Friday, January 18, 2019

When the patient tries to play his loan insurance


In July 2017, 56-year-old Hervé D., a computer engineer on his own, was approached by Habitat de France. He agrees to install photovoltaic panels on the roof of his house and to buy a heat pump, for the sum of 26,500 euros. To this end, he contracts a loan of the same amount from the Cetelem credit institution.
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The loan must be repaid over ten years, in 120 monthly installments of 282.50 euros. On the advice of the Habitat de France sales representative, Hervé also subscribes, with Cardif (BNP Paribas French insurance company), an insurance of 26.52 euros per month, supposed to repay the loan in its place, in case of illness, accident, disability or death after a waiting period of 90 days.
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Waiting period


In October 2017, Hervé D. suddenly falls ill. He has disabling hands (which prevent him from using his computer keyboard), hips, knees and shoulders. He goes to see all kinds of specialists, who can not diagnose his illness, despite the X-rays and MRI they send him. He must take large doses of cortisone, to limit his suffering.


On February 14, 2018, Hervé D. must stop working. He asked Cardif to pay his reimbursements to Cetelem, after the 90-day waiting period, starting on June 14 - and he blocked Cetelem's withdrawals from his account. His doctor fills for him the necessary file, in which he indicates that Hervé suffers from " pseudo-rhizomelic arthritis and other arthropathy in the course of exploitation ". The doctor, to the question do you have regular medical treatment? ", answer " yes, since June 2014, Ramipril-Bisoprol ".
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" False declaration ".


On June 28, 2018, the "Director of Operations " Cardif responds to Hervé that he refuses his support. He accuses her of having declared, when taking out insurance, " do not follow regular medical treatment », what would be " in contradiction " with the document sent by the doctor. Accusing him of false declaration "he decides to apply Article L 113-8 of the Insurance Code, and to cancel his contract.


Hervé D. immediately makes an appeal. He denies having completed any questionnaire. He explains that the treatment he has been following since 2014 is designed to prevent cardiac risk, in the very long term, and that he has nothing to do with his illness. On July 10, his doctor certifies that this treatment " is not related to the pathology presented since November 2017 ".
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Telephone harassment


Without waiting for the outcome of the appeal, Cetelem begins to harass him, on the phone, because the month of June is not paid. The collection service operator threatens to file it with the Bank of France if it does not pay by credit card. He finally gives in, and also pays the one in July - as well as the insurance monthly payments. He must also send all sorts of supporting documents that are required of him: " Being sick is a full time job with them ", he strives to smile, while the mere fact of holding a phone gives him horrible cramps.


On July 20, 2018, the "Claims Department " de Cardif announces to Hervé that he cancels his decision to strike him off. He acknowledges that he did not complete a medical questionnaire when he joined the insurance. He writes to her: " We proceed to the reinstatement of your insurance contract and all the inherent guarantees. We advise our partner Cetelem of this support so that it proceeds to the regularization of your file ... " - it will still be necessary that Hervé insists that Cetelem, paid twice, reimburses him the first two deadlines.
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Twelve refunds only


But Cardif tells him: " This compensation may not exceed 12 monthly repayments, in accordance with the provisions of the notice of your insurance contract ". Hervé D. falls from the clouds: " Since when does a long illness last only twelve months? he asks himself. He never received the "notice " of this insurance contract (no.119/ 022), he never read it (it can not be found on the Internet), never signed, and the salesman who solicited it never told him that it limited compensation to twelve months! " It's amazing that such a critical piece of information has not been given to me! " if he protested.


It calculates that after twelve months, Cardif will have reimbursed in its place 3,708 euros (12 loan maturities + 12 insurance maturities), while after ten years, it will have, for its part, paid 3 182 euros of insurance: « The gain is for me only 525 euros »he says. He wants other consumers, so alerted by its history, require the production of the record, before signing anything.
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