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Terminal life insurance payout

User
Posted 03 Jul 2019 at 09:23

I was diagnosed with advanced PC in 2015.The consultant gave me a letter stating my life expectancy was in the region of 5 yrs.I a!so have a DS1500.

Despite this Aviva with whom I have a terminal life insurance policy to cover my remaining mortgage are refusing to pay out. The last time I tried to claim they said that their consultant whom I have never met said he does not agree with the claim as I have to have less than 1yr ,how can you possibly claim on this insurance ? I am presently on Enz, prostap, slow release morphine and steroids and my PSA as of last week is rising. Has anyone else had this problem with insurance ? If they were to pay out it would pay most of my mortgage off and make one less thing to worry about  if my wife and I haven't enough.

User
Posted 03 Jul 2019 at 10:06

I don't know the conditions of your insurance, so I can't comment if payout out now should be done or not. If you think they're wrong, you could make a complaint to the insurance ombudsman.

However, with your remaining time,
a) do you need the money now?
b) do you want to spend any of that remaining time arguing with an insurance company?

If the answer to these is no, then assuming they would still pay out after your death (and probably much more easily), you might choose to leave it. One other thing to consider is who they would pay after your death, your estate, or your wife (I've no idea), and if that might make any difference for inheritance tax purposes or to the beneficiaries of your will. For example, if it became part of your estate, depending on your will, it might be that it gets split between other beneficiaries and there isn't enough for your wife to pay off the mortgage. Maybe you can express a preference to the insurance company for who gets it, like you can a defined contribution pension pot - I don't know. It may be worth getting some financial advice, to make sure things go the way you intend.

User
Posted 03 Jul 2019 at 10:18

Hi John,

I have the same aviva cover and they will only pay out if the life expectancy is agreed at 12 months or less.  The cover you needed was critical life, which is a different product.

I have a good friend who has been diagnosed with Pca and his critical life cover has just settled with him for around £800,000.  He was paying around £500 per month premiums but he has his own successful business and it was paid by his company.

He is spending £70,000 of the windfall on proton beam therapy in the USA.

Sorry to hear Aviva will not settle your claim.  May be worth taking some advice as your condition certainly appears to be terminal.  The mistake may have been the 5 year letter.  A one year letter may have been what was needed.

Sure there will be many others in this community that have similar experiences and can offer some practical advice.

Good luck on your journey and wishing you much good fortune.

kind regards

Steven

 

User
Posted 03 Jul 2019 at 11:36
Just as an adjunct, policy holders with Aviva’s Critical Illness insurance policies will not get paid out if their PCa diagnosis is Gleason 3+3=6, as they do not class it as ‘life-threatening’. Most people taking out such a policy would expect that any diagnosis of ‘The Big C’, would trigger an immediate payout.

Having said that, Aviva paid out straight away when I left my iPad in Lidl, and again when I sat on its replacement!

Hope you get it sorted.

Cheers, John.

User
Posted 03 Jul 2019 at 13:04

Projected life expectancy......5 years.
Payout when you have 12 months or less to live.
I'll have a guess at......
They will make at least another 4 years' premiums from you.
"Simples!"
(Oh wait......different insurance company).

 

User
Posted 03 Jul 2019 at 15:39

I do need the money now as I rely on my income to pay the mortgage .If I am unable to work I can't afford the payments

User
Posted 03 Jul 2019 at 15:50

Exactly what  I was thinking. How can any one say exactly how long you have to live with advanced prostate cancer. We know everyone's different , they probably hope I'll pay as much as I can before I die and they will pay the least possible

User
Posted 03 Jul 2019 at 18:09
Unfortunately clinically you are usually only classed as terminal when they think you have less than 12 months to live. I have a similar insurance with Legal & General and even though I’m now incureable they won’t pay out as I’m not classed as terminal.

Maybe try to look at it positively in that they won’t pay it out for that reason ie because you are not clinically terminal

Bri

User
Posted 03 Jul 2019 at 21:12

My understanding of payout for a terminal illness clause in a life policy is that it is triggered only when we become effectively on palliative care only. 

