My experience with this insurer
My experience with this insurer
I am currently in dispute with this insurer following the rejection of an Accident & Sickness claim.
The reason for the rejection is particularly concerning to me. The policy wording being relied upon contains a requirement referring to a Primary Care Trust, despite Primary Care Trusts having been abolished in England in 2013.
I have repeatedly asked the insurer to explain how I could possibly satisfy this requirement under the current NHS system. I have provided evidence of the assessment and treatment pathway I have actually followed and explained that the NHS no longer operates through the organisation referred to in the policy wording.
Rather than addressing how this apparently obsolete requirement can reasonably be applied today, the insurer has maintained its position and I have now had to raise a formal complaint.
The matter is now being investigated under the insurer's formal complaints process. I understand that they have up to eight weeks to provide their final response, but this leaves me in an extremely difficult position in the meantime.
I appreciate that the complaint is ongoing and therefore I am not presenting this review as a final judgement on the outcome. However, I feel it is important to share my experience because I believe there is a legitimate question about the application of this policy wording and the way my claim has been handled.
I also cannot help but wonder whether I am the first customer to encounter this issue, or how many other customers may have been affected by a policy requirement referring to an organisation that has not existed for more than 13 years. If this wording has remained in policies throughout that period, it raises a reasonable question as to whether other customers have encountered the same difficulty without realising that the requirement itself may be impossible to satisfy as written.
However i should note the Jamie who i was dealing with was very nice and helpful, so 5* for jamie, this review iscin the process, not the front facing staff.








