An Unfair Struggle

When I was young I thought I was indestructible.  Doesn’t everyone?  I would risk life and limb to get an adrenalin rush.  Such are the joys of youth.

Upon joining the Army, I was introduced to the realities of my chosen career.  This was a job where you could die, a job in which people would intentionally try to kill me.  As I was young, I thought it would never happen to me.  I still thought I was indestructible but I wasn’t stupid!  I took out several insurance policies, ensuring that if something bad happened to me, I would be financially secure or, if I died, my next of kin would be.

For nearly twenty three years I paid my premiums, never complaining when they were increased and never once claiming against them, even when I was badly injured in Iraq.  I didn’t think my injury was serious enough to claim compensation and I wanted to hold the claim until I really needed it.

Unfortunately, I discovered that I am not indestructible.  I suffered a terrible accident that has left me paralysed, in chronic pain and depressed.  I can barely move without being in severe pain and my life has turned upside down.  The injury has resulted in me being medically discharged from the Army, something I never dreamed would happen.  As I was undergoing treatment for my injury, I was advised to see a claims adviser from one of the companies with which I had a policy.

Upon seeing me and getting all the details of the accident, the adviser convinced me to claim on my insurance, stating that I was guaranteed to get the appropriate compensation.  Until I had met this man, the thoughts of insurance and compensation were the last things on my mind.  My only concern was getting my injury seen to and getting better.  When I realised that there was no getting better, I made a claim to my insurance companies.  I was naive enough to believe the adviser and thought that there would be no problems.  I waited for the cheque to arrive in the post.

Little did I know that I had a greater chance of being cured than getting a penny from the insurance companies!

At first they stated that I couldn’t claim for at least a year, just in case I got better again.  I thought this was fair enough.  I had claimed compensation for being paralysed and, you never know, I could have gotten better.  Unfortunately for me, I got worse and once the year was up, I contacted the insurance companies and informed them that my condition had deteriorated.

Obviously, they didn’t believe me and wanted access to my medical records.  I had no problem at all with this, knowing that I was genuine, I signed all the release papers they sent me – then waited for the cheque to arrive in the post.

Guess what?  It never came.  Instead I received a letter stating that the injury wasn’t caused as an accident and therefore I had no basis for a claim.

To say I was shocked would be an understatement.  I was convinced that there was no way the insurance company would deny my claim.  I had been through the rigors of the Armed Forces Compensation Scheme and had been awarded compensation because of the accident.  I thought that if the Ministry of Defence admitted liability then there was no way the insurance companies could deny it.  But they did.

I wrote a long and detailed reply.  I included dates, times, places and all the supporting documentation I could find.  Once I had sent the bulky package that was my hope for the future, I sat back and waited for the cheque to arrive in the post.

But no, it wasn’t going to happen.

By this time, months had passed.  My condition continued to get worse and my dosage of opiates increased, as well as a smorgasbord of other narcotics.  My mind no longer became mine to command and I often wandered off to some alternate reality.  I had a hard time telling what was real and what was not.  This not only caused distress to me but also my family that had to care for me.  The only times I was lucid were those short moments between taking the drugs.  I would have a window in which I could think, not clearly, but enough to understand what was happening around me.  I became depressed, not only because of what I had become but also due to the reticence of the insurance companies to honour their part of the contract.

I received another letter, in due course.  This time, their ‘Chief Medical Officer’ had ascertained that I had an injury prior to my accident that would have certainly led to the situation I was in at the moment.  To say I was stunned would be an understatement.  I was upset, angry, depressed and, most of all, confused as to how they managed to come to the conclusion they had arrived at.  I knew that I had never had any problems with my back before the accident and I wondered how you could get a preexisting neurological condition.