Whilst we are on life extending drugs that appear to be working we are not terminal. It is possible that there may be a cure or further life extending breakthrough discovered whilst we are treading water on abi or enza . It may therefore mean that within the length of time the the insurance policy runs for we may outliv ethe expiry date (unless it is a whole of life policy).

again my understanding is the the terminal illness clause is there for when they insurance co pony knows that death is imminent and they would have to pay out at that time anyway so all they are doing is bringing the payment forward by 6 or 12 months (policies differ).

as another said we have to look at the non payout at this time as a positive. At the time life extending drugs have all failed then we can make the claim supported by our consultant who would confirm that we are now terminal.

it does I believe work in our favour for other insurances as for travel insurance my understanding is that advance prostate cancer is only an insurance limiter at the time th life extending drugs have all failed.

as another said, critical illness is another type of policy and pays out on diagnosis of most forms of cancer amongst other critical things, I know that for pca you have to be Gleason 7 or more and for example they don’t usually pay out for easily treatable skin cancers. 

Sorry it’s not what you want to read.

 

Dream like you have forever, live like you only have today Avatar is me doing the 600 mile Camino de Santiago May 2019

User
Posted 04 Jul 2019 at 09:40
Thanks for all your replies, it just feels a bit unfair when you pay an insurance for 20yrs then when you need some help they seem to look for any way out. I guess I should look on the bright side of life. It's just that if they were to pay it would help greatly by removing some money worries.
User
Posted 04 Jul 2019 at 20:24

Hi there

Ours was paid out because my husband’s liver results went through the roof and the consultant was able to agree that he had less than 12 months to live, he also had a DS1500. He is still alive and that was in 2011! I complained and resubmitted after talking to the consultant first.given your treatments it is very possible that your consultant could agree with a less than 12 months prognosis since you surely are on palliative care.

Ours paid the mortgage and relieved just the situation you are in, and i cried like a baby when I got the letter.

good luck and please speak directly to your consultant and explain the situation, they may help, who knows?

kindest regards

Devonmaid 

User
Posted 05 Jul 2019 at 07:24
Hi JohnD

I was talking to a chap at my local Prostate Cancer support group who had a DS1500 and suggested as my staging was more severe than his that I should ask for one.

I broached this with my Oncologist who gave me short shrift and was told he would only provide one if he considered his patient had less than 6 months to live.

Odd the ways Consultants operate so differently.

User
Posted 05 Jul 2019 at 17:10
The DS1500 isn't a claim form in its own right, or even a passport to other claim forms. It is simply the form that medical practitioners should complete to confirm to the DWP that a patient has a life limiting progressive illness and that the medical practitioner 'wouldn't be surprised' if they died within 6 months. Some doctors and Macmillan nurses will complete it if they believe the patient is unlikely to survive for 12 months but asking someone to falsify an official statement where there is no reason to think they are at death's door is a big ask!

There are other forms you can complete to apply for benefits such as PIP and or attendance / carers allowance where you don't need to be terminal and don't need a DS1500 but you would need to check the DWP website to see whether you are actually entitled. Almost all life insurers only pay out at death or within the terminal stage; it seems you have confused life insurance with critical illness cover. Have you checked with your bank and any credit card companies etc in case you have critical illness cover policies attached to your banking?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 09 Nov 2019 at 01:19

Just been told my PSA is rising and enzo no longer working. Been offered a trial on gene therapy which I think I'll go for as it may help. Lots of aches and pains even with morphine pills!

User
Posted 09 Nov 2019 at 10:02
Hy JohnD ,I have been told my p s a is rising and enzo is not working so good. I have been on enz for 11months and oncologist has said cancer is dodging around it.I'm also on morphine and gabapentin but still get lots of aches and pain,oncologist has now put me forward for radiam 223.Hope your trial goes well if you decide to take it .Good luck Geoff.
User
Posted 10 Nov 2019 at 02:29
Hello Geoff,

It seems everyone has troubles fighting this .Was doing well on enz for 3yrs ,I guess this is just the next round in the fight for us.

Good luck with 223.

John

 
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