A Scottish mum who lives with multiple sclerosis had been denied a £130,000 insurance payout for failing to disclose her symptoms - a year before she claims she had any.
Jade Taylor says that she had planned to use the sum of money to assist in covering the cost for life-changing treatment in Mexico later this year. The mum-of-two adds that she applied for life and critical illness covers in March 2019 after she split up with the father of her children and she was told the policy would ‘go live’ on July 18 later that year.
She has paid around £1,500 in premiums over a span of two and a half years believing that she would be awarded a lump sum if she were to become severely ill. Following a ‘bombshell’ diagnosis that she had primary progressive MS in February 2021, her insurer Zurich has refused to pay out the money she requires to undergo a new stem cell treatment that can reverse the disease, the Daily Record reports.
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Miss Taylor cites a catalogue of errors that have brought her to where she is now, from inaccurate information on her medical notes to being unaware the start of her policy had been delayed. The insurance firm claims Miss Taylor, 38, 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.”
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.
Miss Taylor, from Culloden, Inverness-shire, 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.
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.
But 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.”
She added: “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.”
A spokesman for Zurich told the Record: “Insurers rely on customers to answer questions about their health accurately when taking out a policy. It’s these answers that determine whether or not an insurer can provide cover, and at what price that cover is set.”
The insurer believes that Miss Taylor should have answered yes when asked if she “had, or been advised to take any medication or have any 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.
It added: “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. As cover was issued on the basis of inaccurate information, Zurich declined her claims.”
In its written decision, the Financial Ombudsman said “the symptoms Ms T had been experiencing should have been disclosed to Zurich. So I think this means Ms T failed to take reasonable care not to make a misrepresentation.”
It added: “Ms T has provided additional evidence, both from her GP and her consultant neurologist, clarifying their comments and opinions. But this additional evidence doesn’t change the fact that Ms T was experiencing notable symptoms prior to taking out the policies.
"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.”
Miss Taylor now plans to take her case against the financial advisor to the Financial Ombudsman insisting he gave her the wrong start date for the policy.
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