Claims process

At Legal & General we are happy to share our claims experience with you. We know that this is a difficult time for someone who is ill or who has a bereavement and we hope the following will help you understand what is required before we can make a decision.

Making a claim

To make a claim, the plan must be in force with all premiums paid to date at the time of the claim. For health claims, premiums should continue until a decision on the claim is made. We suspend payments on death claims as soon as we are advised of the death of a client.

On receipt of a completed claims form, the case will be assigned a claims assessor who will be your main point of contact throughout the process.

The person who is the claimant may nominate a third party to act on their behalf, and we will advise you if we require written permission to deal with the nominated third party.

The assessor will decide on the next steps having received the claims form.

It is likely that the majority of health claims will require further medical evidence from the doctors or consultants who are involved in the treatment. We will keep you informed every time we ask for information.

The claims department can be contacted by telephone, letter or email. The claims line is open between 9am and 5.30pm, Monday to Friday. You can leave a message at any time day or night and we will get back to you. We have a specialist helpline designed to offer help and advice to your clients throughout their claim period.

Helpful hints on completing the claims form

By providing detailed information on the claims form, you will help speed up the process.

Details should be provided by telephone, letter or email direct to our claims department.

Full details of any illness, when it started, treatment given and who has been consulted are particularly helpful.

Non disclosure, material non-disclosure or misrepresentation of information

We have a responsibility to pay only valid claims, and unfortunately, there will be occasions when we will not pay a claim for either material non-disclosure or misrepresentation of information.

All items of information on an application form, or a Declaration of Health (DOH) (PDF) in respect of a re-instatement of a lapsed policy, are regarded as material facts. Applicants should inform us of any changes to the information provided on the application form or Declaration of Health (DOH) (PDF) before the policy goes in force.

During the claims assessment if we find that any information originally provided is not correct, or an applicant failed to inform us of a change of information before the cover was provided, we will consider this material non-disclosure.

If the applicant knew about this information when they completed the documentation but did not tell us at the time, it could impact on the payment of benefits as we have the right to void the policy due to non-disclosure of material information. If that happens the policy will be cancelled from outset and all the premiums will be returned without interest.

Fraudulent non-disclosure; i.e. where has been a deliberate attempt to defraud us, will result in no return of premium.