What won’t my critical illness insurance plan pay out on?
There are a few reasons when your critical illness policy will not pay out, for example the main one is if you don’t give the company concerned all the relevant facts when underwriting the case. The other main ones are: -
Suicide, the policy will not pay out if the life assured has committed suicide within 12 months of the policy starting. War, the policy would not normally pay out if there was a civil war, riot rebellion or revolution. If the life assured died as a result of a self inflicted injury they would also not get paid out.
Living abroad, if the life assured lives abroad for more than 12 months then the plan will not payout. This is not always the rule and with some companies so long as you continue paying the premiums with a UK bank account and the claim is made into a UK bank account this is usually sufficient.
Pre-Existing conditions. A claim will not be met if it is directly contributable to a medical condition that the applicant was aware of when he or she took out the plan. If the life assured was taking part in a dangerous sport or activity at the time of death the plan will not pay out. This could be something such as boxing, caving, motor sport, yachting or pot holing etc.
Flying is another claim that will not be a pay out on your policy, so long as your not flying in a commercially licensed aircraft in which case it will pay out. Alcohol or drug abuse, a claim is not normally paid if it is as a result of drink or drugs. In addition to this HIV is another claim that will not be paid out on if the HIV or AIDS is as a result of sexual activity or drug abuse.As with any insurance policy there are certain exceptions to even critical care policies. It is therefore essential that you know in advance what your policy will and will not pay for. One of the main reasons why a claim will be denied is if you have not completely been truthful at the time of underwriting your policy. It is necessary that you give all the necessary details at the very outset. There are certain other reasons too why an insurance plan will not pay out.
One prime exception is suicide. Any policy you take out will not be payable if the person taking the insurance has committed suicide within a year of commencement of the policy. Another reason of a larger perspective is in the country is at war. In the case of a civil war, rioting, a rebellion against the government or an internal revolution, the policy will not pay out to the insured. As a continuation to the suicide clause, if the person insured dies as a result of self inflicted injuries, then the insurance policy will not pay up.
Once you have commenced the policy, living abroad for more than a year at a stretch will result in the pay out not happening. This is a rule that is followed by some insurance providers, not all. In some other cases, if you make your premium payments into the bank of your country, it should not be a problem at all. You will be able to make a claim on your policy.
If you insurance comes to know that you are suffering from some pre-existing conditions, then there is a possibility of the claim being denied. A claim cannot be made if it directly relates to the pre-existing medical condition that the claimant is basing his case on. If you are aware of any pre-existing conditions, you should make that clear in the beginning. Being constantly exposed to dangerous sports, activities or a career path too can result in a pay out being denied. This is often in the case of activities such as boxing, cave exploration, motor sports, yachts etc.
Flight is another reason why a policy will not pay out. This is only in the case of non-commercial piloting. Commercial airline pilots have their own set of insurance policies that are taken up. It is a given that alcoholic, those on substance abuse also cannot make a claim related to illnesses that may arise due to drinking and drugs. Another major clause is the illness HIV. A claim cannot be made for this illness if it is the result of sexual activity or substance abuse.