What does “Eligible Children” mean in a Funeral policy?

November 18, 2017

If you have a casual relationship with a partner who has children that you take care of, it pays to be cautious. Children and funeral cover is a rocky road.

With kids involved, it’s important to formalise the relationship as much as possible. You may have to apply to be the child’s legal guardian in the courts. If you don’t want to do that, check the policy as to who they count as eligible children for cover.

Be sure to explain, when taking the policy, what the situation is. And get confirmation in writing to avoid problems later.

A story about Children and Funeral cover – 

Mrs Z had a funeral plan that covered herself and her children. Amongst the children that she listed, was her sister’s child due to the fact that both the childs’ parents had died. She was the sole carer for the child but did not adopt the child.

When the child died, it was established that she was not the biological mother. She could also not prove that she was the child’s legal guardian by court order.

What the Ombudsman said –

The policy defined “eligible children” as:

  • Biological children – born in or out of wedlock.
  • Officially fostered children
  • Adopted children where there is a legal order.
  • Children staying in your home as if they were your own.

 

Children and Funeral coverThe Ombudsman stated that, in terms of the policy, provision was made for the situation before them. The child’s aunt, Mrs Z had taken over complete care of the child who had been living with her for some time until her death. This proved that the relationship was not casual but permanent.

The child was financially dependent on Mrs Z and under the age of twenty-one. The insurer agreed that they should not have declined the claim. They did, however, feel that they were not responsible for interest on the amount.

According to them, Mrs Z did not give any information to the insurer that the child was not her natural child. Mrs Z should have shown proof that the child was eligible before the need for a claim arose. This was seen as unnecessary as it was not requested in the policy documents.

Secondly, there would have been a need to provide such evidence on claiming. Mrs Z did provide the proof when she submitted the claim.

The outcome Had a Happy ending

The insurance company paid the claim plus interest.

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All info was correct at time of publishing