Dread Disease

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  • pdf CR361 - Dread Desease - Exclusion Clause [NEW]
    Claim for dread disease benefit on grounds of cancer – claim not meeting policy criteria – claim settled
  • pdf CR359 - Dread Disease
    When did Dread Disease claim arise? (CR359)
  • pdf CR349 - Dread Disease / Equity
    Claim for impairment and/or dread disease benefit on grounds of dysfunctional colon disease – claim not meeting policy criteria – claim settled for 50% of sum assured on basis of equity (CR349)
  • pdf CR334 - Dread disease
    Medical evidence not meeting criteria for claim on basis of stroke – claim repudiated - insurer asked to consider whether the evidence supported any other condition listed under “Nervous System” – insurer requesting neurologist report – complainant undergoing neurology assessment resulting in diagnosis of motor neuron disease – claim paid (CR334)
  • pdf CR305 - Definition in relevant clause out of date
    Definition in relevant clause out of date - Strict application of it unfair and wasteful - application of equity - insurer's obligation to obtain necessary medical evidence (CR305)
  • pdf CR251 - Dread disease claim
    Dread disease claim - Interpretation of contract - complainant making second claim in respect of dread disease benefit - insurer refusing to pay claim on ground that benefit cancelled after first claim - policy wording did not support this interpretation - if any ambiguity in policy, wording to be construed contra proferentem (CR251)
  • pdf CR250 - Dread Disease - Cancer
    Dread Disease - Cancer - Definition - is the insurer's interpretation of the definition too strict? (CR250)
  • pdf CR241 - Dread disease
    Dread disease - Complainant claiming for dread disease benefit on grounds of cancer - policy excluding "(a) all skin cancers, and (b) cancer-in-situ, including all melanomas-in-situ"- established that, while complainant's was not a cancer-in-situ or a melanoma-in-situ, the tumour had not spread beyond the skin and therefore remained a skin cancer; insurer's liability excluded (CR241)
  • pdf CR182 - Dread disease benefit claim
    Dread disease benefit claim - Insurer refused claim, as condition did not qualify, but was only prepared to offer more life cover at substantially higher rates (CR182)
  • pdf CR79 - Dread disease claim rejected
    Dread disease claim rejected - Catheterisation and angioplasty cannot be regarded as open-heart surgery (CR79)
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