Our client was a dentist who was obliged to abandon her profession due to disabilities with her hands. When increasing her mortgage years earlier, she had prudently taken out insurance to protect her mortgage in case of death or critical illness. A financial advisor who she had been instructing for years advised her on the best insurance products to meet her needs.
The financial advisor made a mistake when recommending a new policy. He failed to act on the insured’s instructions that the trigger events for a claim must relate to circumstances whereby she was unable to continue her occupation as a dentist. She wanted what is known as an “Own Occupation” policy. In fact, she already had a much smaller value policy of this type which the same financial advisor had previously sold to her.
Instead, the policy she was sold this time around only allowed a claim in circumstances where she could not perform basic living activities such as walking, bending, reading and writing. Clearly, this fell hugely short of the client’s requirements. The client only became aware of this fact several years later, upon submitting a claim for payment of lump sum to cover her mortgage since problems with her hands meant she could no longer work as a dentist. The insurance company refused her claim, pointing out that she was insured on an “Any Occupation” basis.
The client pursued her complaint to the Financial Ombudsman. Her complaint was initially upheld and she was awarded the maximum sum of compensation payable. However, the insurance company appealed and the Ombudsman reviewed the case, reducing the client’s award to just a few hundred pounds.
At this point, the client sought our advice. We were able to obtain a Barrister’s opinion which agreed with the strengths of her claim and we subsequently corresponded with the insurance company, who then appointed lawyers. Court proceedings have now been started, funded by a No Win No Fee agreement. There are good prospects of a successful outcome for the client.
