EASS supports individual in challenging travel insurance quote

Transcription

1 Success Stories

2 About Us The Helpline began life in October It advises and assists individuals on issues relating to equality and human rights, across England, Scotland and Wales. We can also accept referrals from organisations which, due to capacity or funding issues, are unable to provide 'in depth help and support' to local users of their services local users of their services. We are able to support an individual to resolve their issue using alternative informal dispute resolution, as opposed to issuing a claim in the county court or the employment tribunal; needless to say, we recognise situations where issuing a claim may well be the only option. In some instances we may write to a service provider on behalf of a client in order to initiate a resolution. It is important to remember that we will work with you to decide the best course of action for you to take in resolving your issue. We will support you to achieving the best possible outcome. Success Stories

3 EASS supports individual in challenging travel insurance quote Trying to arrange travel insurance for a holiday of a lifetime almost led to a trip being cancelled due to an unbelievably high quote after disclosure of medical information. The Equality Advisory & Support Service (EASS) were contacted by an individual who had received an incredibly high quote for travel insurance due to statements made about health on an online form. The caller was planning a holiday of a lifetime with his family and had previously used the insurance company at a reasonable price. He decided to use the company again and disclosed that he has malignant melanoma more than once yet they were isolated nodes. The online form would only allow him to submit this as a re-occurring condition whereas; in reality they should have been considered as separate conditions. Because of this his premium quote was 961. This left his planned holiday in serious doubt as he simply could not afford the insurance offered. EASS gave the caller advice on how the Equality Act works within insurance services. The caller spoke with Roy, one of the EASS s experienced advisors who talked him through his rights. In particular, Roy discussed that in some cases insurance companies can charge higher premiums but only if a strict criteria justifying the higher charge has been followed. Roy explained that the reason for the higher quote had to be relevant to the risk being insured and, importantly for this caller; it has to be based on information from a source in which it is reasonable to rely. The company s online form was not flexible enough to allow the full facts to be presented. When the individual initially complained about the high premium he was told that there was little that could be done. Roy advised that the caller use a template letter from the EASS website and, combined with advice around disability discrimination, suggested that he asks more details about how the company sets their prices when particular health conditions are revealed. Roy s advice and support gave the caller confidence to challenge the insurance company. When confronted with this information, the insurance company admitted that the online form was not flexible enough to take all information into account and that the decision to charge a high premium was not actually based on any information from a reliable source. They looked again at the information provided and agreed that the quote should have been 136. This is a massive 825 cheaper than originally quoted!. The caller was extremely happy as he now is able to go on his planned holiday with the rest of his family. Roy was also very pleased with the result This issue shows that a high quote can be challenged because strict criteria have to be followed by providers of financial services. If any insurance company cannot advise where they got their information from to charge a higher premium and also cannot show that it comes from a source which it is reasonable to rely, higher premiums may result in discrimination. Roy Conlon, an EASS adviser with over 20 years experience helping individuals understand their rights.

4 Human Rights and Care Funding Decisions EASS helps gain a positive outcome The Equality Advisory & Support Service (EASS) was contacted by an individual who was facing the prospect of being placed in residential care after a funding decision by their local authority. The individual is disabled and needs 24 hour care yet leads a full and active life. Regular contact with family and the wider community play a significant part in her identity. Despite needing care arrangements, the individual was involved in community life and enjoyed many varied interests which gave her a strong sense of identity and independence. This is extremely important to the individual especially as she is still young and active. Funding for care was provided through the Independent Living Fund which has since closed. Funding decisions are now made by the Social Services Department within the Local Authority. Now with the responsibility for care funding, Social Services reviewed the individuals care arrangements and made a decision that no further funding was available for the 24 hour care. A decision was made was to place the individual in a care home. The impact was shattering. Not only would regular contact with family be lost but also her life within the community and her life activities would be seriously diminished if not removed completely. Sensing that immediate action had to be taken, the individual contacted the EASS for initial advice. The call came through to Ann, one of the team of specially trained advisers at EASS. Ann identified that there were possibly important interactions with the Human Rights Act. Due to the massively detrimental impact on the individual s life, Ann wanted to give the right advice so a decision was made to talk the issue through with one of our partners. EASS has a wide and comprehensive partner network where we can draw from expertise in all areas of equality and human rights. Through the partner network, EASS has an immediate route to information and support from some of the UK s experts in discrimination issues. For this issue, we contacted our lead partner Disability Rights UK to obtain their expert viewpoint. Disability Rights UK studied the case notes provided by Ann and concluded that this issue is going to interact heavily with the Human Rights Act. They made some valuable suggestions that Article 8 the Rights to Private and Family Life, Home and Correspondence was very relevant and that the decision to place the caller in a care home based on funding concerns, needed to be proportionally considered alongside the impact on her active life and relationship with family. Disability Rights UK shared their knowledge regarding the closure of the Independent Living Fund and suggested that firstly, a query should be made whether the Local Authority as ring-fenced the funding as they are able to do so. If not, the decision to place her in a care home should be challenged by using Article 8 of the Human Rights Act. Ann returned to the caller with this information and, empowered by the advice and support, the individual put this argument to the Local Authority. What happened next showed that used in the right circumstances and correctly, Human Rights can lead to positive outcomes. By demonstrating the impact of the decision on her life and using the right language around Article 8, the Local Authority could see that a decision based purely on funding capacity could indeed interfere with the caller s right to her private and family life. They thought more about the decision and concluded that it was not proportionate to place this active disabled individual in a care home. Funding would therefore be made available to continue the current care package which was vital to continuing the full and active life and strong family relationships. This is a wonderful outcome from what could have been a desperate situation for a disabled individual. The guidance and advice provided by EASS combined with the support and expertise of our partner, Disability Rights UK has given an individual a voice. A voice that has been used effectively and listened to protect the way she enjoys life. Ann Goldsby, the EASS adviser who helped the caller with expert advice and support.

