Other Insurance co want money back

martindfs

Registered User
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hello all, this is my first post but really really need help.

i work in the emergency services here in the ROI. i had a nasty accident at work which i was off with injuries for over a year. i have my personnal insurance policy(loss of earnings) which i have since 2008 in case im injured at work. after the accident i filled out the relevant forms for my own insurance co and filled it out to the best and as honestly as possible. there is a specific section which states "are you recieveing sick pay from your employer" which i clearly stated yes and dates etc. i have supplied this company with everything and actually went out of my way during my injury to get them additional info etc. they have paid me X amount over the last 8 months but now are looking for all monies to be paid back to them as they are now stating that i was not entitled to the amount on the policy because i was getting sick pay from my employers.

i have clearly stated this from the itinial claim form which i have a copy of as i have a habit of copying everything for my own records. i have kept all monthly premiums up to date and have been 100% honest from day one.

please please can anyone give me some advice asthe amount involved is around 10k which i dont have and its causing me undue stress as i declared everything and hid nothing when filling out forms etc.

thank you guys in advance for the advice

** when i was sold the policy i clearly asked the agent can i get sick pay from my employer plus this policy and he clearly stated yes.
 
hmmm would rather not go down that road as its additional costs' involved. ill pay back every penny if im in the wrong or have done anything fraudulant but i havent told anything false at any stage
 
Clearly if you are a full time emergency worker, you are going to get sick pay for an injury on duty, they should know this.

Are they saying they overpaid you or something on the basis they thought you were getting nothing ? If you are post 95 you'd get sick pay from your prsi anyway..What are they accusing you of ?
 
Clearly if you are a full time emergency worker, you are going to get sick pay for an injury on duty, they should know this.

Are they saying they overpaid you or something on the basis they thought you were getting nothing ? If you are post 95 you'd get sick pay from your prsi anyway..What are they accusing you of ?

coolhand, i have declared on my initial claim form that i was getting sickpay. in fact it had to be completed by my employer in which we clearly stated.

they are accusing me of recieveing the money which i am not entitled to. my questions are- why did they pay me the full premium for the past 8months when i clearly stated that i was getting sick pay from day 1. they are giving me an aweful time and are based in the UK but i have assisted them in every way possible as i have nothing to hide
 
Try your local Citizens Information office, most have Free Legal Aid clinics where you will get 20 mins with a solicitor for verbal advice only. You must not have consulted a solicitor previously about the issue before them so you may as well try them first, its free.
 
Try your local Citizens Information office, most have Free Legal Aid clinics where you will get 20 mins with a solicitor for verbal advice only. You must not have consulted a solicitor previously about the issue before them so you may as well try them first, its free.

i would rather not involve a solicitor as i have all documents copied etc and i am trying to talk with this company and use their official complaints section. i have absolutly nothing to hide and not afriad to meet these people face to face as they have made aot of mistakes during the period and made my life hell in getting payment in the firs place.

these guys will gladly take your monthly premium but when it comes to paying out....different story!
 
coolhand, i have declared on my initial claim form that i was getting sickpay. in fact it had to be completed by my employer in which we clearly stated.

they are accusing me of recieveing the money which i am not entitled to. my questions are- why did they pay me the full premium for the past 8months when i clearly stated that i was getting sick pay from day 1. they are giving me an aweful time and are based in the UK but i have assisted them in every way possible as i have nothing to hide

Why are they saying your not entitled to it ?

If you are sure that you are in the right and have fully informed them, then i would get a named person in the company, send them copies of all your documentation and tell them if you hear from them again you will be making a complaint to the [broken link removed]

After that if they ring you i'd tell them you don't wish to discuss the matter any further.
 
The suggestion of seeking legal advice has been made a couple of times in the thread and rejected by you. I have nothing else to offer you as looking at all the documents, contracts letters, and reviewing them is a legal task. Sorry.

Have you consulted your union?
 
Why are they saying your not entitled to it ?

If you are sure that you are in the right and have fully informed them, then i would get a named person in the company, send them copies of all your documentation and tell them if you hear from them again you will be making a complaint

After that if they ring you i'd tell them you don't wish to discuss the matter any further.

coolhand thanks for the response. the policy is a loss of earnings policy. they are stating that my sickpay from my emplyer was sufficent and that they should not have been paying me x amount per month. i swear i have declared everything but the stress alone is horrific and i just dont need it as i have adhered to everything.
 
