Episode 19 Rip Off Britain

We asked you to tell us who's left you feeling ripped off.

I think this is very, very, very wrong for what they have done.

The bank piles charges upon charges upon charges.

Legally, it was right.

Morally, that's where the question and doubt comes in my view.

And you contacted us in your thousands,

by post, e-mail, even stopping us in the streets.

And the message could not be clearer.

You don't get a straight answer. They try and fob you off.

-I'm not happy at all.

-It's always that very small print

that's got the clause in you didn't realise.

We're being ripped off big time.

Whether it's a deliberate rip-off,

a simple mistake or a catch in the small print,

we'll find out why you're out of pocket, and what you can do about it.

Keep asking the questions, go to the top if you have to.

We do get results. I mean, that's the interesting thing.

Your stories, your money - this is Rip-Off Britain.

Hello, and welcome to Rip-Off Britain,

the programme that shines a light on the companies that you say

haven't given you the service you expected or that you'd paid for.

But you know, sometimes, when you think you've had a raw deal,

it can be those unexpected surprises in the small print

or those catches in the paperwork.

And, believe me, there are plenty of those stories coming up today,

because we are taking on the mighty insurance industry.

That's because hundreds of you have contacted us to tell us

that you really feel let down by insurance policies

that just haven't paid out, despite the fact

that you have faithfully handed over your premiums year after year.

So are insurance companies treating you fairly

or have you perhaps misunderstood the terms

and, perhaps, not read the small print?

Well, we're going to find out.

Also coming up on today's show,

just how ill do you have to be to claim on a critical illness policy?

You automatically think, if something happens, you know, you lose a limb,

you think you're covered and have peace of mind.

But I come to them for help, and they say no.

And more of your problems and dilemmas solved

at the Rip-Off Britain pop-up shop.

It sounds, from what you told me, you've got a very clear-cut case here

and you should be paid out on your policy.

Now, many of us in the UK are apparently more likely

to insure our pets, or indeed our mobile phones,

than we are to take out cover on our own lives.

According to an industry survey,

56% of us don't have any sort of life insurance.

Maybe we don't like to think of what will happen to us after we've gone,

but Audrey Stone did. She wanted to think about it

and, for 20 years, she paid into a life insurance policy

to make sure that her family would be protected.

Unfortunately, there was a snag with her final payments and we all know

how insurance companies can be sticklers for their rules.

Stephen Stone thought that he was prepared for his mum dying.

She'd been ill for a very long time.

But she'd been determined to leave money behind for her family.

My mum started work when she was 14. Worked at Basset's in Sheffield,

you may know for Liquorice Allsorts. That's what she used to make.

Then she went to work on the trams, so she's worked all her life

and, when we lost my dad, and that was 19 years ago,

that's when she decided to take out life insurances.

In 1989, Stephen's mum Audrey

took out two life insurance policies. One with Abbey Life.

And she paid her monthly premiums on both policies for almost 20 years.

The payments started something around £20-odd,

increased over the years to £40. Over that period of time,

she's probably paid back something in the excess of £8,000.

But around five years ago, Audrey started to show signs of illness.

She was in her mid-70s when we first noticed

that she had signs of dementia

and dementia follows generally a certain path.

I was taking her on a regular basis to the hospital

to have health checks and to have mental health checks.

Did that with her for a considerable time.

Then she started then getting worse and worse.

With his mum's health deteriorating,

Stephen turned to social services for help.

'We were unable to deal with all her needs 24/7 and it was good that

'we could then get a package put together by social services,

'who did a very good job of getting carers in to see her four times a day

'to make sure she was taking the appropriate medication

'and she was eating and getting dressed.'

As part of the care package, social services appointed an organisation

to help Audrey handle her bank account and the payments from it.

This arrangement continued until, sadly, Audrey passed away.

'Losing my mum was a great blow to us.

'She was the fifth of six sisters to go.'

All the others have died with forms of dementia.

To add to Stephen's trauma,

he received some unexpected financial news.

