Permanent Total Disability Insurance Claim
Mr L, PTD
Mr L was involved in an accident which resulted in a serious back injury. He was unable to return to his job in a warehouse and was eventually dismissed by his employer on health grounds.
Mr L had an accident protection policy and made a claim under the Permanent Total Disability section of it. In order to succeed, he had to establish that he had “sustained accidental bodily injury which within 12 months resulted solely and independently of any other cause, in death, permanent disability, or hospitalisation”.
The total sum insured was £200,000. Mr L’s insurance company arranged for him to be medically examined by an occupational health doctor, who assessed him to be 25% to 30% disabled. The insurance company made Mr L an offer of £55,000.00 to settle his claim. Mr L asked BLB Solicitors for advice.
After assessing the claim, we referred Mr L to a respected consultant rheumatologist. The rheumatologist advised that Mr L was far more disabled than the occupational health doctor had suggested. The insurance company withdrew their offer and obtained a report from their own rheumatologist.
Following a joint discussion between the two rheumatologists, the insurance company paid out the full £200,000 entitlement under the policy.
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