027 248 9320 theo@uprotectnz.com

Securing the best insurance terms for you!

Taking up insurance cover is a breeze, particularly if you are one of those rare breeds colloquially known as “clean skins”. In the insurance industry, clean skins are healthy people with no pre-existing conditions. However, the reality is that most people have some pre-existing conditions. If they don’t, then chances are they have consulted their GP at some stage in the past who has recorded “symptoms” of some condition. This may only be based on a casual conversation. This is especially the case with GPs who are quick to write, for example, that their client may be suffering from depression or anxiety-related illnesses. This is often done without a proper medical diagnosis.

Challenging unjustified insurance exclusions

Ordinarily, this may not be an issue. However, when a client lodges an application for disability insurance the underwriter may request medical notes from the applicant’s GP. This might happen even after a client has made all their disclosures. If the GP’s notes make any speculative reference to an undiagnosed medical condition, the underwriter will invariably seize on that. They may then exclude the speculative condition.

In the current environment, we regularly see mental health insurance exclusions being proposed by insurance underwriters on the basis of a GP’s casual medical notes. These are notes that are not even backed by actual diagnosis. Here is one such draconian exclusion in relation to mental health:

“No claim will be payable as a direct or indirect consequence of any mental health disorders, including anxiety disorders, depression, stress, adjustment disorders, emotional or behavioural disorders, related to fatigue, including pain syndrome, chronic fatigue syndrome, drug or alcohol abuse, psychosomatic disorders and/or complications thereof.”

In these situations, we at UProtectNZ will push back strongly. Without delay, we will dispute any exclusions that we consider to be harsh and unjustifiable. By presenting more detailed, factual medical information where it is available, we are pleased to say we have met with considerable success.

Do you have a policy with health insurance exclusions yet the issues are no longer relevant? Make sure you raise this with us. As your health insurer advisor, we can then take care of things for you with your health insurer.

We are always committed to securing the best terms for our clients, without reservation.

It’s what we do!

Theo Simeonidis
UProtectNZ Insurance Services