Guardian pays first ‘cover upgrade’ claim

Guardian has paid its first critical illness claim under its unique ‘cover upgrade’ promise.

Related topics:  Guardian,  Cover upgrade
Tabitha Lambie | Editor, Protection Reporter
23rd August 2023
"When Guardian came to market with its critical illness policy and its ‘cover upgrade’ promise, I could see it was special, and that was part of the reason I took out this cover for myself."
- Customer

‘Cover upgrade’ is Guardian's promise to check a claim against both the critical illness definitions that the customer bought, as well as the critical illness definitions for new customers, and to pay out if the claim is valid under either.

When Guardian launched in 2018, ‘Cover upgrade’ was introduced as a central part of the firm’s approach to providing better customer outcomes. The insurer believes that existing customers should always be treated as well as new customers, so ‘cover upgrade’ was developed to improve fairness and trust in the protection industry.

Guardian’s first ‘cover upgrade’ claim was for Parkinson’s. The policy had been taken out in July 2019 when Guardian’s Parkinson’s disease definition was: “A definite diagnosis by a UK Consultant Neurologist of idiopathic Parkinson’s disease. There must be permanent clinical impairment of motor function with associated tremor and rigidity of movement.”

In October 2019, Guardian upgraded its definition for Parkinson’s, writing to all existing customers to let them know that their definition had been upgraded free of charge. The definition now stands as: “A definite diagnosis by a UK Consultant Neurologist. There must be permanent clinical impairment of motor function. This impairment should include either an associated tremor or muscle rigidity.”

In this claim, the customer had received a definite diagnosis from a UK consultant for Parkinson’s and had an associated tremor. However, they hadn’t yet experienced muscle rigidity so their condition would not have been met in the contract the customer bought in July 2019.

Thankfully, under ‘cover upgrade’, Guardian was able to assess the claim against the current critical illness Parkinson’s definition on sale and pay the claimant. They also provided a free referral through HALO to Krysalis for specialist neurological occupational therapy. Working with the customer, Krysalis provided a baseline assessment and six therapeutic sessions addressing their specific concerns, which included fear of the condition and how to manage his symptoms.

The customer was given help with fatigue management, helping them to pace their day more efficiently in hopes of preventing their symptoms from worsening. They were given lifestyle modifications and strategies to manage their condition, help to manage their perception of self, mindfulness and relaxation techniques, support and guidance about how to access NHS services, and support with challenges to do with facial expression.

Commenting on this payout, Phil Deacon, head of claims at Guardian, has said:

“We’re delighted to be able to pay our customer’s Parkinson’s claim as a result of our ‘cover upgrade’ promise. This claim shows why ‘cover upgrade’ is such an important and valuable feature of Guardian’s critical illness cover and it speaks to exactly what we’re trying to achieve as a business. What’s more, through our bespoke HALO claims service and specifically our partnership with Krysalis, we’re able to provide our customers with access to specialist neurological support to help them come to terms with their condition and to manage it.”

Deacon continued: “This customer’s experience demonstrates exactly why we take a bespoke approach to claims support. The challenges of a Parkinson’s diagnosis are complicated and unique to the individual. It underlines the importance of our partnership with Krysalis and their expertise in supporting people with neurological conditions. This, combined with the specialisms of our other HALO partners, helps us to provide personal and valuable claims support for our customers.”

The customer, who works as a financial adviser, added:

“As an adviser, when Guardian came to market with its critical illness policy and its ‘cover upgrade’ promise, I could see it was special, and that was part of the reason I took out this cover for myself. I’m so pleased I did, not just because of ‘cover upgrade’ which means my claim has been paid, but also because of the support I’ve received through HALO and my referral to Krysalis.

“The therapy sessions with Krysalis have helped me to process and organise my thoughts about my Parkinson’s diagnosis. When I was first diagnosed, I had a very bleak outlook, but the therapy has helped me see things differently. I now hold a much more positive outlook for the future.”

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