel more stressed dealing with insurers than I did when I was in hospital.

Anon 

Dear reader,

I was so sorry to hear you had been so unwell and then received such poor treatment from your insurers.

You were bitterly disappointed when Phoenix eventually offered you income replacement of £5,000 a month (equivalent to around £90,000 a year). As you say, your income fluctuates due to the nature of your job, but in the seven months prior to you becoming unwell you had earned around nearly £150,000. On a pro rata basis this works out at more like take home pay of £25,000 a month.

Over the past few years your income had dramatically reduced due to the pandemic and the lasting effect this had on courts, down to five figures in some years.

Before the pandemic you earned in excess of £500,000 in your most lucrative years. Phoenix had used your last three years of earnings to calculate the £5,000 a month payout, even though it had originally stated on a phone call to you that it would be happy to take the last five years’ worth, which, of course, would have been more beneficial to you.

When I asked why it wasn’t sticking to five years, it said you were told this in “error”, and offered you £1,250 in compensation. I said this wasn’t good enough and you provided it with some more information, including details of a big case which would have pushed your earnings above £400,000 over the past year, had you not been forced to stop work.

Although it insisted on sticking to its three-year rule, Phoenix Group raised your monthly income replacement to £13,000 a month, and backdated it to March 1. You were grateful for this, although you are still furious at the amount of stress this has caused you at a time when you desperately need to be resting.

A Phoenix Group spokesman said: “We have accepted the customer’s income protection claim and are making payments until the current medical evidence confirms he can return to work.

“Following his complaint on the earnings considered for the claim, we requested additional information on the financial and circumstantial evidence that was initially provided. Having reviewed this additional information, we are increasing payments based on a consideration of his exceptional personal circumstance. We have offered compensation for any distress and inconvenience caused as a result of delays in reviewing this case.”