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Recent stories in the press have again lambasted the insurers over critical illness insurance. The core problem is that a critical illness claim is not as straightforward as, for example, a claim under life insurance. With life insurance it’s going to be hard for the insurance company to argue that you’re not dead!

By their very nature, critical illness claims are much more complicated. The insurer will need to satisfy itself that the claim is validated in three key areas before it meets the claim: -

Has the illness been correctly diagnosed?

Is the confirmed illness included in the schedule of insured critical illnesses covered by the policy?

Did the policyholder fully disclose their medical history and current state of health on their original application form?

On the first point, it’s obviously in the policyholder’s interest to verify the medical diagnosis - so there’s rarely ever any conflict between the insurance company and the policyholder on that issue. It’s the next two areas which the insurer needs to validate, where conflicts seem arise.

With constant development in the medical knowledge, from time to time there can be some situations where validation falls into a grey area - a policyholder will argue that their specific illness is insured whereas the insurer will argue that it isn’t. Insurance companies are aware of this problem and they often change the wording in their policies in an attempt to clarify the scope of the cover and eliminate areas for dispute. Nevertheless, disputes do happen all too frequently and sparks fly when a policyholder thinks his illness is covered but the insurer disagrees.

A case in point comes before the Courts shortly. Mr Hawkins from Staffordshire is suing Scottish Provident for

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With life insurance, the insured is transferring the risk of death on to the insurer. It is not always the case that the insured is insuring their own life. Therefore there are three parties in a life insurance contract, the insurer, the insured person, and the owner of the policy. The other vitally important party is the beneficiary; this is the person who receives the insurance money if the insured’s death does occur. One or more of these parties could be the same person, for example, if I insure my own life and make my spouse the beneficiary, then I am the insured and the owner. Likewise, if my wife insures my life and makes herself the beneficiary, then she is the owner and the beneficiary.

An important concept in this regard is insurable interest. You must have what is known as an insurable interest in the life of the person you are insuring. Believe it or not there was a practice in the nineteenth century whereby people would take out speculative insurance policies on the life of another.

For example, if I knew you were going on a dangerous voyage, I might take out a life insurance policy on you in the hope that you wouldn’t make it and I would get a big payout. These days you cannot insure anybody’s life. You must show that you have an interest in that person being alive. You are presumed always to have an interest in the life of your spouse and guardians, if you are a minor, but all other relationships will have to prove the insurable interest. If employers have a very highly valued employee, or sports teams have a star player, or a famous actor contracts to make a film, their employers will be able to insure their lives.

Most life insurance policies will have a suicide clause stating that if the insured commits suicide, usually within a period of two years, the policy will not pay out. There is also a contest period. This will also be approximately two years and if the insured dies within this period, the insurance company has greater rights to investigate the death before deciding whether or not to pay out.

The value of the insurance policy will be subject to the principle of insurable interest also. For example, if your spouse provides you with $10,000 per year in support, you probably will not be able to take a $50 million insurance policy on their life. The premium will be calculated based on the amount to be paid out and the assessed risk of the insured’s death

Joseph Kenny is the webmaster of the insurance site http://www.insure121.com/ where you will find information, news and links to the leading providers of insurance in the UK. If you found this article interesting you may find more articles of the same nature in the insurance guide located on site.

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Are you shopping for health insurance? Are you looking for the best rates? Are you totally confused? There are so many people scrambling for health insurance and are trying their best to compare the rates. This is not easy at first because the health insurance companies have had to come up with creative alternatives in their insurance portfolios. Those creative alternatives can give the average person an insurance headache.

The rising costs of hospital and physician services are always passed on to the consumer. The consumer depends on their insurance company to pay for their medical expenses in exchange for a premium. The medical rates are based on several criteria.

Here are a few:

1. Gender - Male/Female rates differ.

2. Tobacco - Non-Tobacco - Tobacco users are higher

3. Household Status - Single, Parent-child, Parent-children, Husband-Wife, Husband-wife-child, Husband-wife-children

4. Deductible - $500 to $5000 (with some companies)

There are some things that you can do to affect the rate. The most cost savings method is to choose a high deductible plan. The higher the deductible calculates into a lower the rate. Low deductibles no longer justify the premiums paid. This trend toward high deductibles is called self-insuring. You are taking on the financial responsibility for the deductible amount.

The best way to offset and prepare for the out of pocket deductible is to start a health savings account. This is a tax deductible savings plan for medical expenses. It’s the equivalent of a medical IRA. The tax deduction offsets some of the out of pocket expense you incur with the higher deductible. Contact your tax advisor or accountant about starting a health savings account.

To view our recommended source for reliable quotes, visit this page: Affordable Health Insurance.

To view our recommended source for all other insurance, visit this page: Insurance Quotes.

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