5 Probably the finest example however comes in the form of Mr Wilson and his son Alfie; a real life case study illustrating just how much of an impact the EASS helpline has had. Alfie is on the Autistic Spectrum, he has high functioning Asperger s Syndrome which is a form of autism. This is a lifelong disability which affects how Alfie makes sense of the world, processes information and relates to other people. Alfie also has a number of sensory issues which are built around structure and routines. When Alfie was due to start primary school, Mr & Mrs Wilson completed the relevant admission forms and complied with the LEA s admissions policy in order to secure a place for Alfie. In addition, Alfie s parents also sought to include further information about their son s condition in order to make the transition to primary school as smooth as possible, with minimal disruption to Alfie s routine and daily structure. Alfie s parents provided the Admissions Panel with documentary evidence from Alfie s healthcare professionals as to why he should be allowed to move up to Primary school with his current set of peers. They stated that moving him to another unfamiliar school, with faces he did not know would cause difficulties in building relationships, an unfamiliar school journey which would trigger a regression in Alfie, as well as causing a set back to his educational attainment by 12 months. Unfortunately, Alfie and his parents were advised that they did not meet the schools admissions criteria, namely children with exceptional medical or social needs, supported by written evidence from an appropriate professional.. As far as Mr and Mrs Wilson were concerned they had produced the written evidence from appropriate professionals., including Alfie s Pre-school Key Worker, his Speech and Language Therapist, and Consultant Paediatrician. Alfie s parents decided to appeal the decision of the Local Authority and were advised to contact the Equality Advisory & Support Service. After studying the information, the EASS advised that the selection criteria could be potentially discriminatory under the Equality Act 2010, in particular, because the Local Authorities admissions policy placed Alfie at a substantial disadvantage because of his disability. The policy did not take into account the need for Alfie to stay within his peer group, supported by medical information. The EASS advisors also highlighted that the Local Authority had:. A duty to consider how their admission criteria indirectly discriminated against a person with Asperger s, and thus could have been adjusted in order to overcome the substantial disadvantage that Alfie had been placed under.. To show that they have applied their admissions policy fairly and proportionately.. Taken into account the information that Alfie s parents Vikki Harvey provided the support to Alfie s parents at a very difficult time.

6 Mr Wilson duly appealed and included this advice in his letter to the Independent Appeal Panel. On the 17th July 2013 Mr and Mrs Wilson were advised of the successful outcome of their appeal, overturning the original decision and securing a place for Alfie at their preferred Primary school. Delighted with their news, Mr and Mrs Wilson and their son Alfie contacted the EASS to thank Vikki and EASS staff for all their advice and support. Alfie can be seen below celebrating the good news! In Alfie s case, and many others, the Equality Advisory & Support Service clearly demonstrates its importance in supporting individuals with their issues, but it can also work highly effectively with organisations to refer individuals for advice. For example, the intelligence which is gathered by the helpline contributes to the survival of smaller organisations by allowing them to free up time and limited resources to concentrate on their areas of expertise. In addition, this knowledge is also shared with EASS partners to ensure it s availability to help influence policy change and development, building of relationships within their communities, and highlight trends both regionally and nationally. Mr Wilson Alfie At the time these stories were published, the Equality Advisory and Support Service had helped over 100,000 people with discrimination and human rights problems. November 2015