CLAIMS PAID IN 2018

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CONTENTSLife cover claims 3

Critical illness cover claims 4

Claims for children 6

Examples of claims we have paid 7

Why we couldn’t pay all of the claims 8

Making a claim 9

There for You: support that goes beyond money 10

INTRODUCTIONWe have a consistent track record of paying claims and we will consider all of the options available to pay a claim.

You can see on the following pages details of how many claims we’ve paid, and how much we’ve paid. You can also find information on the most common claims and an overview of the claims process.

We’ve had a number of initiatives to speed up claims and ensure you receive your money as quickly as possible; you can find out more about this on page 9.

Finally, it’s important to explain why we haven’t paid some claims and how we can use this information to help us improve our products in the future.

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LIFE COVER CLAIMS

100% paid

£36.6m

paid in total

£152,704

was the average amount paid out

2017

99.78% paid

£37.3m

paid in total

£82,931

was the average amount paid out

2018

MOST COMMON REASONS FOR LIFE INSURANCE CLAIMS

CANCER 29.33%

RESPIRATORY 21.78%

CARDIOVASCULAR 11.33%

OLD AGE 6.89%

DEMENTIA 6.67%

AVERAGE AGE CLAIMANTS

Having spoken to my clients, they are overwhelmed by the efficiency and sympathy that this has been dealt with. After an onerous few months they feel that they have been given some comfort at last.

– Financial adviser

CLAIMS BY AGE

79 YEARS OLD

76 YEARS OLD

100% paid

£10.5m

paid in total

£104,244

was the average amount paid out

2016

<39 40 TO 49 50 TO 59 60 TO 69 70 TO 79 80 TO 89 90+

Male 0 0.5% 5.0% 20.0% 35.5% 32.0% 7.0%

Female 0 1.0% 5.0% 12.0% 24.0% 39.0% 19.0%

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CRITICAL ILLNESS COVER CLAIMS

96.2% paid

£19.3m

paid in total

£126,889

was the average amount paid out

2016

94.63% paid

£23.8m

paid in total

£167,748

was the average amount paid out

2017

90.86% paid

£20.3m

paid in total

£127,648

was the average amount paid out

2018

MOST COMMON REASONS FOR CRITICAL ILLNESS INSURANCE CLAIMS

CANCER 66.45%

HEART ATTACK 11.18%

STROKE 7.24%

HEART VALVE SURGERY 3.29%

BENIGN BRAIN TUMOUR 1.97%

OTHER 9.87%

Thank you for helping me through the claim process, during a very difficult time in my life. I appreciated your professionalism and compassion throughout the process.

– Customer

AVERAGE AGE CLAIMANTS

55 YEARS OLD

59 YEARS OLD

CLAIMS BY AGE

<39 40 TO 49 50 TO 59 60 TO 69 70 +

Male 0.0 8.0% 45.0% 38.0% 9.0%

Female 2.0 19.0% 55.0% 17.0% 7.0%

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MOST COMMON CRITICAL ILLNESS CLAIMS FOR MEN

MOST COMMON CRITICAL ILLNESS CLAIMS FOR WOMEN

Cancer 58.18%

Heart attack 15.45%

Stroke 9.9%

Heart valve surgery 4.55%

Angioplasty 2.73%

Other 10.0%

Cancer 88.10%

Multiple Sclerosis 4.76%

Stroke 2.38%

Benign brain tumour 2.38%

Major organ transplant 2.38%

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CLAIMS FOR CHILDREN

Since introducing children’s cover we’ve paid out over £3.4 million in children’s critical illness claims

to our policyholders.

£3.4m Cancer 60.38%

Benign brain tumour 6.29%

Bacterial meningitis 5.66%

Loss of independence 5.03%

Major organ transplant 3.77%

Other 18.87%

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EXAMPLES OF CLAIMS WE HAVE PAID

Thank you very much for your swift response. Your professionalism has been outstanding and is very much appreciated, especially at such a worrying time.

– Customer

SEX AGE ILLNESS AMOUNT PAID

Male 54 Prostate cancer £690,000

Female 49 Breast cancer £257,000

Female 39 Multiple sclerosis £165,000

Male 50 Stroke £75,000

Male 73 Angioplasty £25,000

Female 46 Benign brain tumour £202,000

Male 10 Heart valve surgery £25,000

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We’d like to pay all of the claims we receive. If we can’t pay a claim under the specific condition being claimed for, our claims team check to see if we can pay it under another definition where possible or under an additional benefit, like total permanent disability, if it is included.

Unfortunately, sometimes it isn’t possible to pay a claim. There are two main reasons why we may not pay a claim:

• non-disclosure

• not meeting the definition

NON-DISCLOSURE

Part of the application process for a life or critical illness policy is to answer questions about your health, pastimes and occupation. If the person applying for the insurance does not tell us an important fact, perhaps intentionally, and that missing information would have affected the cover, or even prevented us from offering cover to start with, we may have to cancel the cover from the start and refund the premiums.

