Useful archive material for people with ME/CFS involved in insurance disputes | APPG on ME meeting, December 2004

We have been trying, without success up until now, to find the Minutes of an APPG on ME meeting held in December 2004 which discussed insurance-related issues. This was for one of our members who is having problems with a well-known insurer in relation to an income protection policy.

The APPG Minutes have now been located and provide some useful information for anyone who is involved in an insurance dispute:

ALL-PARTY PARLIAMENTARY GROUP ON M.E.

Chair: Tony Wright MP
Vice Chair: Rev Martin Smyth MP
Secretary: Steve McCabe MP
Treasurer: David Amess MP

MINUTES OF THE ALL-PARTY PARLIAMENTARY GROUP ON M.E.
HELD ON TUESDAY 14 DECEMBER 2004
AT No 1 PARLIAMENT STREET

PRESENT

Tony Wright MP (Chair)
Liz Blackman MP
Rachel Barker, Office of Stephen Hesford MP
Ian Woodcroft, Office of Tony Wright MP
Chris Clark, Chief Executive, Action for M.E.
Dr Charles Shepherd, Medical Adviser, The M.E. Association
James Millar Craig, Royds Solicitors (M.E. Association)
Graham Baggott, M.E. Association
Steve Aggott, M.E. Association
Tony Britton, M.E. Association

APOLOGIES

Apologies for absence were noted

. Richard Allen MP
. David Amess MP
. Roy Beggs MP
. Tim Boswell MP
. Graham Brady MP
. Tom Brake MP
. Ann Campbell MP
. Tony Colman MP
. Helen Clark MP
. Jim Cunnigham MP
. Tony Cunningham MP
. Janet Dean MP
. Clive Efford MP
. Annabelle Ewing MP
. Peter Luff MP
. Dr Evan Harris MP
. Jimmy Hood MP
. Brian Iddon MP
. Kali Mountford MP
. Kevin McNamara MP
. Chris Mullin MP
. Eddie O’Hara MP
. Lord Puttnam
. Joyce Quin MP
. Syd Rapson MP
. John Robertson MP
. Dame Marion Rowe MP
. Bob Russell MP
. Bill Tynan MP
. Rachel Squire MP
. Betty Williams MP

1. ANNOUNCEMENT OF INQUORATE MEETING

Tony Wright announced that, in view of the low attendance of Members, he had no option under the APPG rules than to declare the meeting inquorate. Business decisions from the meeting would have to be deferred.

He said he intended, however, to proceed with the presentation on Permanent Health Insurance difficulties and invited Dr Charles Shepherd, Medical Adviser of The ME Association, to introduce the subject. He would welcome contributions to the discussion from James Millar Craig, PHI specialist at Royds Solicitors, and two MEA members who were present, Graham Baggott and Stephen Aggott.

2. Presentation:

INSURANCE INDUSTRY PRACTICES WHICH DISCRIMINATE AGAINST PEOPLE WITH ME

In opening the presentation, Dr Shepherd said many people with ME depended on insurance protection and insurance replacement policies when they had to retire early from work because of ill-health. Yet it was clear, since the House of Commons adjournment debate on the subject in 1999, that the climate in which people with M.E. were making claims was becoming increasingly more hostile to them. Members could test this for themselves by typing UnumProvident, which figured largely in the 1999 debate, into internet search engines and be swamped with information about complaints against this company.

Functional assessment evaluation – with claimants being put through brief computer-led questionnaires – was being used increasingly as a tool to get people back to work. The use of private detectives and covert video surveillance were techniques being employed to obtain the flimsiest of evidence against claimants.

Government could help obtain a level playing field for both the insurers and the insured by introducing legislation which ensured:

(1) That both medical examinations and functional assessments were independent, and carried out by health professionals who are acceptable to both sides;

(2) That individuals in group/company schemes had copies of their policies and were able to negotiate directly with the insurer if they wished to and did not have to rely on their employer to do this;

(3) Decisions about the future management of the illness should be agreed between the insurer and their own medical advisers. It was unacceptable for the insurers to interfere with or take over medical management – unless this is agreed between the insured and their medical advisers;

(4) Continuation of benefits should not be made conditional on compliance with carrying out a particular form of treatment recommended by the insurer.

James Millar Craig said the greatest problems occurred in group schemes, where there was no privity of contract between the insured and the insurance company. If the employee was sacked or was no longer a member of the group scheme, there was no claim whatsoever. Video surveillance was mostly carried out over a number a days, with the video tapes then spliced together to run for perhaps 45 minutes which ignored the days or long periods of time when the claimant was doing nothing.

Mr Millar Craig said his experience of the Insurance Ombudsman was that the complaints process was very slow and the Ombudsman was over-impressed by functional evaluation testing reports, which they treated as akin to medical reports, and by video surveillance material. To reduce the present climate of hostility and fear that existed between insurers and claimants, he said the insurers needed to dismantle the apparatus they had built up to “knock out” claims and work genuinely with individuals to agree fair and proper ways forward with, if necessary, proportionate benefits being fixed for a genuinely reasonable period to safeguard the incomes and livelihoods of claimants and their families.

Tony Wright said his impression was the insurance claims climate for people with ME had deteriorated, not improved, since the 1999 debate. Dr Shepherd agreed; Mr Millar Craig said group insurers had become much more aggressive towards claimants over the last 10 years.

Liz Blackman suggested that the Commons Select Committee on Health might be approached to conduct an investigation, and that data needed to be gathered to support the APPG’s arguments. It would be a systematic and focused way to raise public awareness in the subject, and there would be an opportunity to canvass afresh for an inquiry when the new Select Committee is named in the next Parliament. Tony Wright said he would be happy to seek another adjournment debate on the subject, and agreed that a Select Committee inquiry would be an appropriate way to bring legislative matters to Government attention.

Dr Shepherd commented that UnumProvident was raising their own public profile by investing £1.5million in a new rehabilitation research centre at Cardiff University, which will be led by Professor Mansel Aylward, current chief medical adviser at the Department for Work and Pensions.

Graham Baggott (MEA member) said that he won a recent claim for income protection insurance, but only after obtaining the services of a solicitor and running up heavy legal costs which his insurer refused to pay. The insurer had overturned the recommendation of a consultant that his claim be reviewed in 12-18 months, by now insisting that the review take place within two or three months.

Tony Wright commented that Mr Baggott’s experience was similar to many others, and recommended that people with these probems draw them to the attention of their constituency MPs, who could then raise them directly with the insurance companies concerned.

Chris Clark (Action for ME) said it would be useful to explore common ground with umbrella charities representing people with chronic and long-termillness like the Long Term Medical Conditions Alliance and the Disability Alliance to see if they would be prepared to be involved in any unified call for an inquiry by the Select Committee.

CLOSE OF MEETING

Tony Wright thanked visitors for attending and expressed regret once again that too few APPG members had been present for the meeting to be quorate.

The next meeting will be the Annual General Meeting of the group in January 2005, when every effort will be made to secure a larger attendance.

ENDS

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