Yahoo News 'It's immoral': Man, 63, REFUSED life insurance pay-out by Aviva after he's told he's dying
Another terminally ill cancer patient has been refused a pay-out from his life insurance policy after being told by Aviva that he does not have long enough left on his plan.
Mark Brookes, 63, was diagnosed with terminal bile duct cancer around four weeks ago. He began researching how to make a claim through his life insurers, Aviva, after buying a policy in 2009.
Instead, Mark found the Manchester Evening News’ recent investigation into Salford resident Shaun Pinkney. Shaun was also diagnosed with terminal cancer and has recently been told by Aviva that he cannot cash out on his 15-year policy because he did not have long enough before its expiry date.
The two men say they have fallen foul of the same small print, which states the terminally ill can only make a claim for an early life insurance payment if they have 18 months or more left on their policy. In 2013, Aviva stopped selling these types of policies where there is a cut-off for claiming for terminal illnesses 18 months prior to the expiry of the rest of the policy.
Mark has been paying £52-a-month for his Aviva life insurance policy since 2009, so has paid almost £9,000 to date. It is due to expire in December this year but, just like Shaun, he cannot renew or get a new life insurance policy because of his terminal status.
“Once they stopped selling these plans, why didn’t they contact me and say ‘you’ve got one of these plans, would you like us to swap you to an updated plan at an extra cost?’” he told the M.E.N.
“Aviva has happily taken my money since 2009. We’ve still got £70,000 of a mortgage left to pay that we thought would be dealt with by a payment that will now be left for my wife to pay.”
Mark has a rare form of cancer which affects the bile duct and can often go without symptoms or pain. It was only when he ‘just turned yellow’ and started suddenly suffering from jaundice, doctors realised what was happening.
Mark had an operation around a month ago, to remove his bile duct and potentially rid him of the cancer. But surgeons found the cancer had irrevocably spread.
“When you finally start experiencing symptoms and pain, it’s usually too late,” said Mark. "I’ve been told that the cancer is treatable but not curable – it’s terminal.”
'It's immoral'
Mark will now start six months of chemotherapy and immunotherapy, but he says that’s the least of his worries.
Aviva says the 'terminal illness benefit allows customers to receive a life insurance payment early, if a medical specialist confirms that they are sadly expected to live for less than 12 months following diagnosis of a terminal condition'.
The M.E.N. understands that in both Shaun and Mark’s cases, Aviva has not changed its decision to refuse their attempts to claim as they do not have a specific prognosis of having 12 months to live. But Aviva has said that they will deny any further life insurance policies on the basis of their general terminal diagnosis.
Mark, from the West Midlands, called the gap between the deadline to claim for terminal illness benefit and the end of the rest of the life insurance policy ‘immoral’, saying it is reasonable that someone could be diagnosed with a terminal illness in that time, be refused any further life insurance, and be left with no help.
Mark, who has worked for his local authority for 42 years, continued: “I was covered but, because my policy ends in December, I’ve only got seven months left on it. I’m going to be paying seven more monthly payments and getting no benefits.
“By the time December comes, I’ll have had no benefit for the last 18 months.”
'They know these policies aren't fit for purpose'
Despite multiple requests, Aviva has not answered whether customers on older policies have been told about the 2013 decision to stop the 18 month deadline for the terminal illness benefit, or if customers are contacted individually to be warned ahead of the 18 month cut-off on their policy to advise them they may want to change or renew their package as a major element of it times out. Mark claims he never received such information.
Aviva has said ‘we communicate with our life insurance customers at the start of the policy and around three months before cover is due to end’, and ‘the terms and conditions of the policy remain the same throughout the term’. The company added ‘information about the terms of the policy, including the 18 month clause, was communicated clearly in the documents provided to the customer when they took the policy out’.
But Salford MP, Rebecca Long-Bailey, urged the insurance company to reconsider its decision, saying: "The fact that Aviva stopped selling policies with this stringent deadline over a decade ago indicates that they know they are not practical or fit for purpose."
'Knowing my mortgage was dealt with would have been something off my mind'
Mark says he has been left fearing for his wife of more than 40 years, Sandra. Sandra has had to give up her job in admin to look after her husband, and finishes work at the end of May.
“If something happens to me, my wife hasn’t got a pension, she’s had to give up work to look after me,” said Mark.
“We might have to sell up and downsize, there’s nothing more we can do. We’ve no children but we’re a close-knit family, my parents are still alive so looking after them is part of my weekly routine – my dad has dementia and needs caring for. I can’t drive now while having my treatment so all of that will fall to my sister.
“I have Crohn's disease as well, and I’ve been told the immunotherapy could mean I develop severe colitis – if that happens, I’ll have to stop treatment. Knowing the mortgage was dealt with would have been something off my mind. I don’t worry for myself, I worry for my wife.
“If they could refund payments as a gesture of goodwill, it would be something – I’m going to be paying £400 to Aviva between now and December.”
But Mark says he has had no such gesture from Aviva and fears the insurance company will not change its decision on the two men’s cases. “The only way they will listen is if this damages the business and people start thinking twice before going with Aviva,” he added.
What Aviva says
An Aviva spokesperson said: “We were very sorry to hear about Mr Brookes’ diagnosis and are very sympathetic to his situation. We understand the seriousness of his diagnosis and appreciate that this must be a very worrying time for him.
“Life insurance is designed to provide a payment to the customer’s beneficiaries if the customer dies within the policy term. Terminal Illness benefit is a feature that allows advance payment of the death benefit up until 18 months before the policy end date, if a medical specialist confirms that they are sadly expected to live for less than 12 months. It isn’t a separate benefit and shouldn’t be confused with critical illness benefit.
“Mr Brookes took out his policy in December 2009 through an independent financial adviser who would have discussed his needs and offered him advice based on his circumstances. As part of the advised sale, the financial adviser would have explained the policy terms and conditions. The financial adviser would also have provided him with copies of the relevant policy documentation including the key facts document, which explain the terms of the policy, including the terminal Illness benefit.
“Life insurance cover is available for the full 15-year term of Mr and Mrs Brookes’ policy. This would be payable to the beneficiary if either of them sadly died. An advanced payment through the terminal illness benefit is not payable within the final 18 months of the policy. This is to ensure that any benefit is paid whilst the policy is still in force. It is clearly explained in the terms and conditions of the policy, as well as in pre and post-sale literature that was sent to Mr Brookes and his financial adviser.
“We are very sorry that Mr Brookes was diagnosed with his condition within the final 18 months of his policy after the terminal Illness benefit has ceased. We regrettably were unable to accept a claim under the terminal illness benefit. To provide fair and consistent outcomes for all customers in this scenario, it would not be reasonable to consider a claim which clearly falls within the exclusion.”
