A woman, whose husband has been diagnosed with terminal lung cancer, has had her claim for a life insurance payout rejected by Aviva. The couple has been paying premiums for 24 years, including terminal illness cover, which promises an £80,000 payout if the policyholder is diagnosed with a terminal illness with less than 12 months to live. However, Aviva is refusing to pay out because the policy is in its final 18 months, and the company has a clause that excludes terminal illness claims during this period.
The woman is devastated by the decision, which she believes is unfair and cruel. She had checked Aviva’s website, which suggests that a terminal illness diagnosis with less than 12 months to live means benefits are paid immediately. However, the 18-month exclusion clause is buried in the small print of the policy, which was taken out in 2001. Aviva policies sold after 2013 do not contain this clause, which the company seems to have realized was unfair.
The woman’s husband was diagnosed with cancer last summer, and the oncologist has warned that he may not live beyond Christmas. The woman is struggling to cope with the emotional and financial burden of her husband’s illness, and the rejection of the claim has added to her stress. She has lost weight and is finding it difficult to work, and the £80,000 payout would make a significant difference to their quality of life.
Aviva has refused to deviate from the terms and conditions of the policy, citing its “principles of treating all customers fairly and our duty to take a consistent approach across all claims decisions.” The company claims that policies sold before 2013 had lower premiums because they did not include the terminal illness benefit in the final 18 months of the policy. However, this clause has been removed from policies sold after 2013, and the woman believes it is unfair that she and her husband are being penalized for taking out a policy before this change was made.
The woman is considering sending her case to the Financial Ombudsman Service and wants to raise awareness about the clause to warn others who may have similar policies. The Financial Conduct Authority has also looked at this issue and has warned insurers that clauses that prohibit terminal illness claims in the last 12 months of a policy can cause “potential foreseeable harm” to customers. The woman’s case highlights the importance of carefully reading the terms and conditions of insurance policies and seeking advice before purchasing.