At last! £280k payout for MS sufferer - after he spent THREE YEARS trying to make L&G honour his illness policy

By Jeff Prestridge, Financial Mail On Sunday

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One of the country’s biggest insurance companies has backed down under pressure from Financial Mail and agreed to pay a disputed £280,000 protection insurance claim to a multiple sclerosis sufferer.

Legal & General had refused to pay up despite two rulings from the Financial Ombudsman Service in favour of the policyholder, 40-year-old Mark Cannon of Strathaven, South Lanarkshire.

Delighted: The payout will bring security for Mark Cannon and his wife Sharlene

Delighted: The payout will bring security for Mark Cannon and his wife Sharlene

Mark is delighted the insurer has finally seen sense and says Financial Mail’s intervention was a big factor. ‘There are no words that can adequately explain my thanks and gratitude towards Financial Mail in assisting my complaint against Legal & General,’ he says.

We highlighted Mark’s long battle with L&G two months ago. It began shortly after Mark, a clerk at the Sheriff Court in Hamilton, South Lanarkshire, fell ill in June 2009 and thought he was having a stroke.

He says: ‘The whole of my left side went  numb. I went straight to hospital and I was referred to a neurologist.’

In early 2010 he was diagnosed with multiple sclerosis. ‘I could feel my life turning upside down,’ he says. ‘For the first time in my life I was scared.’

The only comfort was that Mark and his wife Sharlene, also 40, had bought a life and critical illness policy to protect themselves and their family in the event of either of them dying or suffering a serious illness. Such policies pay a set lump sum when a claim is accepted. The couple have two sons, Mark, 2, and James, 5.

But Mark’s claim was rejected by L&G because he had failed to disclose ‘some medical details’ – an episode of blurred vision later linked to nothing more than a cold virus – on his application form.

Such non-disclosure was deemed negligent by the insurer.

A furious Mark took his complaint to the  Financial Ombudsman Service, which has the power to adjudicate on such disputes and force an insurer to pay up. In July last year the FOS said it was ‘unreasonable’ for the insurer to decline the claim on grounds of non-disclosure. It said it was reasonable for Mark to regard his blurred vision as not significant enough to disclose to L&G. 

 

More importantly, it said the fact that his doctor had not mentioned the eye problem in the report he filed to L&G as part of Mark’s application backed this conclusion.

The Ombudsman recommended full settlement with interest payable at eight per cent a year from the date of Mark being diagnosed with multiple sclerosis.

Pleased: Protection specialist Alan Lakey

Pleased: Protection specialist Alan Lakey

Legal & General challenged the decision, but last September the Ombudsman said it saw no reason to change it. The insurer still refused to pay up. In a statement made to Financial Mail in January this year it said it wanted to seek further evidence as to whether the ‘diagnosis’ of multiple sclerosis had been fulfilled.

Last week L&G said: ‘We have now finalised the claim in relation to Mark Cannon. Our aim is always to pay valid claims. In accordance with the ruling by the Financial Ombudsman Service and the subsequent evidence provided by his consultant, we are pleased to pay him the full amount.’

Alan Lakey, a protection specialist from Highclere Financial Services in Hemel Hempstead, Hertfordshire, says: ‘It is gratifying to see Legal & General paying Mark Cannon’s claim although it seems to me that the process was rather drawn out and could have been handled a lot better.

‘Unfortunately, consumers will always remember the negative aspects and this episode has not helped Legal & General or the protection insurance industry in gaining the trust of the consumer.

Protection insurance is a vital component of a household’s financial armoury.’

Sharlene, who is a foster carer, said last night: ‘I’m shocked but delighted with the decision to pay Mark’s claim. It means that we now have the financial wherewithal to clear our mortgage.

‘It also means we have a financial cushion that will allow Mark to reduce his working hours to cope with his tides of overwhelming tiredness and enjoy quality time with the family.

‘I’m sure if Financial Mail had not got involved, we would never have got our payout. Thank you.’

 

The comments below have not been moderated.

Once again DM you highlight a rare and very large case that went wrong to ring out the most from your readers.Then you wonder why we have so many people not taking out any insurance and then relying in the state when loved ones die or become seriously ill You cannot have it both ways! As ever you fail to mention the hundreds of £millions that are paid out by insurers every year with most providers honouring well above 90% of claims.I am not excusing L&G; here ,far from it ,but lets have some balance in the reporting? Not everyone tells the truth when taking out policies and claims especially in relation to drinking, weight and Dr's visits either.Why is car insurance so expensive now ,despite fewer accidents than 30 years ago? Because of all the false claims encouraged by no win no fee solicitors,yet what is actually being done about them?

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The ombudsman is a great service this case would have cost in excess of £60,000 to take to court,no ordinary working person with a illness could afford this this is why the government should be again looking to increase the ombudsman's powers.the only people who could fine L&G; are the financial service authority they would not do so in this case as it was just the one complaint.however if the power to fine companies who take too long or try to limit the amount by using their own legal team against the ombudsman is passed to the ombudsman we the customer would have far more confidence and security to many of these companies have husband and wife on different boards there cannot be 100percent impartial.

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Can we replace the Financial Ombudsman with Financial Mail please? Its far more effective.

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The ombusman can only legally make the company pay £100,'000 at the time of this complaint ,the amount is now150'000 ,however they can recommend that if the amount is more than that figure that the insurer pays out.L&G; are one of the companies that if they disagree with the ombudsman decision they pay no more or the term they use is limit the amount to the £100'000 enforceable by the ombudsman.There are however other insurers who abide by the ombudsman decisions wither they agree or not it seems the bigger the company the more likely they are to refuse L&G; are bullies and I and all my friends and family will have nothing more to do with them or any company ie Churchill that they own or have any part in until they clean up their act and start doing what the ombudsman asks.

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The most worrying aspect is that despite 2 rulings from the Ombudsman they still failed to pay. So what does that make the Ombudsman .. pretty useless really, We have all been led to believe that the Ombudsman's decisions are the final word and therefore we have kept the status quo thinking we had full proof redress if we were treated unfairly. What this demonstrates is that we are being conned.

Click to rate     Rating   7

well done the Mail for helping out - Sad that it had to get the the stage of involving a national newspaper for L&G; to pay out..shocking!

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The biggest con is national insurance. Even if you're unable to jump through hoops, you have to jump through hoops to claim, and if you can, you're not ill enough to need it.

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So everyone, time to boycott Legal and General. If they want to take money and no treat people fairly even after medical ruling/ombudsman then do not give them your business. AVOID THEM LIKE THE PLAGUE! Do not buy from Legal and General! BAD BAD Company!

Click to rate     Rating   36

Legal and General were quoted as saying they were pleased to pay him the full amount.Firstly it is not him it is Mr Cannon a customer of yours,show this man some respect.Legal and General were not pleased to pay Mr Cannon this because they would have had this claim sorted out ages ago. The Ombudsman came out in favour of the policyholder and this bold company had still refused to pay out.Shame on you Legal and General and thank goodness for Financial Mail's intervention.

Click to rate     Rating   2

We commit To ensure customers do not receive inappropriate advice from our Group Ethics Committee appointed representatives To making it easier for our customers to do business with us. Develop a dialogue with all customers (individuals, intermediaries and institutions). YEAH RIGHT L AND G

Click to rate     Rating   12

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