HomeBusinessHELENA KELLY: Why should PTSD diagnosis cost me vital cancer claim?

HELENA KELLY: Why should PTSD diagnosis cost me vital cancer claim?


I am 32 and was diagnosed with stage four thyroid cancer at the end of last year. I had to undergo a life-saving operation which could have left me unable to speak, and I had to give up my job as a horse-riding coach.

Luckily, I’d taken out a critical illness cover with the firm Guardian 1821, which entitles me to a £30,000 payout. As I am the main breadwinner in my family, my partner and I desperately need this money to help keep us afloat. I have a seven-year-old son, too.

Yet the day before my operation, I spoke to a Guardian 1821 representative who gave the impression that I was highly unlikely to receive a penny.

Abandoned: Health insurer Guardian 1821 refused to payout on a critical illness policy, claiming that the policyholder had not informed them of a nine-year-old PTSD diagnosis 

They suggested this was because I had not disclosed a PTSD diagnosis from nine years ago, for which my GP had prescribed antidepressants.

This has caused me distress and left me questioning whether I should even have the operation. I cannot understand how having PTSD in my early 20s is relevant to my cancer diagnosis.

A. D., Glos.

Helena Kelly replies: What a terrible time for you and your family. I was heartened to learn you did have the operation and did not lose your voice.

But going to battle with an insurance firm is understandably the last thing you need as you try to recover, so I was happy to intervene on your behalf.

The problem here is not the PTSD diagnosis itself, but your failure to disclose it to the insurer before taking out the critical illness cover.

If you are not transparent about your medical history, firms can later deem your policy invalid and reject claims. However, insurers must weigh up whether this act of non-disclosure was deliberate or accidental.

The onus is also on providers to ensure they ask the right questions, rather than expecting customers to know what information they must provide.

And rules set out by the Association of British Insurers (ABI) say firms must have the full consent of the patient before obtaining their medical information.

When considering claims, insurers must also establish if the condition omitted would have impacted the policyholder’s eligibility for cover.

In the first instance, you say the broker which made the application on your behalf never asked if you had suffered from any mental health conditions. You insist you would have declared the PTSD diagnosis had you known.

Experts also say it’s unlikely that a prescription for antidepressants would have resulted in your application being rejected.

Alan Knowles, who founded Cura Insurance, says: ‘Insurers have become better on the topic of mental health in recent years, so it’s hard to see how the disclosure would have impacted the policy. A lot of people on antidepressants are offered cover at the same rate as those who are not.’

A Guardian 1821 spokesman refutes claims that an employee told you it was ‘highly unlikely’ you would receive a payout. But the firm refused to provide the call transcripts to support its claim.

Regardless, the conversation obviously caused you enormous distress at a very sensitive time. When I first contacted Guardian 1821, I was told they were still reviewing your case.

But they have since agreed that you will receive the full £30,000 owed — though deny this is down to Money Mail’s intervention.

A spokesman says: ‘We were made aware, via information sent from the customer’s GP, of some information not being disclosed at the point of purchase. We paid [the claim] in keeping with our usual claims processes, having considered all of the information, because it was the right thing to do.’

With more people seeking help for mental health conditions, your letter serves as a timely reminder to take care to declare any treatment to insurers.

Can’t get Barclays to change my address

In July my husband paid in £20 for me at Barclays, and handed in a signed letter from me asking to change my address. The teller said I must go into the branch.

My husband said that I can’t walk far, as I am nearly 80 and have hip and back problems. There is no nearby parking.

Barclays then wrote to my old address saying that it would not change my address because there was no proof of identity.

The account only holds £311.74 so I decided to close it. I sent a form, proof of identity and my Lloyds Bank account number to transfer the money to. 

Barclays refused, saying I could open an online account to change my address. I don’t have a debit card or smartphone so I couldn’t do this. I was also told that there is no record of £20 being paid in.

I then went to the small claims court. Barclays hired a solicitor who said I would lose and have to pay all their costs.

S. C., Trowbridge, Wilts.

Helena Kelly replies: Barclays has failed to take into account your lack of mobility, nor offered sufficient support. I’m concerned that the threat of costs was made to encourage you to withdraw your small claims case.

Barclays says you were given a number of options to prove your identity including by telephone, and that you didn’t take up this offer. However, it admits that it could, and should, have done more to help resolve the matter.

What of your £20? Well, that falls at your door. The paying-in slip was for an account you had closed before 2003. Barclays had recycled the account number so it is now in someone else’s name.

Barclays admits it should have spotted the account name and number didn’t match. It apologised for its errors, credited your £20 and closed your account. It also refunded your £50 court fees.

A Barclays spokesman says: ‘The safeguarding of customer accounts is our highest priority, and we therefore have verification steps to protect against fraud. For this reason, address details can’t be changed in branch without the account holder being present.’

Straight to the point 

I read in Money Mail last week that first and second-class stamps will be phased out next January and replaced with ones with barcodes. 

It said stamps used after this date would be subject to a fee. What does this mean?

Anon, via email.

If you use a stamp without a barcode after January 31, 2023, you will incur an incorrect or insufficient postage charge in the same way you would if you had not used a stamp at all.

You will be able to exchange old stamps for new ones from March 31 this year, when Royal Mail launches its ‘Swap Out’ scheme. More details about this will be available soon.

*** 

In October 2020, my Thames Water bill was double the usual cost. I told the firm I thought I had a leak, which was confirmed in June 2021. 

A water meter was installed in September. The bills should have been adjusted in light of this, but I have heard nothing since.

B. H. via email.

Thames Water confirmed that an engineer fixed a leak at your property in June and has recalculated your bill. 

A spokesman apologises for the delay in refunding you, and offered a £200 goodwill gesture and a £20 ‘customer guarantee scheme payment’.

*** 

My husband and I were due to visit Blenheim Palace as a Christmas treat. 

Sadly he became unwell during the two-hour journey and we had to return home. I am now struggling to get the £117.10 tickets refunded.

R. T., via email.

You paid extra for cover in case you could not make the date. But the third-party provider said it could not accept a claim without medical proof, which you did not have. 

However, Blenheim Palace has now refunded the money.

*** 

My wife and I parked in a disabled bay in Gainsborough, Lincolnshire, and paid 50p for a ticket. But we later received a £100 fine, reduced to £60 if we paid it within 14 days.

C. R., Lincs.

Your wife had kept the ticket which you sent as evidence when challenging the fine. But it was only reduced to £20. 

I contacted Ombudsman Services, which runs appeals on behalf of the British Parking Association, and it has now agreed to cancel the fine altogether.

*** 

I paid £35 for an annual delivery pass with Morrisons but only used it four times as I started doing my shopping elsewhere. 

According to its website, I am entitled to a refund of the unused portion. I have not been refunded, and £35 was also taken from my bank for another pass.

A. R Comber, via email.

Morrisons accepts you are eligible for a full refund and has apologised for the time it took for this matter to be resolved.

  • You can write to: [email protected] dailymail.co.uk or, if you prefer, Ask Tony, Money Mail, Northcliffe House, 2 Derry Street, London W8 5TT — please include your daytime phone number, postal address and a separate note addressed to the offending organisation giving them permission to talk to Tony Hazell. We regret we cannot reply to individual letters. Please do not send original documents as we cannot take responsibility for them. No legal responsibility can be accepted by the Daily Mail for answers given. 

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