I suffered a cardiac arrest at work but my insurer won’t hand over my £50,000 payout: SALLY SORTS IT

I suffered a cardiac arrest at work in February. Thankfully, my heart was restarted by paramedics with CPR and a defibrillator. I was in a coma for two days and in a critical care unit for six days. I spent three weeks in hospital and had an implantable cardioverter defibrillator – a type of pacemaker – inserted in my chest.

I will have to take medication for the rest of my life and reduce my workload. I went to claim on the LV= critical illness policy I’ve been paying for since 2011 but was told cardiac arrest was not covered and I would not get the £50,000 payout I expected. This is so unjust. Please help.

Anon

Sally Hamilton replies: I am so sorry to read about your health incident, which was horrific enough. But to then be told you were not eligible for a payout from protection insurance you have held for 13 years, was beyond the pale. You were rightly furious, an emotion better avoided by someone recovering from a cardiac event.

Many modern critical illness policies cover cardiac arrest but older plans, like yours, exclude it mainly because the chance of surviving used to be slim. Improvements in medical care mean more people are likely to pull through.

By contrast, heart attack is included in old and new plans as survival prospects have always typically been better, even if a person’s health suffers as a result.

Cardiac arrest is when the heart stops pumping, typically triggered by an irregular heart rhythm. With a heart attack, the organ keeps pumping, but a blockage prevents the blood flowing properly and can cause heart muscle to die.

Critical illness plans are designed to cushion the financial blow for families, paying a lump sum to policyholders diagnosed with serious illnesses that may affect their ability to continue working at full capacity.

You are 63 and used to work full-time as manager in a cabinet making business moving around different sites. But after five months off work, you have only been able to return part-time in an office-based role at one site.

It has cut your income dramatically so you could do with the £50,000 lump sum from your policy to help support you and your wife. You’ve paid roughly £11,000 over 13 years for cover from LV=.

LV= introduced cardiac arrest to its plans two years after you took out your plan. I contacted LV=, which confirmed the exclusion on your policy but said it would reconsider the claim if medics could provide further information that perhaps enabled you to meet its conditions.

You arranged for detailed reports to be sent to LV=. Your cardiologist provided the insurer with the results of an MRI scan that showed a heart attack had preceded your cardiac arrest.

I am pleased to say LV= accepted the assessment and has now sent you the £50,000 owed, plus £900 interest. You told me the relief was hard to describe and that your financial concerns will be eased for the foreseeable future.

Critical illness cover ends once a successful claim is made and the lump sum is paid out. When I checked on you last week, I was pleased to hear that though you struggle with fatigue you are making progress with your health. I hope you continue to improve.

The lesson of this case is to not to just accept an insurer’s initial refusal and demand a thorough assessment of a claim.

A spokesman for LV= says: ‘Upon receiving further medical evidence and writing directly to his cardiologist, we were able to pay his claim on the condition of a heart attack.’

I booked tickets for a Take That festival with three friends. We originally opted for four-day tickets for the event in Malta at £279 each. We then heard via fan forums that Ticketmaster was letting people exchange these for more expensive two-day VIP tickets giving you access to special areas and bars, so we contacted customer service and were told all we had to do was purchase the VIP tickets at £325 each using the same accounts we used to buy the original tickets, then we would be refunded for those.

My friend made it clear four of us were involved but Ticketmaster said we needed to complete the exchanges separately. Half our party succeeded but my request was refused. I am out of pocket and very upset.

S.H., Sutton, Surrey.

Sally Hamilton replies: Your battle with Ticketmaster threatened to take the ‘Shine’ off the enjoyment of your trip to see your beloved group in Malta.

You forked out for VIP entry, but didn’t get VIP treatment when trying to get refunds of your original tickets, despite carrying out all that was asked to the letter.

There were three caveats to ensure a refund: the new tickets had to be for the same venue as the original booking: tick; they had to be a higher price than the originals: tick; and new tickets could not be resale tickets: tick. Despite adhering to all three, you were told the only way you would see your money was if the event was cancelled, or if you were able to sell them on Ticketmaster’s resale platform.

There had been an option to upgrade your tickets to VIP status for £150, which though more than the replacements you went on to buy, would have been less than the bill you ended up with.

It was time for Ticketmaster to face the music. When I pointed out the problem, the agency responded swiftly. It thanked me for bringing your case to its attention and promised to refund £279 each for you and your friend.

You’ve confirmed this week that the refund was ‘Back for Good’ in your account.

You told me the experience had been ‘absolutely fantastic’, and while you described the VIP tickets as a modest upgrade, they let you get closer to the stage without queuing all day and gave access to separate toilets – a huge bonus in my view.

Straight to the point 

I’m an expat living in France but my bank account was closed ten months ago due to Brexit rule changes. My £15,000 is still in a holding account. I’ve sent the required documents. Where is my money?

F.E., France.

The bank says you had six months’ notice of your account closing and it sent you monthly letters requesting information to release the money, which you say you didn’t receive. You have now received your funds.

My daughter hired a car from Europcar and crossed the Dartford Crossing three times. I paid the fee using the registration number on the Europcar key fob but it had a letter missing. We’ve been fined for two crossings plus Europcar’s admin fees. One fine was reduced to £2.50 as it was my first failure to pay, but the second has increased as Europcar didn’t let us know about it soon enough.

K.E., via email.

National Highways says it will reimburse payments made against the wrong number plate and has cut the outstanding penalty charge to £2.50. Europcar apologises and has cancelled its fees, refunding you £80.

We booked a stay in Largs, Scotland, for July via Booking.com. Four days before we were due, the owners said we couldn’t stay and they had told Booking.com months earlier. Booking.com said we could book alternative accommodation and it would refund us the difference in price. Three months later we still don’t have a refund.

B.D., Halifax.

Booking.com apologises for the delay in getting your refund, which you now have.

I flew from Gatwick to Mauritius but my luggage didn’t turn up for ten days so I spent £75 on essentials until it did. The online compensation form won’t send.

G.P., Dorset.

You have been offered £143 compensation, which you are not happy with.