SALLY SORTS IT: Insurer won’t pay £36k claim after my cardiac arrest

I went into cardiac arrest in October 2020 and tried to make a claim on my critical illness insurance with Royal London. The claim was rejected.

I contacted the Financial Ombudsman but did not proceed as I wanted to put the events behind me and move on with my life. Unfortunately, two weeks before Christmas 2022, I suffered another cardiac arrest and was in hospital for two days.

I had thought the original incident was just a blip and I was very lucky to survive, but now I accept that this is something I have to live with.

While lying in bed I saw your article on 28th December in which you helped a fellow cardiac arrest survivor successfully claim his critical illness insurance with Royal London.

My experience is similar and I was wondering if you could help me. I have had a policy with Royal London since 2006 with a critical illness benefit of £36,258. Any help is greatly appreciated.

Ann.

Sally Hamilton replies: To return to the case of cardiac arrest referred to in your letter, the policyholder I helped was initially told that he could not claim on his critical illness insurance because this type of health incident was excluded from his policy .

But after my intervention, Royal London fully investigated his case and agreed to pay him the full £244,000 cover, taking into account additional aspects of his state of health.

Cardiac arrest is a typical exclusion in old-fashioned critical illness policies because, to put it bluntly, few people have survived such incidents in the past. Cardiac arrest is when the heart stops pumping blood around the body, usually caused by an irregular heart rhythm.

In the case of heart attacks (which are usually covered), the chance of recovery was much higher and policyholders could benefit from the financial buffer of a benefit.

Heart attack means the death of part of the heart muscle, usually due to a blockage, clot, or narrowing of the arteries.

However, due to medical advances, the chances of surviving a cardiac arrest are higher today. As a result, some more modern critical illness policies than yours now cover these episodes, as long as they are severe enough to require an implant as part of treatment.

As happened with the first case I investigated, you were delayed from making an official claim in 2020, apart from the initial investigation to Royal London, because the call handler had told you that cardiac arrest was not covered.

After contacting me, you wrote to Royal London citing my article and asking the company to reconsider your case.

At the same time I made a similar request and the insurer agreed to take a closer look at your case to check if anything was missed as long as you filed a full claim.

You did this quickly, with the help of your wife. As you were still ill I contacted her and Royal London in the weeks and months that followed, with the insurer confirming investigations were continuing.

As with any medically related insurance claim, it can take forever to reach a conclusion, with letters and documents going back and forth between policyholders, doctors, claims handlers, and in-house medical experts.

But finally, more than five months after I set the ball rolling, Royal London got back to me with some excellent news. It had decided to still pay your claim.

Royal London said that while cardiac arrest may not have been covered, the fact that you were unconscious and unresponsive after the original incident meant your claim could be considered under the policy’s coma definition, which is covered.

A spokesman for Royal London says: ‘After considering all medical evidence and reviewing the matter with our medical adviser, we will pay the full amount insured.

“The case is complex and did not definitively meet any of the definitions of his policy.

Cardiac arrest is not one of the defined events covered in his policy and our loss adjusters, in consultation with our medical officers, have found no evidence to allow the claim to be paid under the definition of a heart attack in this case. We also examined the evidence to see if the coma definition was met.

“While it is not clear that the policy definition of coma has been met, we recognize the significance of the event he experienced and taking into account all the overall circumstances, we have concluded that sufficient elements of the coma definition have been met. to justify a payment.

“The decision is in line with Royal London’s objectives to pay as many claims as possible and the sum of £36,258 will be paid.”

Your wife told me that you were both very happy with the result.

DVLA demolished granddaughter’s license plate

In 2014 I bought my granddaughter a personalized number plate from the Driver and Vehicle Licensing Agency (DVLA) for £799 to keep and give to her for her 17th birthday in 2027.

I put the paperwork in a drawer for safe keeping.

In 2020 I read in the press that unless “cherished” numbers like mine, which were held in trust, were re-registered, they could be lost.

But when I tried to register the record again, I discovered that there was a problem.

As I hadn’t made a one off payment of around £25 – which I knew nothing about – DVLA had scrapped the number.

I have tried to appeal, but to no avail. I’ve been thinking about it again recently and was wondering if you can help as it seems completely unfair.

GR, Newcastle upon Tyne

Sally Hamilton replies: You were pleased with yourself when you found the YV13 JAY license plate, based on your granddaughter’s name, to give as a special present, albeit many years in the future.

You explained to me that when you received the documentation by mail you could see the correct registration number through the window of the envelope, so you left it unopened and put it away.

This turned out to be a big mistake. If you had opened the letter it would have revealed that the document – a V750 certificate of entitlement – had an expiry date and you would have to re-register the personalized number after 12 months and pay a £25 fee.

Your timing was unfortunate in this regard, because a year after you made your 2014 purchase, the DVLA rules changed.

As of 2015, buyers of personalized license plates (also known as cherished license plates) only had to renew the certificate after ten years for future use, if the number had not already been assigned to a vehicle.

I asked DVLA to check if anything had been overlooked in your case, but I’m afraid it confirmed it couldn’t do anything because you didn’t make the correct payment.

A DVLA spokesperson says: “As per standard procedure, DVLA has correctly issued the customer with a V750 Certificate of Entitlement with the expiration date on it.

As a service, DVLA also sends reminders three to four weeks before the due date to remind customers of the payment of the retention fee, which has been issued in this case.’

You told me you never received the reminder from DVLA. With this in mind, I asked if DVLA might, as a gesture of goodwill, consider giving you a comparable registration number in lieu of the one that was lost.

After all, the original number had been paid for. I’m afraid to say DVLA refused.

For people who have a personalized registration, whether for later own use, or as an investment or gift for someone else, it is essential to check the expiration date to avoid the same loss and disappointment.

Basically, registration numbers purchased before March 9, 2015 were typically valid for 12 months and had to be renewed each year for a fee.

Purchases made since March 2015 come with a certificate with a ten-year expiration date, after which holders must renew if it has not been transferred to a vehicle. If a certificate has expired, unfortunately the license plate has also expired, as happened with you.

I’m sorry to be the bearer of this bad news. Yours was an expensive lesson to learn that it is vital to read important documents received in the mail before filing them away.

• Write to Sally Hamilton at Sally Sorts It, Money Mail, Northcliffe House, 2 Derry Street, London W8 5TT or email sally@dailymail.co.uk – include telephone number, address and a note addressed to the offending organization giving them permission to talk to Sally Hamilton. Please do not send any original documents, we cannot take any responsibility for that. The Daily Mail assumes no legal liability for answers provided.