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Pre-existing Medical Conditions


PPI Insurance Policies and Pre-Existing Medical Conditions?

One of the main reasons that companies refused PPI payouts was because of pre-existing conditions, and they often applied very liberal use of the term. In many cases – particularly with back problems – they linked illnesses and injuries to pre-existing conditions, regardless of whether or not this is true.

If you have a PPI policy and pre-existing medical conditions, you will probably not be covered for them. The same applies for any past medical issues. Most PPI policies also will not cover for stress and back problems.

These exclusions should have been made clear to you at the time of taking out the policy. If they weren’t you may be able to claim the PPI premiums back.

The terms and conditions of your PPI policy will state what the insurer classes a pre-existing condition to be, so you need to check this carefully. Insurers are generally quite strict in how they apply their definitions.

When making a claim for PPI, it is possible the insurer will ask to see your medical records, the reason is to rule out a pre-existing medical condition. This could provide the insurer a reason to reject a claim.

Regarding back pain for example, if you’ve had issues with your lower back before but are now experiencing problems with your upper back, your insurer may rule this as a pre-existing condition.

Problems arise when being sold PPI policies as sales people are not medical professionals – they won’t go through your personal medical history. Regardless they must mention the exclusions contained within the policy. If the exclusions were not mentioned, you may be able to make a claim.

However, if it was made clear that a pre-existing condition was not covered, and you still took out the PPI policy, you will not be able to claim compensation.

If by chance your policy does cover pre-existing conditions and you have been free of symptoms for ‘x’ number of years, you still would not be able to claim compensation if this was explained to you.

What is a pre-existing condition?

Pre-existing conditions are any medical conditions that you have received advice about, had symptoms and had treatment for in the past. This will include any consultations, prescribed medication for, had surgery or any form of treatment by the NHS or through private healthcare.

If you’ve had any symptoms of a condition or had treatment for it in the last five years, insurers will consider this to be a pre-existing condition, regardless if the diagnosis was made much earlier. The time factor varies for different providers, some look at the last three years, others look as far back as seven years.

A general rule of thumb is to mention any medical condition that you’ve had serious or not.

Examples of Common Medical Conditions

The list of pre-existing conditions will change from insurer to insurer, so it is imperative that you check to see what information is being asked for. However, the most common conditions asked about are:

  • Heart conditions, including heart attack, high blood pressure & angina
  • Cancer
  • Breathing conditions, including asthma or emphysema
  • Joint and bone conditions, including arthritis
  • Diabetes
  • Gastrointestinal condition (problems with your stomach) – includes Irritable Bowel Syndrome (IBS) & Crohn’s disease
  • Psychological issues, including depression or anxiety
  • Strokes
  • Back pain you needed surgery for

How to check if you had PPI

If you’ve ever had any type of loan or credit finance, you need to check your paperwork to see if there is any mention of the term ‘PPI’ or ‘payment protection insurance’ to know if you had PPI or not.

The paperwork to check for ‘PPI’ will include the original credit agreement, recent statements and the terms and conditions for each finance product. On statements, the PPI payment may appear as an extra charge in addition to the repayment figure.

The type of finance products PPI was usually sold with are loans, credit cards, store cards, mortgages, overdrafts and car finance. As there are different types of loan and credit products, it is important to check your paperwork carefully.

Other product names to look for

PPI or payment protection insurance are the most commonly used terms for this type of product. However, it is also known as any of the following for PPI and related products:

  • accident, sickness and unemployment (ASU) insurance
  • account cover
  • credit insurance
  • credit protection
  • loan care
  • loan insurance
  • loan protection
  • loan repayment insurance
  • mortgage payment protection insurance (MPPI)
  • payment cover
  • protection plan

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PPI Claims for Deceased Persons

Deceased Persons

If a PPI policyholder is deceased, any money owed to them becomes part of their estate, so whoever inherits the estate is entitled to make a PPI reclaim. This can be done by an executor or the person appointed to carry out their wishes after death. We automatically assume that reclaiming mis-sold Payment Protection Insurance (PPI) for deceased parents and grandparents may not be possible due to the passage of time.

However, the truth of the matter is it is quite straight forward to make a successful claim for mis-sold PPI for someone who is deceased.

To reclaim mis-sold PPI start with a FREE PPI check** with us today.

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Armed forces personnel have cover for sickness, accident & unemployment built into their salaries. This protection means that if a member of the armed forces was unable to work due to one of these reasons, they would still be able to meet any mortgage, loan or credit card repayments they had. So any PPI insurance policies would NOT have been appropriate. To find out if you can reclaim for mis-sold PPI, start a FREE PPI check** with us today.

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Expat PPI Claim

Did you have a loan, credit card or mortgage in the UK between 1988 and 2014? As a British Expat or Non-UK National who has lived in the UK for a long period, it is likely that finances were arranged while you were a resident in Britain. This may include loans, mortgages or credit cards and, even though you are no longer living in the country you can still claim mis-sold PPI. You could be eligible to claim for mis-sold PPI!

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For many public sector workers, the Payment Protection Insurance (PPI) they were sold was useless. However, for some of these workers it would not have been useless, depending on the policy type and cover it provided them with.

If you had PPI and it provided you with extra cover that hadn’t been included in your employment contract, then it may have been useful for you.

Pre-Existing Medical Conditions PPI

Pre-Existing Medical Conditions
and PPI Policies

If you had a pre-existing medical condition and were sold a PPI insurance policy with a loan, credit card, mortgage, store card or catalogue account that excluded pre-existing medical conditions under the policy sold - then the insurance was clearly inappropriate for your needs and your are entitled to claim your money back.

Let us check if you have PPI to reclaim

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Business PPI Check and Claims

Business PPI Claims - Mis-sold Payment Protection Insurance

Business PPI - Like most consumer PPI policies, business PPI also know as commercial PPI was sold alongside secured and unsecured loans, overdrafts, credit cards and mortgages. Business Loan Repayment Insurance is a type of insurance policy sold alongside commercial loans, including Fixed Rate Loans, Variable Rate Loans and Treasury Loans. If you had a commercial or business loan between 1988 and 2014 you may be eligible for a PPI refund. Start a Free Business PPI Check and find out if you have mis-sold PPI to reclaim.