Only one of Audrey's life insurance policies was going to pay out.

'We went to our financial advisor,

'who has been a family friend for many years. I was fully expecting

'to get then paid out for both of the insurance policies

'to help us towards the funeral costs, etc.

'He just gave me a cheque.

'I asked where the other one was from the other policy'

and he says, "Oh, that's lapsed," and that was the first time

we learned that the premiums had not been paid.

Not been paid?

But Audrey had faithfully been doing that for years.

So while Stephen had expected the policy to now be worth £17,000,

according to Abbey Life, he wouldn't see a penny.

I think my mother's reaction to the policy not being paid out

would've been horrific.

It was one thing that she always said whenever I went up to visit

that, "There's no worries when I go,

"You'll have this, you'll have that, you can do this, you can do that."

Stephen discovered that, towards the end of Audrey's life,

the organisation appointed by social services to manage her bank account

had been trying to pay the premiums on her behalf,

but Abbey Life had refused to accept payments from the third party,

even though it was all official, and Audrey was too ill to do it herself.

So, after 19 years of never missing a payment,

Audrey's policy was now worthless.

My initial thoughts at Abbey Life refusing to pay it

was that was an absolute disgrace,

that an insurance company who'd been accepting payments

for nearly 20 years on a premium and never missed a date,

would suddenly decide, after a couple of premiums missed,

that it was fair enough for them to just lapse that policy.

Abbey Life told us that,

although they sympathise with Stephen over the loss of his mother,

all too often they see attempted identity thefts,

so they need to protect policyholders

and especially those in a vulnerable position.

They say they were never shown the necessary valid authority

to prove that a third party was acting on Audrey's behalf and that,

ultimately, all insurance policies lapse if the premiums are not paid.

But when Abbey Life wouldn't budge,

Stephen took his case to the Financial Ombudsman Service.

In September, they ruled in his favour, saying that the company

should've taken a more understanding and consumer-friendly approach.

They said it was clear what Audrey's intentions had been

and, as a result, ordered the company to pay out, which, thankfully, they've now done.

But Stephen feels that they should have done that in the first place.

I think it's grossly unfair that they should refuse to pay out

on a policy that has been in place for so many years,

when this person then becomes the subject of mental health problems.

If you feel you've been short-changed by a company

that you put your faith in, then do let us know.

We'll have all the contact details later in the programme.

Next today, though, a rip-off viewer who got in touch

after an experience that left them feeling bitterly let down.

So we decided to investigate.

For Yannick, a decision to move into a rented flat in Crystal Palace

was one he and his wife would live to regret.

I started looking for a flat in July 2010.

Me and my wife had moved from Portugal and were desperate to find somewhere, as I'd started a job.

'We were looking in South East London predominately,

'close to where I was working.

'And, eventually, we found somewhere to live and it was £500 a month,

'so we thought it was quite reasonable for the area.'

All bills included. So I made a commitment and signed a contract.

But before too long, Yannick and his wife Fatima wished they had

taken a closer look at the property before signing on the dotted line.

After a few days, I realised things weren't all as they seem.

'I noticed that the walls had mould on,

'I noticed the carpet was in a bad condition.

'I realised, obviously, I'd made a mistake.

'It was a shock for my wife as she'd moved to England for the first time.'

She couldn't believe we were paying £500 to live in conditions like that.

After eight months, they'd had enough and decided it was time to move out.

After requesting the deposit,

we received an invoice from the landlady requesting £468.

This was for repairs to the property, including replacing the carpet,

replacing the toilet seat, cleaning the curtains, this kind of thing.

I couldn't believe she was claiming we had broken and damaged all these things in the studio.

I was really shocked and there was no way I was going to pay for that.

Disputes between tenants and landlords are not uncommon,

which is where the Deposit Protection Scheme comes into play.

It is authorised by the government and is designed to arbitrate

in cases where agreement can't otherwise be reached.

