The policies of disability: Nic Cicutti explains how insurers' varying definitions of ill health could seriously damage your pension plan

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The Independent Online
PEOPLE who opted to ensure that their personal pension payments are protected if they fall seriously ill are finding that they are excluded by the wording on insurance policies.

Definitions of disability vary widely, and some companies insist that a person must be unable to carry out any job whatsoever in order to claim.

Even where they accept that someone cannot work any longer, companies differ in the exclusions they apply when considering how that person became disabled.

Sun Life will no longer insist on a person being accepted as disabled only if he cannot carry out any job. From now on, disability will relate to a person being unable to do his or her existing job.

Ian Leech, the company's business manager, said: 'In making these improvements, we have been as concerned with our existing policyholders as with new ones. I am pleased that we have been able to extend this to existing contracts.'

Alan Lakey, an independent adviser with Highclere Financial Services in Hemel Hempstead, Hertfordshire, has carried out a detailed survey of the problem.

'The way the system works is potentially unhelpful,' he said. 'It means a roofer who falls off a ladder and is left in a wheelchair is told that his pension premiums will not be paid because he can still type at a desk.'

Waiving of premiums is an option used to skirt round Inland Revenue rules, which say that pension contributions have to be linked to net earnings in that particular tax year. If a person earns no income for a long period of time, he or she cannot normally make contributions to a personal pension. However, for a few pounds a month, the company may agree to waive those premiums until retirement, so that any pension paid assumes they have been made.

However, Mr Lakey pointed out: 'The definitions vary widely, both for the disability and the exclusions. A strict interpretation would allow companies to deny claims unless a person was quadriplegic, in hospital or in a coma. That seems a bit unfair.'

Examples of strange policy wordings include those of Axa Equity & Law. The company excludes illness contracted during a stay of more than 30 days between 20 degrees north and south of the Equator, plus North Africa and the rest of Asia.

This excludes much of northern Australia and all of the West Indies other than Cuba, suggesting that it is better to be run over by a bus in Havana than in Darwin.

Royal Life's policy was no easier to understand, given that it excluded sickness in certain places outside Europe, Mr Lakey said.

Eagle Star excludes claims arising from racing, unless on foot. So a swimming race from one side of a pool to the other could lead to exclusion while a marathon run across the Gobi Desert would not.

'About half of all companies will deny claims from people who are HIV-positive or have Aids, regardless of how the virus is caught,' Mr Lakey said. 'An accidentally split condom is judged as deniable a claim as intravenous drug use, which hardly makes sense. '

David Wilson, assistant marketing manager at Sun Alliance, said: 'Every office has a different underwriting experience, and it is on that basis that exclusions and definitions are determined.

''The fact that there are so many different waiver policies around is a product of competition in the market, which is surely a good thing.'

Phil Veale, protection product manager at Axa Equity & Law, said of his company's latitudinal exclusion policy: 'The aim is to give a rough idea of what we are prepared to waive premiums for.

'We would operate within the spirit rather than the letter of that wording, so if a person was seriously ill or disabled in north Australia, we would be prepared to consider waiving premiums.'

(Photograph omitted)

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