It transpired that an entry had been made in my medical documents that stated that I had back problems.  I only realised this once I had managed to obtain a copy of my medical notes (a lot harder to obtain than you may think).  I was shocked.  I never had this problem and wondered why it had been written in my medical notes.  I scrutinized my notes in detail and noticed numerous other errors in them.  I couldn’t believe it and there was little or nothing I could do about it.  I spoke with my doctor and asked if it was possible for her to write a letter stating that these were clearly errors.  There were no other entries to support this one damning report; it stood out alone with nothing to support it prior to or after it had been written.  The doctor agreed and wrote a letter stating that to the best of her knowledge it was an error.

I wrote back to the insurance company, with a copy of the doctors letter.  I explained that the entry was erroneous and that there was no other medical evidence to support it.  I then waited for their reply, sure that they would cling to that one damning entry and deny my claim.  Needless to say, I wasn’t disappointed.  They denied the claim and told me that the case was closed.

That was that.  The insurance company that professed to support the military had turned me down flat.  It was obvious to anyone that they were wrong to do this but they had a single piece of evidence that was enough to deny my claim.  I was devastated.

Once I had calmed down and gotten my thoughts in order, I went down the only avenue left open to me.  I wrote a complaint to the Financial Ombudsmen.  They received my case and said they would investigate it.

Some time later, I received a letter from the insurance company asking me to sign another release document in order that they could contact the specialist that had treated me at the time of the accident.  This was the same person that had signed my insurance claim form, the same person that had stated that I had suffered a terrible accident and that there was nothing else they could do.  And my insurance company hadn’t even bothered to get his opinion!!!  I signed the release form and wrote a terse letter back to them stating that I didn’t trust them to do anything to help the military as they professed in all their literature.

It’s nearly two years now and I am still waiting.  I have since contacted a solicitor and am attempting to get my medical records sorted out.  There is little I can actually do apart from have my objections noted.  It’s too late for the records to be changed.  I can understand how errors can be made, the doctors writing down notes for numerous patients and then handing them to clerks to be inputted on the database.  Errors are bound to be made.  The errors made on my documents have resulting in making my life a misery on top of the misery of my injury.  What didn’t help is the difficulty in obtaining a copy of your own medical documents.  Had their been more transparency, maybe the error in my notes would have been discovered sooner and righted.

I haven’t heard from the insurance company although letters from the Financial Ombudsmen assure me that the investigation continues.  On the plus side, the Armed Forces Compensation Scheme has increased the award made to me.  It’s not a lot, but it helped to reassure me that the accident wasn’t my fault and that someone knows that.

I cannot believe that I am an isolated case.  I think of the amount of money I paid this company over the years in order to give me peace of mind should anything have happened to me.  Now they are causing nothing but distress to both me and my family.  I cannot believe that we, the consumer, are powerless to do anything apart from complain.  It’s unfair.  I thought I had enough to content with after the accident, the drastic change in my personal life is not easy to come to terms with and I am still in denial.  This additional struggle shouldn’t, in my opinion, be happening.  I was naive to think that an insurance company would part with money, but why should I have thought differently.

I now wait to be evicted from my house as I am no longer in the military.  All my hopes, dreams and plans have been shattered.  I wait for a response that I half dread, just in case the insurance company have managed to sweet talk their way out of paying me.  It’s unfair, but that’s life.


4 thoughts on “An Unfair Struggle

  1. James, I know it’s hard, and you know that I really do understand. But, please don’t ever give up. Keep on writing those letters. What about finding an attorney who would be willing to take on your case on a pro bono basis? Write letter, insisting that you speak to the highest power in your insurance company. Deal with somebody specific and do not let up, ever. Write to Pres. Obama or his lovely wife Michelle. Go to the media with your story. Kick up a fuss. You know, and I know, that you deserve better than this.

    It took four long years for my insurance to pay me out. It almost ruined me physically and emotionally. But in the end, it was all worth it.

  2. Thanks, Tracy. To be honest I can’t bring myself to be optimistic. Nothing seems to have gone right over the last few years and I am fed up of being upset or disappointed. I’ll just wait and see what happens. You never know….

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