I'd asked if she'd registered with the Deposit Protection Scheme,

as she was obliged to under the terms of the contract.

After a week of chasing the landlady to get an answer to my question,

the landlady told me that she hadn't registered the deposit as she felt she didn't need to.

I told her that, under law,

she was actually obliged to register the deposit and I asked her to do so,

otherwise I would take legal action against her.

Yannick was right. Landlords with Assured Shorthold Tenancy agreements

in England and Wales have an obligation to lodge deposits

with protection schemes within 14 days of receiving the money.

Yannick's landlords did eventually do this,

a full eight months too late.

The DPS was then faced with two very different versions of events.

'Me and my wife put in a claim for the full £500 deposit

'and the landlady put in her claim.'

So, basically, that's just led to a stalemate with counterclaims.

The landlady sent through her evidence as to why

she believed that we caused the damage and then I sent

a counterclaim detailing why I felt that her evidence was not accurate.

We asked Yannick's landlords to comment.

They told us that there are two sides to every story. They claim,

when the couple moved in, they signed an independent report

stating that the condition of the property was fine.

The landlords also told us that they'd initially been advised that,

because the flat was part of their home,

it didn't need to be registered with the Deposit Protection Scheme.

Campbell Robb from the campaign group Shelter believes that

some tenants don't do enough to protect themselves

and this can lead to all sorts of problems.

If you're thinking about renting a flat, get some advice.

Don't just do this alone. Come to Shelter, go to the Citizens' Advice,

there's loads of stuff available. One of the key things

that anybody needs to do if they're taking a private rented property is

make sure that their deposit is safe.

The government has a scheme which ensures that landlords

put your deposit somewhere safe, so you get it back at the end of that.

So make sure your landlord is part of the Tenancy Deposit Scheme.

It's a key way of protecting your money while it's with the landlord.

In this couple's case, this protection meant they eventually

got the majority of their money back.

And Yannick says that, in future,

he'll be much more cautious before agreeing to sign anything.

If I had my time again, I wouldn't be as naive as I had been

and I would really check everything first and make sure that

I was entering a legitimate contract and that all parties can be trusted.

Now, there can't be too many things worse than that sickening feeling

when you realise that you haven't actually got

what you thought you would be getting for your money.

But that's exactly what happened to this next Rip-Off viewer

and we were absolutely determined to get them some answers.

Meet Graham Burt, a bus driver from Bury.

He lives with his partner Rachel and their four children

and, generally, he has his hands full.

Every day needs careful planning. So when the Burts' car broke down,

they knew they had no option but to get a replacement and fast.

We only had two days to find the car. We had to have it by Monday

because Rachel wouldn't be able to take the kids to school

then get to work on time in the centre of Manchester.

I was working as well, so I had to take my car to work

because I had no public transport either to my work.

So it was very important to get the car.

It wasn't long before Graham found a card he liked on a car supermarket website.

He headed down to Carcraft's Rochdale showroom to take a look.

It didn't have the car I wanted.

They only had the three-door Mitsubishi Colt or an automatic

and I said I needed a five-door manual, because of the children.

I need to get them in and out of the car.

And he said, "We'll have a look on the computer, see if there's any in stock,"

and he said, "Yes, there's one in Leeds.

"We can get it driven up for you and you can pick it up tomorrow." I said, "That's perfect."

The following night, the car arrived.

It was dark, but Graham gave it a quick once-over and agreed to buy it.

It was priced at around £7,900.

All he needed now was a finance plan to pay for that.

I have dyslexia and I'm very slow at reading,

so it takes me a while to read through things.

There was that much documentation, I would've been a while,

so I asked the salesman and he said, "This is your finance agreement.

"Your APR's this over five years, and just sign at the bottom."

He put wee crosses and I had to sign there and, the next page, sign that.

Dotted line signed, Graham drove off. But almost immediately, he began having problems.

As I was driving home, I noticed the car was pulling to the left.

If you took your hands off the steering wheel slightly or took pressure off,

the car would veer to the left, towards the kerb.

