Sudden and long-term illness is not something anyone likes to think about, but taking measures to safeguard your income when you are ill is essential for you and your family. Also your employer may have health insurance cover. If the insurer won’t pay, or seeks to terminate your claim, you need to urgently contact experts like ourselves to give you the best chance of securing the income that you urgently need.
Expert help to support your Permanent Health Insurance claim
Permanent Health Insurance (PHI), which can also be known as Income Replacement insurance, Income Protection Insurance, Long-term Disability Insurance or Disability Income Insurance policies. PHI policies are highly complex; they come with a variety of exclusions and the level of cover differs widely. In addition, PHI claimants are actively targeted by insurers, often with surveillance, pro-insurer doctors, functional evaluation testing and other methods.
Our team at Royds Withy King have over 25 years’ experience in dealing with all types of PHI dispute. If your claim has been either rejected or your existing claim has been terminated, you should seek urgent advice from us.
The illnesses we tend to deal with for claimants include;
For CFS/ME, we are recognised as experts by the the two leading charities ME Association and Action for ME, and have assisted PHI claimants for many years suffering from this serious illness.
Find out more about what to do in the event your insurance has been denied, is being reviewed, has been terminated, or when you’ve been offered a lump sum in our denied health insurance guide here.
How much can I claim?
Claims can be very significant in size, particularly if a long-term PHI policy is being restored for payment by the insurers. The sums involved can be between £50,000 and £500,000, or even more.
How long will a claim generally take?
Time frames are hard to predict as they are dependent on many factors, such as the severity of your injury or condition. It is also about the type of cover you were claiming / have been denied.
Our team know, over many years of experience, how these claims work and how insurers are likely to behave; so the sooner you contact us the better.
Should I use the Financial Ombudsman Service (FOS) before I contact a solicitor?
No, we would recommend that you contact us first. However, bear in mind, that the FOS have a six month time limit from the date of the insurer’s Final Decision Letter.
What if my employer is treating me unfairly because of my illness?
We can also obtain rapid advice for you from our employment law department. Employers have duties in law, and also under the Disability Discrimination Act, in relation to employees who are unwell.
Legal assistance with a Critical Illness Policy claim
Critical Illness Policy claims are also notoriously difficult with insurers anxious not to pay out, even when your family member has a serious illness.
Insurers routinely trawl through your GP records and the policy application form. They may wish to allege that there has been material non-disclosure regarding your medical history which will invalidate the claim. The policies also narrowly restrict the level of critical illness that the insurers will pay out on.
Our track record includes successes with claims against Unum, Liverpool Victoria, Aviva, Canada Life, Zurich and many other insurers.
Our personal injury law expertise means that have an understanding of the medical aspects of your claim and excellent links with medical experts in the right disciplines who will be able to help us and you get the right result.
We often persuade the insurers’ solicitors to honour PHI claims without resorting to lengthy and stressful court proceedings.
“What the team is known for:
Somerset-based practice that comes recommended for its focus on spinal cord and brain injuries. Also offers niche expertise in areas such as fatal accidents and animal cases. Demonstrates further skill in the area of asbestos-related diseases.
“I feel there is a strong culture within the firm that fosters excellence delivered in a friendly, approachable way,” reports a source.
Another interviewee states: “They are the best local firm for me to deal with as their whole focus is professional and efficient.”
Represented a claimant who suffered serious brain injury, in a Criminal Injuries Compensation Authority case worth £15.8 million.
Stuart Brazington (Band 1) leads the brain injury team and possesses notable expertise in serious spinal cord injury claims. One source highlights: “He’s a brain injury specialist; it’s a tricky area and he’s very good at it. He knows a lot about medicine as well as litigation tactics.”
Senior associate Mark Hambleton (Associate to watch) offers particular strength in severe injury cases arising from accidents involving animals, sports and motorcycles.
Louise Hart is Recognised Practitioner.”
Chambers 2018 Somerset
“What the team is known for:
Outstanding personal injury practice adept at handling an impressive breadth of claims, including industrial disease cases, cycling accidents and equine matters. Notable expertise in chronic pain and fatal accidents as well as catastrophic injuries, with a focus on brain and spinal injuries.
Interviewees praise the lawyers’ involvement in each case: “They are very supportive of clients, you get the feeling that it’s not just business to them. They work well in teams, are responsive and quick to get back to you.”
Others agree, and attest the success of this ethos: “We were never made to feel like a case, we were treated with open communication as we if we were in a partnership. The attention to detail and professionalism of the lawyers led to great results.”
The “tenacious and excellent” Ian Carrier (Band 1) focuses on catastrophic injury work, primarily spinal and brain injuries, as well as fatal accident claims. One client states: “He has strong communication skills, and excellent and far-reaching technical knowledge. We could not have asked for a better partners, it was just superb case management.”
Tracy Norris-Evans (Band 1) is highly reputable in claims of high complexity and severity including paediatric cases as well as those with complex neurological issues. One interviewee states: “She is very thorough and has an exceptionally good manner with clients. She is someone who inspires trust.”
