I agree; I'm not sure that my advice was all that different to yours save only that I sought to emphasize to the OP that the law is fundamentally on his side, provided he has clean hands, which is why insurance companies behave in the way they do.

It's only sols who seems to have a major problem with what I said; maybe sols will come along and explain himself...

ex-banker

As part of the process for making the claim the poster would have been required to submit paperwork from doctors. This would have confirmed the relevant dates, details of medical issues etc. First Assist would have relied on the doctors information and not on any statements by the poster to decide on the claim. If First Assist were in any doubt about the validity of the claim, they had plenty of opportunity to ask for more information.

Having worked in Insurance for a long time, mistakes can happen, with claims paid, that in hindsight should not have been. But on the occasions such mistakes have been made, we have asked nicely for the money to be paid back, knowing that we would not pursue legally. Some customers did pay back the money but a few did not. Some of the amounts involved were more than the £1200 concerned here.

The other angle to the posters claim is that the Insurers appear to have agreed to deal with the claim and confirmed that it was within the terms of the policy. They are now liable for all sums related to the claimed event, for any ongoing issues. By asking for the payment back, they are effectively asking for the poster to agree that the claim was not valid. This is also to avoid any further payments that may be claimed.

This is a matter for the FOS to sort out and icemancomeths would be mad not to make a complaint.

Huckster

Ok, here's where me and Sols are going to differ, and he's going to assert he knows best.

Question one, are the company estopped from making a claim because you relied upon their statement that you could claim? I'm not sure, because I don't know how much you told them before they paid out. Neither does Sols, but he's certain I'm wrong. That's an interesting position to take on the basis of so little knowledge. If you told them nothing about the injury predating the operation, then I'd guess you're in a weaker position than if it's documented that you told them everything and they simply changed their minds.

Second; would a judge apply equitable principles if a claim for restitution were issued by the company? Sols says the insurance company are 'obliged to consider your financial position and health'. Those are equitable considerations. So we seem to be asserting the same thing but sols doesn't recognise some pretty basic legal language and principles. That's interesting.

icemancomeths:

Agree with sols, go to Citizens Advice for some free legal advice.

Then I would suggest that you submit a complaint to the Financial Ombudsman Service (FOS)and write to first assist to advise them that you want the FOS to decide on this.

See the link below for the FOS complaints process. Would suggest that you give them a call, so they can answer any questions you have about the complaint process. Making a complaint to the FOS is free to you, but First Assist will have to pay a fee, whether or not you are successful.

http://www.financial-ombudsman.org.uk/consumer/complaints.htm

You cannot afford to sit on this matter. First assist could go to court and I am not certain as to whether they could obtain a judgement in their favour. They may be on dodgy ground, as no doubt you will have documentation where First Assist have agreed to pay. I am not sure of the law in this area, where someone agrees to make a payment under a contract and then changes their mind. I would have thought that if First Assist had a legal case, they would have made this clear, when writing to you. If they have not stated a legal case, perhaps they are not confident enough to test this in court.

If Sols works as a Solicitor for an Insurance company, no doubt he will have had some experience of similar circumstances and can point to the law that applies and case examples. In the past I have had some involvement in trying to get money back from claims paid in error and have received advice from the companies legal team not to bother i.e write it off. As customers refused to pay back we declined to provide further cover, giving notice of cancellation.

Huckster

Hi as previously advised you need to go to the Financial Services Ombudsman if they are dealing with your complain the company cannot issue proceedings. You need to get free legal advice asap, go to your local CAB. If you need any more advice come back to me. The advice from banker is with all due respect wrong. The issue is whether there has been a breach of contract between you and the company if they are not obliged to pay out on the policy you owed them the money but they are obliged to consider your financial position and your health. From what you have said it does appear that your accident pre-dates your policy so you weren't covered. If the operation is a direct result of the injury you sustained in the accident you won't be covered either. If it is seperate you should be.

Good luck get advice now!

Unsure of who to contact? A solicitor, that's who to contact.

The key question here is one of good faith. Did you act in good faith throughout? My view is that you have, in equity, a right to refuse their claim for restitution if you have acted in good faith. They, I'm sure, will argue that you should have known the terms of the policy, but I'd test that with a solicitor and see if the insurers fancy half a day in front of a District Judge...

Hi all, I am still in need of help here and I am unsure who to contact.

Just to point out that they are willing to settle that I pay back £50 per month until they recieve full payment. The £50 per month will go into their solictors account it seems.

In the policy book it does state that if any related illness/accident in the prior 12 months relates to this then I will not be covered.

But my argument is that its the operation that caused me to be off work not the accident, I was still able to work until the op.

Anyway, to cut a long story short what happens if I refuse to pay, can they take me to court, do I have to pay?

Please help as I really cant afford it.

Regards

Hi I was on the website and noticed your message.

I am a solicitor with an insurance co so I may be able to help. Some times companies threaten to issue proceedings but will not do because it is not economically viable i.e. the value of the disputed amount is too low. Because they claim you owe £1200 it is likely they will issue. Which company is involved here?

My advice to you is

1. Call the co in question and explain you cannot pay, you need to buy yourself some time.

2. Check the policy are they correct?

3. Send a complaint letter and threaten to complain to the Financial Services Ombudsman, you may owe them money but they have no right to threaten you especially if you are in poor health.

Good Afternoon all,

I am needing some advice as I have received a letter requesting the my 2 months Mortgage Protection Insurance Payments back as these were paid incorrectly*

On the 16^th December I applied for MPI with First Assist, the policy start date was 28/12/08.

I had an accident on the 27/12/08 which caused me to go to A&E, at first it seemed I just needed a pot to fix a break and was able to return to work for the next 2 weeks. After 2 weeks I went back for a review and they said I would need an operation- This operation would then see me out of work for 3 months.

At first I wouldn’t be able to claim anything due to the accident been before the policy start date, so I contacted them via phone to alert them of my situation. While on the phone they advised me that I could make a claim because it was the surgery (12/1/09) that was within the policy start date which incidentally caused my sickness, not the original accident as I was able to continue to work in just a pot.

So I completed the claim form with my doctor (£125 cost) and attached all necessary documentation such as sick notes and operation discharge notes. I then received a cheque for £1200 to cover 2 months mortgage payments and said the matter was now closed.

On the 18/05/09 I received a letter requesting £1200 back after findings in an investigation that the policy does not cover the following:

as a result of any medical condition for which treatment had been given or diagnosis had been made 12 months prior to the start date and which comes back within 24 months after the start date.

It then states if I do not respond within 7 days I will be contacted by their solicitors requesting reimbursement of £1200.

Please help.

So I completed the claim form with my doctor (£125 cost) and attached all necessary documentation such as sick notes and operation discharge notes. I then received a cheque for £1200 to cover 2 months mortgage payments and said the matter was now closed.

On the 18/05/09 I received a letter requesting £1200 back after findings in an investigation that the policy does not cover the following:

- as a result of any medical condition for which treatment had been given or diagnosis had been made 12 months prior to the start date and which comes back within 24 months after the start date.

It then states if I do not respond within 7 days I will be contacted by their solicitors requesting reimbursement of £1200.

Please help.