I was like, "Oh, that's a bit strange."

The car was used for the children to go to school in,

so from a safety point of view,

I didn't feel it was safe to drive the vehicle with the children in it with that fault.

Putting safety first, Graham headed back to Carcraft the following day.

Their mechanics said the steering fault was to do with the tracking.

While they were checking the tracking,

they noticed one of the tyres was completely bald almost.

They said the cogs were showing so they had to replace it that day.

They told me to come back the next week to get the tracking repaired.

Graham's confidence in Carcraft was beginning to waiver.

He couldn't understand how the Mitsubishi had been approved for sale when it had problems.

There was big banners as you drive in - 120 point check, two year free warranty, parts and labour,

and it all looks though it's all sold round this check and everything,

so you expect the car to be perfect, cos the salesman told me the car had a big check on it.

It's been checked out, serviced, everything.

Graham claims the car was repeatedly in and out of the garage as Carcraft tried to fix the steering.

And as if that wasn't enough, when the finance agreement kicked in,

he got another nasty shock.

I realised I had two loans coming out of the bank, totalling £232 a month.

I was quite shocked because I was expecting the car to cost just under £200 a month.

So it was an extra £36 nearly I'm paying a month which I was expecting.

It turns out the loans are to two different companies.

The first thought the car was overvalued and so would only loan Graham £5,800.

The shortfall, just under two grand, came from the second firm.

And the extra £36 a month that Graham's being charged for?

Well, that's for an extended four year warranty,

something Graham can't remember agreeing to.

We asked Carcraft to comment on Graham's claims,

and they told us they were sorry for the problems he'd encountered.

They said, "All our cars undergo a standard 120 point inspection."

"There is always the risk of unforeseen issues,

"but we believe we have a fair approach to resolving these."

Carcraft admitted to us that this hasn't always been the case, saying,

"We're genuinely sorry that in the past some customers didn't receive the levels of service we now offer."

As for the paperwork, they told us that it's always fully explained to customers

with time allowed for reading and questions.

In addition to this,

"Each document signed clearly states the monthly repayments."

Graham may not remember signing up for the additional warranty,

but his signature is on the paperwork, so he has to pay.

Problems on both sides in this story. But one thing's for sure,

Graham has definitely learned one of life's most valuable lessons:

act in haste, repent at leisure.

If you've had a similar experience and aren't sure what to do next, don't worry.

We've done some of the hard work for you.

Here are the key things you need to bear in mind.

If you buy a new car, it's going to come with an extended warranty, perhaps lasting three years or more.

If you buy a second-hand car,

it is possible that things are going to go wrong with that vehicle.

You may be entitled to have those things repaired,

but it might be difficult for you to negotiate those repairs with the dealer.

Your rights when buying from a second-hand car dealer are covered by the Sale of Goods Act.

That says that good must be of a satisfactory quality, that is, they must be free from faults.

In addition to that they must be as described

and they must be fit for the purpose for which you buy them.

That is, you must be capable of driving it and driving it safely.

You have to act quickly and you're pretty limited on why you can reject a car.

There will have to be some serious defect with that car,

such as the engine blowing up, or a major fault that isn't readily fixed.

So, it's what's reasonably expected.

If a salesman's misled you about a second-hand car, you've got two options,

the first being you can reject that car and get your money back.

Alternatively, you could negotiate a reduction in the price on that vehicle that you're happy with

and continue with the purchase.

If you bought a car on finance, that provides you with additional protection,

because it makes the finance company equally liable for anything that goes wrong with that vehicle

as well as the dealership.

So if something happens to that car dealer, then you can make a claim against the finance company.

Still to come on Rip-Off Britain:

Caught out by the small print on your insurance policy?

Martin Wells is familiar with that feeling.

MARTIN: It says you can't pay out unless you have two limbs amputated.

I just sat there... "You are joking, aren't you?"

He says, "No."

Our experts have been rushed off their feet at our pop-up shop for consumer advice.

