Home Money Aviva won’t pay £50,000 claim because I had a cardiac arrest … not a heart attack. SALLY SORTS IT

Aviva won’t pay £50,000 claim because I had a cardiac arrest … not a heart attack. SALLY SORTS IT

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Aviva won't pay £50,000 claim because I had a cardiac arrest ... not a heart attack. SALLY SORTS IT

I suffered a cardiac arrest in November last year, but insurer Aviva says I am not eligible for a payout under my £50,000 critical illness policy because it only covers heart attacks and not cardiac arrest.

I always thought they were the same. Since then, the insurance company has made me dance happily. Can you please help?

RG, Surrey

Sally Hamilton responds: You described to me with remarkable calm the terrible events of last November, although you said that your wife had to explain them to you because she does not remember what happened that day.

Aviva wont pay 50000 claim because I had a cardiac

He woke up with flu-like symptoms and, after first consulting his brother-in-law, a family doctor, followed his advice to visit his own doctor. She took his pulse, which was 300 beats per minute, when the normal range is between 60 and 80.

He was sent to A&E where, shortly after arriving, he went into cardiac arrest and was out for about 12 minutes before being resuscitated. He spent ten days in a coma and on multi-organ support, and was not expected to survive.

Even when you unexpectedly regained consciousness, your wife and daughter were told that you may have suffered permanent brain damage and may need a wheelchair.

As the weeks passed, this terrifying prognosis fortunately did not come true, and after a month in intensive care, he was discharged on December 27 and returned home without the aid of a wheelchair.

While he may have emerged in much better shape than anticipated, his heart is still too weak (and always will be) to allow him to return full-time to his occupation as a self-employed carpet and oven cleaner.

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PEOPLE should beware of fake train ticket adverts on Facebook offering gift cards worth just £3 for a year of train travel – which ones? warns.

Hoaxers posing as Great Western Railway claim you can get one of a ‘limited number’ of gift cards by clicking on the advert and answering a few questions.

However, the link leads to a malicious phishing website which will trick you into handing over your personal details, according to the consumer campaign group.

Do not click on any links in the ad. Instead, select the three dots at the top right of the Facebook post and press “Report Ad.”

At 55 years old, he was naturally worried about how this would affect his family finances.

You believed the critical illness policy you established in 2001 with Norwich Union (now Aviva) would be a financial lifeline.

But your cardiac arrest claim was rejected twice: first, after your wife called Aviva while you were in a coma.

Unfortunately, older policies like yours typically cover heart attack but exclude cardiac arrest. Few people, other than medical professionals, understand the difference. Cardiac arrest is when the heart stops pumping blood through the body, usually due to an irregular heart rhythm (like it happened to you). Heart attack occurs when a portion of the heart muscle dies, perhaps due to a blockage, clot, or narrowing of the arteries.

Cardiac arrest is now covered as standard in many newer critical illness policies. Even Aviva has included it for many years.

It was excluded from previous plans because, to put it plainly, people rarely survived cardiac arrest. Therefore, life insurance was the relevant policy. Medical advances mean victims are now more likely to pull through.

When he went into cardiac arrest for the second time, Aviva suggested he might qualify for permanent total disability, but that could not be determined yet because the insurer said his condition could change.

You were shocked, as your heart is now functioning at approximately 35 percent of its full capacity and you have been told it will never return to normal. He has also been fitted with an implantable automatic defibrillator, a type of pacemaker that helps control heart rhythm.

That’s when you came to me for help. I have investigated two similar cases involving cardiac arrest claims being denied, and after asking the insurers to reopen the claims, they were able to find a way to pay.

In his case, I was immediately struck by references to coma, a condition I thought should trigger a payout. Armed with this argument and other details she had given me about her incident, I asked Aviva to look again.

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Can Sally Sorts It help you?

Do you have a consumer problem you need help with? Email Sally Hamilton at sally@dailymail.co.uk; include the phone number, address, and a note addressed to the offending organization giving them permission to speak with Sally Hamilton. Please do not send original documents as we cannot be responsible for them.

The Daily Mail or This is Money cannot accept any legal responsibility for the answers given.

It took only a few days for the insurer to confirm that it would pay after all, according to the definition of a coma. Her £50,000 payment was quickly transferred to her bank account, with £750 added as an apology for the poor service she had received.

You were delighted and said the money would allow you to pay back the friends you borrowed money from after the incident. It will also give you a break to focus on further recovery before (hopefully) returning to work. Carpet cleaning won’t be possible due to the heavy equipment involved, but you hope to return to cleaning ovens part-time.

An Aviva spokesperson says: ‘We are very sorry that our customer did not receive the claims experience they should have received. Upon review of the case, and in light of new information available to us, we may pay a claim based on the policy’s definition of coma.

“We always look to pay as many claims as possible, and although the policy did not cover cardiac arrest, we regret not having fully explored whether he met the definition of a coma during our initial discussions with him.”

Aviva said it will take steps to improve the claims process as a result of its experience.

I sincerely hope that other insurers learn from their history and understand the importance of gathering all the facts at the beginning of a process so that customer claims are not dismissed without due consideration.

On October 9 last year, whilst doing my usual online shopping at Asda, I ordered two Nintendo games costing £40 each for my grandson’s Christmas present. I immediately wrapped them up and set them aside. On Christmas Day, my grandson opened the packages and found dummy cases that contained no games. This caused great discomfort.

I contacted Asda several times but they did not offer me a refund. I was told to return the cases to the store, which I did, but again I received no refund.

The manager of the online grocery store then promised a refund and a £20 goodwill voucher, but nothing materialised. Now I have no products or refund. Please help.

KE, Yeovil, Somerset

Sally Hamilton responds: I remember the dismay, when I was young, upon receiving a battery-operated toy for Christmas that came without batteries. So, I can imagine his grandson’s disappointment as he opened the empty game boxes.

I asked Asda to put things right because you had waited too many weeks for a repair. Asda investigated and, I’m pleased to say, she quickly apologized, refunded him £80 and sent him a £20 voucher for the inconvenience.

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I ordered two pairs of trainers from Sports Direct in October, but had to return a pair because they were too big. I returned them to the post a few days later but never received a refund.

BL, Tavistock, Devon.

Sports Direct apologizes and says it received a pink dress instead of the trainers, which it believes is due to a labeling error made by the courier. He has now refunded you £59.99 and offered you a 20 per cent discount on your next order, which you declined.


I had to cancel two holidays, in March and May 2022, after my son passed away. I made a claim to my travel insurer but they will only pay me £450. She says I didn’t tell her in time about my son’s illness, roof. I still haven’t received the £2,580 settlement I was promised.

Anonymous, via email

His insurer says it has no record of his call. She claims that she did not contact him until May, thus reducing the insurance payment to which she was entitled. She has agreed to pay him the full cost of £2,198.


I paid £3,800 to install a boiler but the installer left a leaking joint. It flooded my loft and brought down the roof. I still haven’t received the £2,580 settlement I was promised.

Oh, by email

Since he lives in a bungalow and the unit is in the attic, he didn’t detect the drip for some time. The installer has promised that the cash will be in your account within 21 days.


In January I ordered a curling iron from havegoods.uk for £21.99. When it arrived it didn’t work so I wanted a refund. The company only offered me a new one, but the website claims to offer refunds. I complained but have not received a response.

M.W., Richmond, Y.orkshire

After my participation, you have been told that you will receive a refund to your account within ten business days.

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