Cancelling on CI: one customer's story

So I'm sitting on a train last week and the BlackBerry goes. It's my very patient PA, Claire, and she's just flagged up a critical illness (CI) claim that really shows TCF in action.

The email outlined a claim that was, to say the least, unusual in circumstance. A customer who has had CI cover with us for a considerable length of time underwent a medical test, the results of which showed everything to be just fine.

Some time after, the customer reviewed their personal finances and chose to cancel their CI cover. Nothing particularly unusual about that I hear you say.

But what happened next represents an industry-wide lesson about the very real consequences of cancelling a policy.

As the customer was still concerned about their health, they decided to undergo further tests. They were diagnosed with a critical illness.

At a first glance, any provider could well assume this claimant was a victim of nothing more than devastatingly bad timing.

But nothing is ever that simple and the customer sought further medical advice, focusing on the first set of medical tests. The evidence revealed the first set of results may have been misinterpreted.

Our chief medical officer felt that, owing to the aggressive nature of the illness, the customer was likely to have been critically ill when they had their policy and so we took the decision to pay the claim.

Perhaps many readers will disagree with our decision and I welcome anyone to comment about their experiences of dealing with challenging claims.

This wasn't a case of 'computer says no'. Expert opinion combined with common sense prevailed over policy rules. Stories like these go to show that claims handling isn't just about policing policy terms, but requires an investigative attitude that has the objective of treating the customer fairly.

The role of the financial adviser is to bring to light potential risks, risks we're all susceptible to.

The message that one negative medical test does not mean they will all be is something financial advisers should be communicating to their clients, without scaremongering.

Of course the other issue this claim raises is that customers should avoid cancelling their policies completely and instead pay the amount of money they can afford. It comes back to an old saying in this industry: 'A little cover is better than no cover'.

Understandably, in today's current economic climate, we're all being told to tighten the purse strings ready for the rough financial ride ahead. Yet all of us also need to understand the real value of some of our outgoings.

Which leaves me with just one more thing to say: I'm glad the motor racing season has begun.

Graham Harvey is managing director, protection, at Axa