You can take the claims through the Financial Ombudsman Service yourself.

Persevere and I think you've got a good chance of getting a pay-out.

So many of you contacted us, telling us about your stories,

that we decided to open up our own pop-up shop

so that we could meet you face-to-face to tackle your issues.

Here in Manchester, one subject that seems to be the source of many problems for people is insurance.

So let's find out more.

-Hiya!

-Hiya.

-What's your name?

-My name's Dawn.

-Dawn.

So what are you here for today?

I had a heart attack in January

and I bought some critical illness insurance about ten years ago.

To cut a long story short, I'm having difficulty with them to pay out.

Time to see if Dawn can be helped by James Daly from Which?

They're actually saying to me that I don't have a claim,

that I haven't suffered a heart attack.

I've been told by my consultant, by my cardio nurse,

by quite a few people that I've actually had a heart attack.

In fact, I'm on five lots of medication,

and I've spoken to the insurance company and told them what the consultant has said,

and they've told me that for future insurance I would have to inform them that I've had a heart attack.

In one hand they're telling me I've not had a heart attack

and on the other they're telling me I've got to inform them that I've had a heart attack.

We've gone in to appeal and we've got a final letter from them stating,

"No, no way. You haven't got a claim."

It's just a big full stop on it.

There's a good chance you will get your claim paid out here.

But you will need to persevere.

Ultimately, when it comes to whether you had a heart attack or not,

hopefully, that's something that the doctors can verify.

It seems very odd to me they'd be trying to deny it,

but at the same time saying you need to declare it

for future policies which doesn't make any sense.

The next step is to take the case

on to the Financial Ombudsman Service.

That's an independent service.

They're looking out for your rights and trying to look at the case cold,

no preference either side and see who's right and who's wrong here.

It sounds from what you've told me that you've got

a very clear cut case here

and you should be paid out on your policy.

If you put in your claim to them today,

and you can do that online.

Go to their website. File your claim.

It's not that difficult to take the claim

through the Financial Ombudsman Service yourself.

It might take a bit of time,

persevere and you have a good chance of getting a payout.

Good advice, but there is more advice on our website.

And you will be pleased to know

Dawn's case is currently being investigated further,

so we really wish her well.

Opening up our pop-up shop here in Manchester

has been a great opportunity for us

to investigate your rip-offs face to face.

£600, that will buy you a few Christmas presents, won't it?

It certainly will.

It's been so nice to actually get to meet you

and to hear what you've got to say directly.

It went really well, I managed to save £271.

Five minutes of your time online

and I can afford to go on holiday now.

I feel a lot easier, I feel a lot happier.

The advice I have been given is very sound, very sensible.

It was definitely worth coming down today.

Got some useful information, so we're going to go home

and put that advice to action.

Here's someone else with a problem.

And they are not at all happy about it.

In October 2007, Sally Murray and her husband-to-be Matthew

were looking for a place to rent in Lancashire.

We found a property in a little village called Summerseat

which we thought was an ideal place to start off,

our first home together, renting together.

When we initially went to view the property

the landlord was living there.

There was furniture in there, there were things in cupboards

and it all looked like a normal house.

It looked like a homely home.

After deciding it was just what they wanted,

the couple agreed terms and paid a month's rent up front.

As well as the same amount again as a deposit.

In total, £1,350.

But it wasn't long before Sally was telling her father Alan

that the home of their dreams was turning into a nightmare.

Shortly after getting the keys and moving in my belongings,

we went on holiday.

Then my boyfriend came out in all bites over his legs.

We didn't really know where it had come from at that stage.

We got back from holiday and went to the house again

and these bites had cleared up almost

and he got some fresh bites on his legs.

And we went another evening

and he got some more bites and I got a few bites.

Then we sort of thought, this is a coincidence.

We had a look in the Hoover

and that's when I found the fleas jumping around in the cylinder.

Once we found the fleas, that was the final straw,

we couldn't move into a house that had fleas.