Fortunately, we have taken steps to ensure our application forms ask clear, specific questions and are user-friendly in order to reduce non-disclosure, allowing us to pay a larger proportion of claims.

NOT MEETING THE DEFINITION

Some of the critical illness claims we declined last year were because the illness being claimed for did not meet the definition of that illness, as defined by the policy wording, or because the policy did not cover the illness being claimed for. You can see some examples below.

We look at the reasons why we declined claims, as well as which conditions are becoming more common, and use this information to help us create new policies that cover additional conditions and have different definitions in order for us to be able to pay more claims in the future.

WHY WE COULDN’T PAY ALL OF THE CLAIMS

EXAMPLES OF NOT MEETING THE DEFINITION

CONDITIONS CLAIMED FOR

WHY WE DECLINED THE CLAIM

Stroke When the customer claimed for a stroke we contacted their consultant to get medical confirmation. The medical report showed that the customer did not have a stroke or permanent symptoms and therefore did not meet the definition.

Cancer In the case of this claim the customer’s policy excluded cancers of a low severity and that do not spread. When a claim for cancer was made, we received a doctor’s report which confirmed that the cancer was one of the low severity cancers not covered by the policy. We therefore had to decline the claim.

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MAKING A CLAIM

Call us on 0808 171 2626

When you call us, we will put you through to the right person to help you with your claim.

Having to make a claim usually comes at a very distressing time, so we try to take away as much of the worry and stress as we can by making your claim experience as smooth as possible.

Contact us to discuss a claim or for a claims form.

We send the form and advise you of any documents and information that we may need.

We receive the form and assess the claim. For a death claim, if we have everything that we need we will pay the claim.

For an illness or disability claim we may need medical reports to help us assess the claim. if you have your own copies of medical reports, sending these in with the form can help speed up the claim.

We aim to pay the claim within 2 to 3 days of receiving all the information we need.

SPEEDING UP A LIFE INSURANCE CLAIM

We have a number of initiatives to help us speed up life insurance claims so that we pay them as quickly as possible:

• Fast track – payment of claims up to £300,000 without waiting for probate.

• Small claims – a faster process for claims up to £30,000.

• Direct to HMRC – a payment of up to 25% of the claim directly to HMRC to help pay an inheritance tax bill.

• Scanned documents – if possible we will accept scanned copies of certain documents from your financial adviser or solicitor.

• Funeral pledge – we are able to pay up to £10,000 from the cover to a funeral director, on your behalf, to pay for the funeral. This payment can be made before probate is complete.

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THERE FOR YOU: SUPPORT THAT GOES BEYOND MONEY

When we talk about comprehensive cover we mean more than just helping to relieve the financial difficulties you may face when you or a child is seriously ill.

If you or your child become ill you’ll have a lot to deal with practically and emotionally. You may have lots of questions but be unsure who you can turn to for answers. Or you may just need a sympathetic person to talk to.

There for You is a service to help answer those questions and provide the practical advice and emotional support needed to see you and your family through a difficult time.

You’ll have your own, telephone based, dedicated personal nurse adviser who will be with you for as long as you need them to be.

The nurses are all highly trained and are able to help you in a variety of ways:

• Serious illness – support and information to help you understand the condition and its implications. Your nurse will also help you find any special equipment you may need and ensure you get the best use from of the NHS and charities, plus complementary therapies.

• After hospital care – a tailored ‘Get well, stay well’ plan for after you or your child leaves hospital, plus ongoing support and practical advice.

• Depression, stress and other mental health issues – a combination of the advice and support of your trained nurse and external counselling can help you and your family to cope.

• Bereavement – a combination of emotional support and practical advice including supporting parents with their child’s grief as well as their own. Bereavement counselling or complementary therapy may also be available.

• Second opinions – a face to face consultation with an NHS or private sector consultant plus support after a consultation to help you understand the results.

• Help with care issues – your nurse can help you find a suitable care or nursing home. They can also provide information on specialist equipment, home adaptations, the financial implications of care and even arrange some short term help at home.

WHEN IT CAN BE USED

There for You is provided at no extra cost for you, your spouse or partner, and your children to use whenever you need it. It’s available as soon as your cover starts and you don’t have to make a claim on your policy to use it.

Words themselves cannot express how your encouragement to overcome and face this condition has given me hope for the future. You listen. You made me feel like a human being. You gave me time to come to terms with my illness. You gave me strength when I was so very low.

– RedArc patient

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For more information please speak to your financial adviser.

You can also visit our website

www.oldmutualwealth.co.uk/products-and-investments /life-insurance/

SK9984/219-0286/March 2019

www.oldmutualwealth.co.ukPlease be aware that calls and electronic communications may be recorded for monitoring, regulatory and training purposes and records are available for at least five years.Old Mutual Wealth Life Assurance Limited is registered in England & Wales under number 1363932. Registered Office at Old Mutual House, Portland Terrace,Southampton SO14 7EJ, United Kingdom. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Financial Services register number 110462. VAT number 386 1301 59.