I hope I am posting this in the right place, yet another sleepness night has me still up at 5am and on this forum now in an attempt to get a resolution to a 2+ year old problem.
Here is the basics:
I registered a 'Ltd' Business in Jan 04 with a view to obtaining a premises and opening a bathroom showroom later that year. I worked very hard getting some money through the books and into the bank account (with Lloyds TSB) so that they would consider me for a loan, I did this by doing some fitting work, the obvious work required to start a new venture, hundreds of meetings and more. I took no pay and was not PAYE at this time. Later that year (Nov 04) I located a suitable premises and Lloyds TSB provided me with a sizeable loan (2 in fact), secured on my home, for the development of the premises and opening. They also provided me with a secured (but not yet insured) overdraft too.
As part of the package, my business manager sold me an insurance policy (underwritten by London & Edinburgh Insurance) to cover the 2 loans against illness and death etc. These were paid initially as part of the loan amount.
During the application process, which was fully handled by my Bank Manager, I was asked if I was working over 16 hours a week - I replied I was working over 16 hours per DAY - I was also asked if I had any pre-existing medical conditions and I mentioned that a few years before I suffered from M.E. and M.E. related symptoms.
Time past and the business started to pick up nicely. It had its fair share of issues (obtaining good staff) but sales were good and we were on target.
Around September 2005 I was incouraged by a new bank manager to obtain some overdraft payment protection insurance, which was also underwritten by London & Edinburgh and cost £15 per month but would pay around £750 per month if I were ill etc. So I now had 2 loans and an overdraft all secured on my home and all insured by London & Edinburgh.
Now this is when things turned nasty. Following a particularly stressful time with staff at the beginning of 2006, I was finally signed off work during August 2006 with stress and anxiety disorder (serious and nasty 'panic attacks' initially). Following monthly visits to the doctors I was later noted to be suffering some depression, this would be clearly due to the stress and the extra burdan my health and situation placed on my life and business.
Insurance payments for the loans commenced with no real issue and I felt confident everything was going to be OK and I would be back working asap. My wife did all she could to keep the business running but I would often have to attend to sort some matters (especially as I could not be left alone at home), deal with some easy clients (to ensure money was still trickling in) and handle banking matters as I was the only signature on the account.
Despite high hopes, fresh plans for the business and even a very successful side track into web based sales - which I managed to get sorted just before I was signed off - I finally realised (out of sheer desperation and distress) that I was not able to run this business enough and my wife was also now getting ill from the heavy burdan of such a fast growing and stressful business. So on March 28th 2007, with my wife also now signed off work, I closed the doors.
It was shortly after that I was informed by my bank manager that the insurance payments had not been made for some months for these reasons:
1/ The overdraft policy was considered 'cancelled' following an accidental cancellation of the Direct Debit arrangement (around Oct/Nov 2006) for the cover. The DD arrangement was reinstalled within hours of being accidently cancelled and no payments should of been missed but London & Edinburgh are STILL using this short hicup as an EXCUSE not to pay this cover. Despite calls from me and my bank manager, over a few month period they did not collect any more payments. They did eventually agree and I made up for the missed payments by cheque. They did make a few months payments following this problem but then stopped again around Feb 07 and decided to use their original excuse to justify why they were not making payments. I ask you, why on earth would I cancel an insurance cover that was paying out over £700 a month that was costing me only £15 a month?????? Quite simply, I didn't!!!
2/ London & Edinburgh stopped payments for my other 2 loan covers while they did a "normal" investigation.
It is now over 2 years later and we are still arguing and no further. No more payments have been made. I referred this matter to the Ombudsman over a year ago (maybe even 18 months ago) but still a decision has not been reached.
The current excuses from London & Edinburgh (and there have been plenty) are still the same reasons for not paying the overdraft cover, but the load cover excuses are never detailed and are rather vague reasons for not paying the loan cover. Here is the latest reasons as emailed to me from the Ombudsman:
1/ I am suffering from a pre-existing medical condition
2/ I am not/was not eligible for the cover
3/ They MAY decide to try and recover the already made payments if I decide to continue my claim.
My other big problem is that I had to sell my house (could not afford the mortage when not working and nearly got repossessed too) and now live in a rented house. I used my equity to pay Lloyds TSB otherwise they would not lift their security off the house so now they have the money sat in a seperate account that I can't touch until this is settled in my favour. The amount we are now talking is over £40,000. I have no other money, no savings, no assets (sold them all to pay the rent here) and little hope of being well enough to work any time soon.
My health has dipped from purely Anxiety and Stress Disorder into bouts of Depression after I closed the business and lost everything. Watching my business struggle and my wife get ill between me being signed off and me closing the business also caused serious sessions of depression. I am assuming that they are claiming that my current depression is the same depression I had when I had suffered with M.E for over a year and had lost my job and "normal life" then too. I know of no other similarities in my current medical condition that those.
Despite asking several times for a detailed explanation of the "eligibility" issue, I get very vague replies and just pushy requests for my personal bank statements, business trading accounts, full accounts for years before and more.
They currently have the following from me:
* Full reports from 2 (yes that is TWO) 4+ hour long sessions from privately employed pushy investigators
* Full medical records
* Lots of my private bank records
* Lots of my business bank records
* Business trading accounts up to Feb 2005 (the day before the shop opened, therefore showing a trading loss while the business was formed and setup)
Due to my health, I have not and will not be able to complete trading accounts for the trading years when the shop was open. I can not even have the paperwork in the house without getting extremely ill. BUT I can verify, through bank statements, that we took around £250,000+ per annum though - surely a good figure for a new business! Don't for a second think that this was a small concern, I owned one of the largest exclusive bathroom outlets in the country with a huge '40+ display' showroom, exclusive deals with numerous luxury manufactuers and more - I worked hard to get that business that far and started but before I saw any real benefit my health gave in under the strain.
Anyway, the Ombudsman don't seem to be doing much except passing information back-and-too between us. They have suggested me allowing them to make a final decision but without a good list of detailed reasons I feel that I can not counter-act with the right evidence. To make it worse, the insurers now want yet ANOTHER meeting with their bullying investigators (I have no idea why now) and the Ombudsmans does NOT think this is an unreasonable request - but they still will not provide me with detailed reasons for not paying.
PLEASE can you suggest something to try and resolve this asap. I have dealt 100% honestly in everything I have done but my health limits my ability to fight this like I normally would - maybe that is what they are banking on! I have around £30k of personal debt at the moment due to having no income since I closed the business and due to the poor state of the business as a result of me having to stand back between August 06 and when I closed it and my health would improve if I could use this insurance money to pay off my debt and start again!
One more thing, the insurers even said that they won't pay as I was fit to work seeing I was still handling some business matters after being signed off in August 06. What sort of state do they think the business would of been in if I have disappeared! Who would of signed the cheques, sorted the payments, handled the company contracts????? I was the sole director and signature of the account, I had to do something.
Anyway, any advice is greatly appreciated as I don't want this to drag for another 2 years and I can't cope with their threats of pursuing the around £10k they have already paid (which I obviously don't have!).