The suggestion of seeking legal advice has been made a couple of times in the thread and rejected by you. I have nothing else to offer you as looking at all the documents, contracts letters, and reviewing them is a legal task. Sorry.

Have you consulted your union?

mathpac, its the money and stress involved in using a solicitor. i would rather try and do it myself as i have all copied documents to use in my favour. my union......hmmmmm dont think they would give a toss
 
Does your union provide any 'free legal advice' service? IMPACT started providing this service this year - see if you union does something similar.
 
Seeing a solicitor in Citizens Info is not involving a solicitor as they will do nothing for you but give you verbal advice, they don't get involved in your case or write letters or anything like that. They will just give you some free advice, what harm can it do?
 
coolhand thanks for the response. the policy is a loss of earnings policy. they are stating that my sickpay from my emplyer was sufficent and that they should not have been paying me x amount per month. i swear i have declared everything but the stress alone is horrific and i just dont need it as i have adhered to everything.

Seems to be par for the course with these policy's, in that they try anything to get out of paying.

Bottom line, if you are really adamant you have done nothing wrong and have the paperwork to prove it, what exactly are a uk based insurance company going to do ? A few strongly worded letters, a mildly annoying phone call or two, i certainly wouldn't be getting stressed out in the slightest......
 
thx guys for all the replies and advice. i downloaded the complaints form for financial ombudsman so all documents will be posted in the morning. i will also go to my family solicitor and have a brief chat but i have no prob repaying money if im in the wrong but i clearly am not and this kind of bullying behavior sickens me when all you do is claim and be as honest as you can.
 
True, somehow I can't see an UK based company sending the bailiffs back to Ireland....again, so OP stop stressing yourself out. ;)


cashier, easy to say it LOL but thx.:) the policy is true a company based in ireland but the underwriters who actually pay me are based in the UK. i will keep everyone up to date over the next few weeks and we will see how it goes and hey...thx again to all for the input!:)
 
coolhand thanks for the response. the policy is a loss of earnings policy. they are stating that my sickpay from my emplyer was sufficent and that they should not have been paying me x amount per month. i swear i have declared everything but the stress alone is horrific and i just dont need it as i have adhered to everything.

I'm not a lawyer, but.....

The basic concept of this type of insurance is to compensate you for loss of income, should you have not other source - in this case you were receiving sick pay from your employer, so you probably should not have made the claim... on the other hand you provided them with all the information and they should have noticed it as well, so they are not exactly blameless either.
So there should be some room for negotiation...

Most likely outcome would be to get them to agree to write off a certain amount and you pay the rest back over a certain period. But who knows, perhaps some good Lawyer could get a very different outcome.
 
I'm not a lawyer, but.....

The basic concept of this type of insurance is to compensate you for loss of income, should you have not other source - in this case you were receiving sick pay from your employer, so you probably should not have made the claim... on the other hand you provided them with all the information and they should have noticed it as well, so they are not exactly blameless either.
So there should be some room for negotiation...

Most likely outcome would be to get them to agree to write off a certain amount and you pay the rest back over a certain period. But who knows, perhaps some good Lawyer could get a very different outcome.

Jim, why take out such a policy in the first place and why have this company agreed to take on my policy? why have they paid me over the last 8months and now are doing a uturn? i honestly have adhered to all information to the very best of my knowledge and wouldnt tell a lie especially if its gonna backfire.

if i am at fault i will pay back all monies but i clearly havent and they must accept that they have made the mistakes
 
What does your policy actually say? If you don't want to engage a solicitor then you need to go through that line by line.

I know a few people who thought they were entitled to a payment on these types of policies when in fact it only kicked in once you went on half pay/off pay or whatever the small print said. The companies were quick to tell them as they are usually aware of the sick leave policies for the big employers like the HSE etc.

Were you down income in the form of premiums? Did your policy cover that if you didn't get it.
 
What does your policy actually say? If you don't want to engage a solicitor then you need to go through that line by line.

I know a few people who thought they were entitled to a payment on these types of policies when in fact it only kicked in once you went on half pay/off pay or whatever the small print said. The companies were quick to tell them as they are usually aware of the sick leave policies for the big employers like the HSE etc.

Were you down income in the form of premiums? Did your policy cover that if you didn't get it.


Becky they never asked me once if i was getting x or y. i clearly stated i was getting sickpay on the claim form but it seems as if they have not realised it till now. on the t&c's it states that you are allowed x amount but i have clearly informed them of all
 
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