January 09, 2007

Multiple sclerosis PC's case is lesson to insurers

For ten years, police officer Gary Dimmock's doctors thought he had multiple sclerosis. They wrote as much in his notes. But they never told him.

Now, after a legal battle, his East Sussex NHS trust has admitted this was not right. He's been paid over £10,000 in compensation.

This story is powerful ammunition for changes to the way health and life insurance is sold.Dimmockjan9373036full

As my colleagues and I have reported for years, insurers expect people to complete insurance applications honestly and completely. But the insurers don't usually bother to look at doctor's notes at the time of application. (Too expensive, they say.)

The insurers only bother to call in the doctors' notes when a claim is made. At that point they spare no expense in trying to find a discrepancy between what the policyholder said at application, and what appears in doctors' notes. A discrepancy will often mean that the claim can be thrown out.

What would have happened in the case of PC Dimmock, right? He would have told his insurers one thing - and his medical notes would have contained something different , and far more sinister.

His story may be extreme, but our experience of investigating cases on behalf of readers shows that the phenomena of patients not knowing what is written on their doctors' notes is far from uncommon.

And it often results in claims being thrown out. Read about these cases, for instance, here. I've described the problem in greater detail here.

Recently, though, the Commission for Law Reform has suggested that UK law be changed by the introduction of something known as 'non-contestability'. Such a clause in an insurance contract would limit the insurer's ability to scrutinize previous medical records once a fixed period of time had elapsed since the cover was arranged (read more here). It's a good idea - and overdue.

As PC Dimmock's case makes horribly clear, patients often don't know what their medical notes contain.

- Richard Dyson

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