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Fair Go: Shot Update

Published: 5:30PM Wednesday April 22, 2009 Source: Fair Go

Reporter - Hannah Wallis

Satinder Kaur first came to Fair Go a year ago with an doozie of an insurance dilemma - she'd been turned down for a $350,000 mortgage insurance payout when her husband was killed, shot dead. Fidelity Life Assurance policy is that if a claim is made on a  policy that's been held for less than two years, then Fidelity will check back through medical records to see if they hold any information that's different from the info in the insurance application.

In Satinder's husband's case, he'd told Fidelity he didn't smoke and had never smoked; his GP's notes said he had been a smoker. There were other health issues too that Fidelity were concerned about, which appeared in the GP's notes, and because of this non-disclosure, they would not pay out the full $350,000, but would pay out a lesser amount of $80,000 which took into account that Jagdev should have been on a smoker's policy.

Fair Go had serious issues with the doctor's notes - both on the smoking issue and other health problems Fidelity raised. We argued the notes were - frankly - all over the show.

Contradictory, unclear, inconclusive. We helped Satinder put together a case to take to the Insurance Ombudsman, and after careful review of the case, the Ombudsman recommended that Fidelity pay Satinder a further $100,000.

A year after we first talked to her - Satinder says life with her two young children is gradually getting better, and this payout will really help out.   

We'd suggest anyone with life insurance, mortgage insurance, health insurance - go check your policy - did you keep a copy of your questionaire, your application? Did you answer accurately? Has anything changed since you filled it out? Would you pass the disclosure test? And take care when you discuss health matters with your doctor, and the doctor makes notes. Make sure that whatever's written down, you and your GP get it right. Finally, applications for insurance often have a preposterous number of complicated questions. If you don't know or can't remember - say so - or, invite the insurance company to check your medical records.

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