Helen Childs (Band 2) is a specialist in industrial diseases and is especially noted for asbestos litigation. One client attests: “She is an expert in this field, which was paramount. She worked tirelessly and went to the moon and back for us. She was empathetic and genuine, nothing was too much trouble.“”
Chambers 2018 Oxford and Surrounds
“Royds Withy King’s personal injury team has ‘a wealth of experience and a very client-focussed approach’. It is ‘very strong on brain injury claims’ and provides an overall ‘excellent’ level of service. Particular areas of expertise include spinal injuries, chronic pain, complex regional pain syndrome, amputations, asbestos-related diseases, fatal accidents as well as claims arising from accidents involving animals, in particular horses. The ‘vastly experienced’ team is jointly led by Louise Hart and Stuart Brazington. The ‘tenacious’ and ‘knowledgeable’ Hart has ‘unrivalled’ experience in acting for clients who have sustained a personal injury with subsequent chronic pain’ while the ‘highly competent’ Brazington is ‘a very good strategist’. Senior associate Mark Hambleton, whose specialisms include sports-related injuries, is ‘client-focused’. The practice’s recent caseload includes representing a client who had suffered a severe hypoxic brain injury in a multi-million-pound claim before the Criminal Injuries Compensation Authority (CICA) First Tier Tribunal, the High Court and the Court of Appeal.”
Legal 500 2017 South West
“The ‘excellent and forward-thinking firm’ Royds Withy King in Oxford, which ‘strikes the right balance through quality advice and great client care’, was created through a merger between law firm Royds and the Bath-based Withy King in September 2016. Team lead Tracy Norris-Evans specialises in brain injury and paediatric claims and also acts as a professional deputy, while the ‘experienced practitioner’ Ian Carrier is known for his spinal injuries and fatal accidents work and has ‘impressive attention to detail and case preparation skills’. Other notable individuals are Richard Brooks, who regularly handles animal-related claims and ‘knows equine matters inside out’, and industrial diseases expert Helen Childs. As a result of the merger, James Millar Craig, who gained experience in permanent health insurance cases, was added to the team. The ‘highly organised, knowledgeable and approachable’ associates Jennifer Seavor and Rachel James joined from Boyes Turner and Irwin Mitchell, respectively. Especially recommended in ‘asbestos-related claims’, Seavor represented a client who had developed mesothelioma through his occupation at a railway company from the late sixties to the early seventies; he wanted the claim to settle during his lifetime and accepted an offer of £230,000.”
Legal 500 2017 South East
PHI Client Testimonial
Sarah* had an ongoing condition and was off work for some considerable time. Her PHI policy continued to pay monthly payments until such a time her employer’s insurer offer to consolidate payment and offered her a lump sum.
Without specialist legal advice, Sarah decided to refuse the lump sum. Her thinking was that, as she had a real medical issue, there was no problem with continuing to receive monthly payments and she would easily be able to argue her case, based on genuine medical evidence.
Unfortunately, after refusing the lump sum, Sarah received a letter in the post with recordings that had been taken by a private investigator. With this information, the insurer argued that they had reason to cease payments immediately.
Sarah was obviously upset at receiving this information. However she couldn’t find any solicitors to help with her case, until she contacted Royds Withy King’s PHI team.
Along with James Millar Craig’s help, Sarah embarked on a lengthy – but ultimately successful – appeal process which took some nine months, during which time she was left without any income.
Sarah had this to say about the help she received:
“They understand insurance companies and the way they operate; especially when it comes to video evidence. If anyone found themselves in the same position, I’d say contact James Millar Craig and his team without a shadow of a doubt.
You need the right person for the job, and you certainly get what you pay for with Royds Withy King; you can’t put a price on their knowledge. There was no stone left unturned, and even though James and his team are based a long way from me, it didn’t matter at all, they were so responsive and reassuring. I couldn’t have asked for any more – they were absolutely brilliant.”
*our client’s name has been changed for legal reasons
PHI Client Testimonial
Our client experienced illness and depression, partly as a result of workplace stress and conflict while working for a large international bank.
As our client had to take time off due to sickness, during which time they continued to suffer badly from depression, they received worker insurance payments in order to support their family. However this was stopped and the client was subject to surveillance by her employer’s insurers on a regular basis.
After a difficult process with the employer, the Royds Withy King team managed to win a settlement through the company’s insurer. James Millar Craig and his team also fought on the client’s behalf to secure the necessary tax relief on the settlement.
Our client said:
“If it wasn’t for Royds Withy King’s input, help and expertise I wouldn’t have managed to go through the PHI application or embarked on this journey.
Everything was on a pressurised time limit, but despite all the stress it was good to know James Millar Craig and his team were there. James was fully supportive and I had faith and trusted in him, that he was going to deliver.
I can’t thank Royds Withy King enough; they’ve been so supportive throughout.”