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Insurance company refusing pay leg amputee

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A man who had his leg amputated due to severe infection was told by his insurance company that they would not pay out because he still had another leg.

Bus driver Martin Wells has paid more than £4500 over 12 years for critical illness cover with his insurance company, which cannot be named for legal reasons, in the belief that he would be financially covered should the worst happen.

Mr Wells cannot work for up to 18 months after having an above-the-knee amputation, and expects that he will only be able to work part time when he is able to return.

Martin, who first injured his leg 30 years ago in a bike accident, planned to use the money from the pay-out to cover his £40,000 mortgage.

A distressed Mr Wells said, “I was told in no uncertain terms that I would need to have two limbs amputated before they would pay.”

Mr Wells has been paying up to £35 a month for the last 12 years for critical illness cover, which will not provide for his future.

 Mr Wells, is intending to return to work after he has undergone an operation to have a false leg fitted. His employer, Premier Travel, has buses with automatic gearboxes so he will not need to operate a clutch pedal.

Unfortunately Mr Wells has developed arthritis in his other knee, and the combination means he will be unable to work full-time again.

Martin Wells underwent surgery at the Royal Derby Hospital to have his leg amputated, three decades after the original accident. Eleven years after his bike crash, a fall at work ripped open a scar on Mr Wells knee had his leg amputated at Royal Derby Hospital in May three decades after the original motorcycle accident.

Eleven years later, that scar was ripped open during a fall at work.

A spokesperson for the insurance company said that they were just following standard procedure.  

“The policy covers 'loss of hands or feet - permanent physical severance of any combination of two or more hands or feet at or above the wrist or ankle joints.”

The spokesman continued, “Under the Association of British Insurers loss of limb definition, adhered to by us, a critical illness policy only pays out when two limbs are lost.”

However many critical illness polices now offer enhanced cover.

What the enhanced cover offers is a pay-out if you lose one limb instead of the requirement of both.

This trend has been popular for five years in a bid for insurance companies to win more customers, and it is standard practice for many companies to offer these policies to new clients.

By Ben Malkin

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