Insurance win for teacher

September 27, 2013

by Natasha Boddy, The West Australian. September 27, 2013.

A Perth primary school teacher who was forced to give up her career because of a rare allergy and was battling her insurer for income insurance is overjoyed after the company yesterday agreed to reinstate her claims after she went public with her story.

High Wycombe grandmother Barbara Devine this week opened up to The West Australian about her battle over the past several months for income insurance from her long-term insurer MLC.

But yesterday after inquiries from the newspaper, it is understood the company advised Mrs Devine that her claims would be reinstated.

The 60-year-old was advised by her doctors to stop working as a teacher after she was diagnosed with a rare condition known as abnormal bradykinin metabolism, which means she is allergic to viruses and particularly upper respiratory infections.

“It broke my heart to give up teaching,” Mrs Devine said through tears about the difficult decision to leave the profession she had been in since she was 21.

Mrs Devine, who also has an autoimmune disease of the liver known as Primary Biliary Cirrhosis, was diagnosed with the potentially deadly allergy after several serious anaphylactic episodes which escalated over time and left her swollen and, on one occasion, struggling to breathe.

After her diagnosis and medical advice that she should stop working, Mrs Devine told her employer about her condition, took long-service leave and used a two-year salary continuance plan before resigning from her job in December and applying to her long-standing insurer MLC for income insurance.

Mrs Devine took out insurance, including income insurance, with MLC in 1998 and said she received payments from the company for about four months until a “completely unexpected” letter earlier this year advising her that her claim had been declined.

The letter said a detailed review of her claim had been completed and her claim had been declined because the medical evidence did not support her currently having an injury or sickness which meant she was unable to perform the duties of her occupation.

Melissa Payne from Shine Lawyers – the firm representing Mrs Devine – said she believed MLC had misinterpreted the terms of the policy and if Mrs Devine returned to work, she would be putting her health “at significant risk”.

She said she was seeing more and more income insurance cases and Shine Lawyers now had more than 600 cases involving income or disability insurance claims.

“Insurers don’t always get it right so if a decision seems unfair, people need to seek expert advice about whether it is unfair and some assistance to challenge the decision,” she said.

“One of the tactics that we find insurers, deliberately or not, employ is delay and sometimes people do get worn down by the delay but don’t take no for an answer.”

Mrs Devine said she took out income insurance for peace of mind but had never anticipated that she may one day need it.

She said her condition had had a big impact on her life

“Because it’s viral, I don’t mix with huge crowds of people because of that fear that I don’t know if it’s going to strike again so there’s that consciousness the whole time that I must stay in my own little world because that last attack scared the bejesus out of me,” she said.

She said she was overjoyed by MLC’s decision yesterday.

Her daughter Bronwyn Pescud said earlier this week it had been upsetting to see the emotional and financial strain her mother had been under.

“All of mum and dad’s plans for preparing for retirement have been put on hold,” she said.

Ms Payne advised people to “do their homework”, investigate an insurer’s claims payment history and seek expert advice before taking out a policy. She also advised people to seek advice if they believed an insurer’s decision was unfair.

http://au.news.yahoo.com/thewest/a/-/wa/19132777/insurance-win-for-teacher/