Medical insurance question

[ubersonic]

Hey all, I don't think asking a question about medical insurance triggers the no medical advice request rule but if so please delete.

Anyway just wondering if anyone knows how the laws works around medical insurance (or insurance in general) work with regard to this scenario as it came up in conversation today and Google is no help:

1. Person pays insurance policy for years.
2. Person gets brain cancer.
3. Person lets insurance payments lapse due to brain cancer.
4. Person is diagnosed with brain cancer.

Do they have any right to claim as they had an active policy at the time they contracted the illness? Or are they screwed because they don't have the policy anymore.

 

[Hades]

It would come down to what's in the contract. But I very, very, very much doubt it.

 

[BDEE]

If the policy has lapsed because they stopped paying it then they no longer have a policy.

If they were diagnosed whilst the policy was still active and there is evidence to prove this, then the insured person was covered at the time - If it only lapsed because of the illness preventing them from managing their finances and this could be backed up by a doctor, then I would expect the claim to be paid, as they had active insurance at the time of it happening.

I highly doubt any decline panel (usually made up of about 6-8 people) of any insurance company would decline the claim if they had valid insurance at the time of diagnosis, although as Hades says, it does depend on the contract wording.

Interestingly I know of a case where someone was paid out on a life insurance policy which expired 7 minutes before they died (died in a car crash at 00:07 and the policy had lapsed at 00:00). Legally it didn't have to be paid out on, but the panel felt it would cause too much reputatational risk to not pay out.