AEGON Scottish Equitable pays 91 per cent of CI claims

Nia Williams

March 27, 2009

Only 9% of critical illness claims were declined, which is half of the number of claims declined in 2007. Of these, 41% of those declined claims were due to non-disclosure, where the customer had failed to disclose important information, and 59% were due to the definition of the critical illness not being met with the claim. Cancer continued to be the most common reason to pay out and the average age of a critical illness claimant was 44-years-old.

In January 2008 the ABI introduced three high level categories of non-disclosure with the aim of improving customer clarity and certainty around paying claims for protection policies. The new ABI guidelines of innocent (resulting in the claim being paid in full), negligent (applying a proportionate payment) and deliberate or without any care (resulting in a declined claim) have helped lead to an extra £1.52 million being paid out in lump sum benefits.

Helen Morris, technical claims manager at AEGON Scottish Equitable said: “We have changed our approach to claims handling following the new ABI guidance on treatment of non-disclosure and worked with IFAs to educate them on the areas where non-disclosure occurs and what they can do to stop it occurring at application stage, along with launching a new understanding claims website.

“In addition, as our book of business matures, more claims start to arrive on older policies where the risk of non-disclosure is reduced. We are also looking at how we can improve the customers’ experience in the event that they do have to make a claim.”

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