Even though we said we wanted it fumigating,

we just couldn't be happy there.

So Sally got in touch with the landlord.

We met him at the property with my parents

and he agreed to give me my deposit back

once I gave him the key which I did.

I gave him my bank details and he was to put the money into my account.

When the money didn't materialise,

Sally's dad Alan, a retired policeman,

took up the fight on her behalf.

He was supposed to be electronically moving the cash,

didn't move anything.

She tried texting, e-mailing, ringing and got absolutely nothing.

Annoyed that her money had not been returned,

Sally and dad Alan decided to take legal action.

I actually had to interview him myself and sit next to him in court

and ask him questions about his finances.

They made a claim to the county court and the judge ordered the landlord

to pay them the money back plus penalties totalling £4,088.

But the landlord claimed poverty.

And Sally has never received a penny.

I'm now out of pocket £1,350 which is £675 for the deposit

and £675 rent and I feel totally ripped off

because I've not stayed one night in the property.

He hasn't given us a proper response, but when Rip-Off Britain

spoke to him on the phone,

the landlord claimed there were no fleas,

and he hadn't promised Sally her money back.

Although, of course, the court judgment tells a different tale.

In any case, Alan feels Sally's money should have been protected

by the Government's tenancy deposit scheme.

The purpose of the tenancy deposit scheme

was to make sure tenants weren't ripped off by avaricious landlords.

And to a great extent it's probably working.

However it seems to me there is no real check

to see that landlords are doing what they should be doing.

Four years after it all began,

Sally now accepts that she will probably never get her money back.

I feel totally annoyed with the whole situation,

that I'm owed the money, I need the money.

I could be spending it on my baby, I could be spending it on my house,

I could be spending it on myself, my husband now.

And he's walking around, and to be honest,

I feel like he's laughing at me now.

He's walked away with my money, it's as easy as that.

He's ripped me off and there's nobody there

to stop him from doing it.

At a time when money is tighter than ever,

you need to know that your cash is working hard for you,

avoiding rip-offs and sharp practice along the way.

We've put together a booklet of tips and advice

to help safeguard your hard-earned cash.

You can find a link to the free guide on our website.

Or to receive a copy in the post, send an A5 self-addressed envelope

to the address we will give you at the end of the programmes.

One type of insurance that all too often

proves controversial is critical illness.

Around 9 million of us have it, usually in the belief that

if we do become seriously ill, our bills and expenses will be covered.

Unfortunately, for a lot of us that won't be the case.

Many critical illness policies are quite limited

in their scope, only paying out in very specific circumstances.

Just how specific those circumstances need to be

can often come as quite a shock as Martin Wells discovered.

Martin Wells is a bus driver

and has worked hard all of his life to support his family.

I was the main provider, I used to bring home a reasonable wage.

My wife worked part-time,

but unfortunately she had to finish work as well for medical reasons.

Worried about how they would cope if he was ever too ill to work,

Martin took out a critical illness insurance policy

with Scottish Widows.

It was taken out to pay the mortgage off so the family didn't have to worry,

they would have a roof over their heads and somewhere to live.

-Not long now.

-Yes.

-Skeggy stadium.

-Awesome.

'It wasn't cheap, it was one of the more expensive policies I've got'

as opposed to life insurance.

But I was willing to pay it, again, for peace of mind.

And he did get peace of mind,

expecting if he ever had to stop work because of critical-illness

the policy would pay out half a million pounds.

12 years on, when an old motorbike injury began to deteriorate,

he found he was struggling to do his job.

I couldn't walk more than about four or five steps

without it really...really hurting.

I was hobbling around, still driving, still working,

trying to keep going as long as I could

and I just got to the end of the pain I could take, basically.

Martin retired from driving buses on the grounds of ill-health,

but his leg continued to get worse with many ulcers and infections.

Eventually his doctors told him that the only solution

was, unfortunately, amputation.

The fact I was going to have my leg amputated...

..I knew it was going to cause a few problems.

