An Inverness mum with multiple sclerosis has been refused a £130,000 health insurance payout for failing to disclose her symptoms – a year before she claims she had any.
Jade Taylor was planning to use the six-figure sum to help pay for life changing treatment in Mexico this September.
Miss Taylor applied for life and critical illness cover with Zurich in March 2019 after splitting from the father of her two young children and was told the policy would “go live” on July 18 that year.
She paid £1,500 in premiums over the next two-and-a-half years with the belief that she would be awarded the lump sum should she fall seriously ill.
But after a “bombshell” diagnosis that she had primary progressive MS in February 2021, Zurich has now refused to pay the funds she planned to spend on revolutionary stem cell treatment to reverse the disease.
‘Catalogue of errors’
Miss Taylor blames a catalogue of errors, including inaccurate information in her medical notes and being unaware the start of her policy had been delayed.
The insurance firm claims the 38-year-old failed to disclose “neurological symptoms” it said she had for seven months before applying for the policy.
A doctor wrote a letter clarifying that the “numbness” she had been suffering for a year was “a term which relates to skin, not the leg itself” and was a result of post surgical scarring, after she lost 10 stone in weight and had 1lb in excess skin removed from each leg.
A spokesman, however, claimed had Miss Taylor told the insurer about her symptoms, it would have “postponed her application, pending a full investigation, and her applications would have been declined at the point of an MS diagnosis.”
Miss Taylor was not diagnosed with MS until February 2021 – two years after first applying for the policy – and doctors only began to suspect MS in July 2020.
Miss Taylor said “I was asked in my application if I had any numbness or tingling in the limbs, which I didn’t at that time. Nowhere on the form was there any question about skin. Had there been, I would have told them about that.”
Policy delayed due to holidays
She said she was also told her policy would start on July 18, 2019, but the financial advisor dealing with her application “went on holiday for a month and didn’t activate the policy until August 12”.
Miss Taylor received documents dated July 18 asking her to check her medical details and formally accept the policy, which she said did. She was then sent the documents again, dated August 12, which Miss Taylor said she never saw until she got help to open an online portal a year later.
Therefore, when she made an appointment on August 6 to see her doctor she said she did not disclose the call as she was led to believe the policy was already active.
‘I haven’t done anything wrong’
Miss Taylor, from Culloden, said: “I was coming out of the gym and my leg felt so heavy, I thought I had trapped a nerve after lifting weights.
“So I called the GP and they booked me in for an appointment on August 14, 2019.
“But because it took five months for the policy to go through and I called the GP on August 6 and I didn’t declare that, they’re saying I lied.
“But I haven’t done anything wrong. I wasn’t diagnosed until February 2021 and I took out the policy in March 2019 and I had no signs of MS until July 2020.”
At the appointment on August 14, 2019 – two days after her cover officially started – the GP noticed she was showing signs of “drop foot” and referred her to a neurologist.
Zurich is arguing that her “neurological symptoms” were already present for a year before her policy was active.
But a letter from her doctor states: “Jade did not attend the practice complaining of drop foot – this was found on examination by me on August 14, 2019. The issue with Jade’s leg (feeling heavy etc) were new symptoms but the skin numbness of her right upper thigh had been present for around 12 months post surgery.
“In my referral to neurology I mention this numbness and you can see that my working diagnosis is that this is likely post surgery haematoma/scarring.”
Miss Taylor was seen by a neurologist, who, on finding no cause for her symptoms, discharged her to physiotherapy in January 2020.
It was only months later when she felt her symptoms get worse a scan eventually led to an MS diagnosis in February 2021.
Appeals to Financial Ombudsman
Prior to her diagnosis, Miss Taylor also discovered her health cover already contained an exclusion that meant Zurich would not pay out should she be diagnosed with MS.
This was later removed as it was based on inaccurate information taken from her GP notes in 2010 when an orthopaedic trainee wrongly stated she had “various investigations for her hips as well as for demyelinating disease (MS)”.
A neurologist confirmed this was “incorrect” and that “no investigation or tests for demyelinating disease had been done or requested”. This was upheld by the Financial Ombudsman and the exclusion was removed.
Miss Taylor insists she declared everything to the financial advisor dealing with her application, including arthritis in her hips and knees and issues with her bowel and womb following the birth of her son.
She took her latest case to the Financial Ombudsman but last month was told it would not uphold her claim.
Money would have helped mum get back to work
The mother-of-two said: “It doesn’t make sense because if Zurich thinks I’ve done something wrong, why cancel my policy and then refund all my premiums and give me a £150 goodwill gesture for all the hassle? Surely if they think I lied to them I wouldn’t be entitled to that. Now they’ve left me uninsured.
“It’s not like I was going to use the money on shoes or handbags. I wanted to use it to get myself better so I can get back to work and look after my children.”
Miss Taylor was hoping to travel to Mexico last month but unable to raise the £54,000 to pay for the procedure she has been forced to reschedule the treatment for September.
She said: “After you clear one hurdle, it seems you have to clear another that’s even worse. And all because the financial advisor went on holiday.
“If he had done what he was supposed to, they would have paid out. It’s so unfair. It makes you wonder what’s the point in taking out insurance when it’s not worth the paper it’s written on.”
Cover received did not ‘accurately’ reflect health
Zurich said Miss Taylor should have said yes on the question about taking medication or treatment for any “tremor, numbness, loss of feeling or tingling in the limbs or face, blurred vision, loss of balance or coordination, epilepsy, seizure, or loss of muscle power.”
A spokesman said: “Additionally, Ms Taylor stated that she was not aware of any symptoms that she intended to seek medical advice or treatment for. Unfortunately, these statements were made despite the fact that Ms Taylor had been experiencing neurological symptoms for some time.
“A record of a consultation with a GP two days after her policy went live shows that Ms Taylor was aware of symptoms affecting her functioning. This resulted in a referral to a neurology specialist. As these symptoms were present for approximately seven months before Ms Taylor first spoke to her financial advisor about taking out cover with Zurich, and a year before the policies went live, the cover she received did not accurately reflect her health at the time of application.
“Had Ms Taylor disclosed these symptoms at the time, Zurich would have postponed her application, pending a full investigation, and her applications would have been declined at the point of an MS diagnosis.”
‘Symptoms should have been disclosed’
In its written decision, the Financial Ombudsman said “the symptoms Ms T had been experiencing should have been disclosed to Zurich.
Describing it as a “misrepresentation”, the ombudsman said the evidence by the doctor did not “change the fact” Miss Taylor had been suffering “notable symptoms” prior to taking out the policy.
It adds: “The issue is not whether the root cause of those symptoms was MS, but rather that, whatever the underlying cause, the symptoms were not disclosed to Zurich.”
Conversation