Guardian has paid its first critical illness (CI) claim under its cover upgrade promise.
The commitment, introduced upon Guardian’s launch in 2018, sees it promise to check a claim against both the CI definitions that the customer bought, as well as the CI definitions for new customers, and to pay out if the claim is valid under either.
The claimant in this case was for Parkinson’s, with the cover taken out in July 2019.
At the time Guardian’s Parkinson’s disease definition was:
“A definite diagnosis by a UK consultant neurologist of idiopathic Parkinson’s disease. There must be permanent clinical impairment of motor function with associated tremor and rigidity of movement.”
Guardian upgraded its definition for Parkinson’s in October 2019 and wrote to all existing customers to let them know that their definition had been upgraded free of charge.
Today’s definition is:
“A definite diagnosis by a UK consultant neurologist. There must be permanent clinical impairment of motor function. This impairment should include either an associated tremor or muscle rigidity”.
In this case, while the customer had received a definite diagnosis by a UK consultant of Parkinson’s and had an associated tremor; they were not yet experiencing muscle rigidity.
Although the definition would not have been met in the contract the customer bought in July 2019, under cover upgrade, Guardian was able to assess the claim against the current critical illness Parkinson’s definition on sale and was able to pay the claim.
After listening to the customer’s concerns about their Parkinson’s diagnosis, Guardian revealed its claims team provided a referral through HALO to Krysalis for specialist neurological occupational therapy, which comes free as part of their policy.
Working with the customer, Krysalis provided a baseline assessment and six therapeutic sessions addressing their specific concerns, which included fear of the condition and how to manage it.
The customer was given help with fatigue management, helping them pace themselves better through the day to prevent symptoms of the condition worsening.
They were also given lifestyle modifications and strategies to manage their condition, help to manage their perception of self, mindfulness and relaxation techniques, support and guidance about how to access NHS services, and support with challenges to do with facial expression.
Phil Deacon, head of claims at Guardian, said: “We’re delighted to be able to pay our customer’s Parkinson’s claim as a result of our cover upgrade promise. This claim shows why cover upgrade is such an important and valuable feature of Guardian’s critical illness cover and it speaks to exactly what we’re trying to achieve as a business.
“What’s more, through our bespoke HALO claims service and specifically our partnership with Krysalis, we’re able to provide our customer with access to specialist neurological support to help them come to terms with their condition and to manage it.”
Deacon added this customer’s experience demonstrates exactly why Guardian takes a bespoke approach to claims support.
“The challenges of a Parkinson’s diagnosis are complicated and unique to the individual,” Deacon continued.
“It underlines the importance of our partnership with Krysalis and their expertise in supporting people with neurological conditions. This, combined with the specialisms of our other HALO partners, helps us to provide personal and valuable claims support for our customers.”
The customer, who works as a financial adviser, added: “As an adviser, when Guardian came to market with its critical illness policy and its cover upgrade promise, I could see it was special, and that was part of the reason I took out this cover for myself.
“I’m so pleased I did, not just because of cover upgrade which means my claim has been paid, but also because of the support I’ve received through HALO and my referral to Krysalis.
“The therapy sessions with Krysalis have helped me to process and organise my thoughts about my Parkinson’s diagnosis.
“When I was first diagnosed, I had a very bleak outlook, but the therapy has helped me see things differently. I now hold a much more positive outlook for the future.”