But it was the only course of action I had got left open to me.

I couldn't go on for ever with the infections.

Once he had recovered from the operation,

Martin planned to make a claim on his critical illness insurance

assuming that losing a limb was the kind of event the policy covered him for.

But when he called Scottish Widows he got a huge shock.

They said, "Well, I'm sorry to tell you,

"but the fact you're only having one leg amputated, we can't pay out.

I sort of sat there somewhat stunned. "I beg your pardon."

He says, "We can't pay out unless you have two limbs amputated at the same time."

I just sat there... "You are joking, aren't you?" He says, "No."

He said, "That's our policy,

"you have to have two limbs amputated before we'll pay out."

Although it seemed unfair to Martin,

a close look at Scottish Widows critical illness policy

shows that what he was told is correct.

The policy covers, to quote, "permanent physical severance

"of any combination of two or more hands or feet."

That apparently is pretty standard in the industry,

but for Martin the news was devastating.

I don't need it, I've enough on my plate now.

I'm in a wheelchair.

It's difficult. It's very, very difficult.

Plus I've also got the pressure of, is everything being paid?

Martin is waiting to see if he's suitable for a prosthetic leg.

If he gets one, he is hoping to return to the bus depot

and drive buses again part time.

-Hello, Martin.

-Hi, Alan. How are you, mate? All right?

But for now things are really tough.

Money for us at the moment is extremely tight.

We have to be very, very careful.

I mean, if we need new things, like we have to replace anything,

we have to sort of juggle things around to afford it.

And it's...it's a strain, to be perfectly honest.

Martin's story is similar to ones that Emma Parker

from the Financial Ombudsman Service has heard many times before.

Last year alone, they received 598 complaints

about critical illness policies not paying out.

But the majority were not upheld because insurance of this type

is usually much more limited than people realise.

Critical illness is a policy that covers you for certain named illnesses

and they are carefully defined within the policy.

The Association of British Insurers has been doing work with insurers

and have published information about how they expect insurers

to define conditions under critical illness policies.

It is the insurers' responsibility to make sure that information

is there and clearly in line with the ABI standards.

Scottish Widows told us that they always look for ways

to see how a claim can be paid and in this case,

even in the absence of a formal claim,

they did investigate whether Martin might be covered

under any other definition of the policy, but he wasn't.

They point out that since 2000, they have paid out well over

£1 billion in life and critical illness claims.

They have helped over 30,000 families and that all customers

get an annual benefits statement

setting out the cover that they have.

So it is worth checking the small print to avoid

discovering too late as Martin did,

that your premiums haven't given you quite the protection you think.

You automatically think, if something happens,

you lose a limb or you have a heart attack,

you have to have open-heart surgery, you think you're covered.

You have got peace of mind.

But I come to them for help and they say no.

Well, Martin's insurers aren't budging

and however sympathetic you may be to his situation,

technically there is no reason why they should.

As they say, they are following the standard industry guidelines.

It just goes to show how vital it is that you understand the terms

and exclusions, of not just critical illness,

but any form of life insurance.

Critical illness insurance is designed to pay out a lump sum

if you are diagnosed with a serious illness.

But it has to be an illness that's on the insurer's list.

So typically it will be something like a heart attack,

cancer or a stroke.

Most of these insurance policies will cover around 30 illnesses

although some cover far more.

It's important to understand these policies won't normally automatically pay out

just because you've been diagnosed with a serious illness.

The policy small print will specify how severe the illness has to be

before you qualify for a payout.

For example, if you've had a heart attack,

some policies will specify the amount of heart muscle damage

that has to occur before your payout.

With some policies, you also get a payout if you are what's called

"permanently and totally disabled" and cannot work.

It's important to understand that here there's a difference as well.

Some will pay out if you're

permanently disabled and can't do your own job,

others will only pay out if you can't do any job.

It's really important when you take out a critical illness policy

that you're honest and upfront about your medical history.

