Aviva denied our sick son help after five-month wait | Insurance
Our 16 -year -old son has an incurable degenerative disease And now needs care 24 hours a day. My husband had to abandon the work to take care of him but Aviva Refuses to pay by our serious illness policy.
We pay £ 60 per month for coverage since 2007.
Our son was born in 2008 and diagnosed with spinal muscular Atrophy with respiratory distress (SMA-RD) when he was eight years old.
He succeeded in the general public school until June of last year, since when his health has deteriorated considerably and he has a paralysis in the four members.
We contacted Aviva in January to discuss our eligibility for a complaint. We were transferred between three departments and expected More than three and a half hours. A adviceEr said on several occasions that he did not meet the criteria, but would not tell us what the criteria were.
We have twice asked copies of our politicians, but they have never been received. We raised an official complaint concerning their communications in February And our consultant submitted medical reports.
At the end of June, our complaint was refused. His argument is that Sma-RD is a genetic condition This would have been present at birth, while its coverage on our policy only started its first anniversary.
I guess that’s why Aviva reported £1 billion Operating profit in the first half of this year.
Nl, Belfast
Insurers look at human suffering through the objective of terms and conditions and cold cold money. These must be – they are companies. But trade does not prevent compassion and it was shamefully missing in the relations of Aviva with you.
Despite the urgency of your situation, it took five months to make a decision. The messaging track you sent me shows your repeated procedural actions for updates.
Your serious illness policy automatically covers children once they have reached their first birthday. The terms and conditions indicate that the diseases that are present of the birth are not covered and that the symptoms should not have started at the start of the coverage.
You asked for advice when your son was one because he did not fill out certain development targets, but not all tests came back. It took seven years before being diagnosed with SMA-RD.
The Ombudsman’s financial service stipulates that it generally maintains complaints concerning complaints rejected due to pre -existing conditions of which the customer was not aware.
He also indicates that he replaces the exclusions of the terms and conditions of insurers if the customer had only general symptoms at the start of the coverage, and would not have reasonably predictable that they would later give a complaint.
There are many reasons why a year may miss widespread development milestones and most are not incurable diseases. So I put it in Aviva that you would have had no way of knowing that your young son had a serious illness that would lead to a complaint 15 years later. I suggested that, given the complexities and time ladders, she rejected the unreasonably complaint on technicality.
I was surprised by the speed of Aviva’s response. Within two days, he had told you that, although he considered that your complaint had not respected his terms and conditions, he would pay you the £ 10,000 allowed by your police. He freely recognized that his turn was caused by my intervention. The money was on your account a few hours later.
He says: “We fully recognize that our service and our communication do not meet the standards that our customers rightly expect us. The family situation should have caused a more urgent and compassionate response.
“Although we are unable to approve the complaint of NL’s son because of the terms of the policy, we recognize the unique circumstances of this case and the shortcomings of our service, and believe that it is appropriate to make a goodwill payment which is equivalent to the profit that the family would have received if the complaint had been eligible.”
Come to zero
Most companies succeed most of the time. Most do it well when they don’t. And some go beyond expectations so beautifully that they deserve a cry.
“I have a pair of sunglasses of £ 73 that adapt to ordinary glasses,” writes LR of Colchester. “I have macular degeneration and UV protection helps slow this. My puppy kept them and scratched the lenses. I called the company to ask if it damaged UV protection, and I was told that, under the terms of the warranty, I could get a new pair by paying £ 2.99 for post costs.
“I said that I did not think that a four -month German shepherd was considered” normal wear and tear “, but a new pair has duly arrived.”
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