My only concern is that insurance companies are notorious for worming their way out of payouts when push comes to shove.
Yep, and the only reason we do not have it either.
At that stage in proceedings, all of the nice brokers, friendly agents, helpful telephone receptionists, the pleasant salespeople and the magnificently marketed brochures with bright cheery smiles and 'cute as a button' little kids carrying teddy bears all step away from the podium and you, sick and injured and not producing any income with the bills mounting up....hereinafter known in the Contract as the "insured party", finally get introduced to the two characters you're going to be conversing with from now on. The Insurance Co's lead counsel and the Insurance Co's appointed doctor.
These two characters are the only people that stand in the way between the payout you
thought you were covered for and the shareholders of the Insurance Co....hereinafter known in the Contract as the "insuring party", who frankly, have diametrically opposed financial goals to you.
This is not a good situation to be in by any means, as you are almost always in the weaker negotiating position, for a number of reasons...
1. They already have your premium, it's been placed into their investing float, and they are earning money from it every day.
2. The crucial factor of time is definitely on their side.
3. I have never met any sick individual who is wealthier than the collective Ins. Co, and hence they have the ability to always appeal to a higher court if they wish to drag it out.
4. The solicitor who drew up the Contract and specific wording would have been through every minute detail many times over, and already have been through various vetting and refinement procedures to the wording to strengthen their legal / medical position over the years. I can absolutely guarantee ( no opinion necessary) that the chap who wrote it and refined will know it, and the intent and meaning behindthose words, far better than any chap lying there unable to work.
5. Even if you are obviously sick, cannot work, have that confirmed in writing by your Doctor, none of that counts for diddly. What's important is that the Ins. Co. doctors confirm it (exactly) in writing. This is an onerous burden to overcome....and yet until you do, you get nothing.
6. Almost everybody knows the standard tactic of all Ins. Co's is to deny coverage as standard practice at the start, this clears off a certain percentage of claimants right there, and then of course we all know about their private investigators who work miracles to disprove your medical capabilities / claims.
We had a look at the TPD conditions, and they were so onerous to meet (and the list of exlusions went on for 6 pages !!) that we knew for a fact we could never qualify for it. The nurse said at the time of our assessment "To tell you the truth, you may as well be dead before qualify for that". It wasn't her place to tell us that, but the truth was nonetheless enlightening.
Anyway, we both felt, after detailed study of the Contract, the only insurance coverage we could qualify for would be Death coverage, but even then we felt a Death Certificate might not satisfy their criteria. It's certainly not clear cut and there were about 5 exclusions.
I'd very much like to see the exact wording of this "Rolls Royce" policy.