Insurers generally won't cover you

for previous illnesses you've suffered from,

so you shouldn't just mention the big illnesses

but also the minor ones as well.

When you buy a critical illness insurance policy,

it's important not just to go for the cheapest one.

You have to look at the details in the small print

because they can make the difference between you getting a claim

and being rejected.

I'd really recommend you talk to a specialist broker.

Not only will they understand how different insurance policies work

and how the insurers pay out,

but if you have to make a claim, you're not going to be in a position

to fight against an insurer if you have to.

They'll help you fight your corner for you.

I'm joined now by the Director of General Insurance

at the Association of British Insurers

and that's Nick Starling.

What sort of checks do you do on your members

to ensure that when a customer is buying an insurance policy,

they are getting the right kind of information that they need?

We don't do individual checks with our insurers.

We couldn't do that but what we do is we write guidance.

In the case of critical illness, we have a code of practice

which all our members must as a condition of membership adhere to.

If our members don't abide by that, they'll take regulatory action

or the Ombudsman would decide in favour of the customer.

There have been situations

where people have taken out a critical illness policy

and been very honest on their application form

and then developed an illness during the run of that particular policy.

Sometimes they're not treated with the same kind of fairness

that they would expect.

What happens then?

When you take out a policy,

it's usually some time before that policy is confirmed.

During that period, before you sign on the dotted line,

if you do develop something, you need to tell your insurer

because that is important in terms of selling the policy.

If you develop it after you've signed?

If you develop it after you've signed

then it's covered by the policy.

If you develop it very quickly after you've signed,

they may want to check to make sure everything is above board.

Essentially, once the insurance company is satisfied

you've made a proper application and you've taken out the policy,

then that policy is in effect.

Do you feel that these policies and the people who sell them

are sufficiently consumer-friendly?

I think we made great strides in recent years

and they are extremely valuable policies to have.

We've done a number of things to make it easier for people.

We've focused the questions so it's much easier to answer,

easier for them to apply and therefore easier to claim.

And yet still our postbag is full of letters from people

who when they make claims on their insurance,

find something tucked away in the small print they didn't realise.

There's lots of reasons why claims might be turned down.

There are some, regrettably, which are fraudulent.

There are some where people are trying it on

even though it's not a valid basis for a claim.

There are some where genuine mistakes occur

and we want to iron them out.

I have to put to you something that was put to me

by one of our viewers who came to our pop-up shop in Manchester.

This man said to me,

"How on earth do some insurance assessors sleep at night?"

Everyone regrets it when a mistake happens

or when something goes wrong.

None of us want that to happen.

One mistake is a mistake too many.

We do want to make sure

that people are satisfied that they get products they want,

those products are delivered to them when they're at most need

and I hope that's something we can agree on.

-Nick, thank you very much.

-Thank you.

Here at Rip-Off Britain,

we're always ready to investigate more of your stories.

Confused over your bills?

Trying to wade through small print that leaves you totally confused?

I might have been stupid for not reading it

or I've read it and not took it in.

I could kick myself, I really could.

Unsure what to do when you discover you've lost out

and that great deal has ended up costing you money?

I thought, this cannot be true. It's totally unacceptable.

I was so angry.

You might have a cautionary tale of your own

and would be happy to share the mistakes you've made

so that others don't do the same.

No-one knows about this.

This is very strange to me

and I really would like to get this much clearer.

You can write to us at:

Or send us an e-mail to:

The Rip-Off team is ready and waiting to investigate your stories.

Well, as we've heard, although it can sometimes seem

as if insurance companies will try anything to avoid paying out,

it could be that you haven't got as comprehensive a policy as you thought.

When you're shopping around for the best cover,

I guess the advice is, don't just go for the cheapest,

make sure you've got the protection you really need

and analyse the small print

to make sure you're happy with what you're getting.

As usual, our website bbc.co.uk/ripoffbritain

will give you more advice if you're still confused.

We're out of time for today but thanks very much for joining us

and I hope we'll see you again soon.

Until then, from all of us, goodbye.