You don't say if you are in the UK
If you are I have attached some general information and advice from The MEA on critical illness insurance problems:
Many insurance companies have been very reluctant to accept claims from people with ME/CFS in relation to critical illness policies
Problems often stem from the fact that critical illness policies contain a list of all the medical conditions they will cover, often with detailed inclusion and exclusion clauses attached, and ME/CFS tends not to appear in these lists as a condition that is INCLUDED
In some cases ME/CFS is actually EXCLUDED - see reference to ME/CFS under encephalitis in the Zurich policy document on page 18:
https://www.zurich.co.uk/internet/zurichintermediary/Documents/113293.pdf
So the way to make a claim might be under a section covering total and permanent disability
However, the small print defining PERMANENT and TOTAL disability can again make this very difficult for people with ME/CFS when the insurer disputes that ME/CFS is a permanent illness, or that it can cause major disability
To help cover this type of situation, we have an MEA information leaflet that summarises and references all the key published research data on prognosis and permanency in ME/CFS:
http://www.meassociation.org.uk/shop/management-leaflets/pensions-prognosis-and-permanency/
Two cases where people with ME/CFS were refused critical illness cover that are worth looking at if you are in this position:
From the MEA website:
http://www.meassociation.org.uk/201...y-on-income-protection-insurance-21-may-2011/
And a Financial Ombudsman decision:
http://www.ombudsman-decisions.org.uk/viewPDF.aspx?FileID=35737
However, there are now cases where people with ME/CFS have persevered with a claim - or involved a solicitor who specialises in this type of claim and succeeded
Information from Brian Barr - a solicitor who deals with ME/CFS and Fibromyalgia claims:
http://www.brianbarr.co.uk/category/critical-illness-insurance-claim/
We also work with a very good solicitor - James Millar Craig - at Royds Solicitors in London on insurance and legal cases. Contact details Royds are on the back page of ME Essential magazine
Details posted on MEA Facebook on January 2nd 2016 from a member who had won a critical illness case are below. The full discussion can be accessed using the search facility on MEA Facebook page.
SOMETIMES IT CAN BE SO WORTH PURSUING THESE CLAIMS AND THE LUMP SUM I'VE RECEIVED – £152,000 – DOES NOT AFFECT MY ESA!
Anonymous please:
I'm not sure if you will remember but I once asked the question regarding whether it was possible to claim against a life/critical illness policy I had that also covered me for total and permanent disability.
At the time, it was of the general opinion that I would be unsuccessful with a classic as ME/CFS is not a critical illness and is not considered to cause total and permanent disability.
However, I did decide to pursue a claim with Zurich. My original policy was with Allied Dunbar and was a whole-of-life policy taken out in 1998. The claim was submitted in February /March 2015.
After obtaining extensive medical reports as well as psychological one's, I finally received a decision at the beginning of October 2015.
I was told by the senior underwriter at Zurich that I had met the qualifying criteria and I was awarded the full amount of the sum assured: £152,000
I informed the DWP of this award and because it is a lump sum, does not affect my rights to receive Employment and Support Allowance as this is based on my National Insurance contributions.
I thought this information may be useful to your organisation as it may be of assistance to other sufferers.
Dr Charles Shepherd
Hon Medical Adviser, MEA