Jessie Hewitson is a veteran money journalist and editor, and financial agony aunt for The i Paper.
Nina, a reader, writes
For the past three years I’ve been fighting Aviva over an “own-occupation” Total & Permanent Disability (TPD) claim. I woke up with sudden hearing loss — permanent and life-changing. One ear was already damaged; then the other went too. I can’t reliably follow spoken conversation and can’t use the phone.
I believed my Life & Critical Illness policy with a TPD benefit would protect me if I could no longer do the main duties of my job (national sales manager). Instead, Aviva has delayed, shifted goalposts, and — in my view — treated me like a suspect, including covert surveillance. They even paid £500 for “unacceptable delays” but then pushed me back into their process when the Ombudsman was involved. Twice I’ve had to file Subject Access Requests just to see my own file, and both times they missed the legal deadline.
I’ve tried to keep working, becoming self-employed out of necessity, but on a much smaller scale and for far less income. Aviva says that means I can still do my old job; I don’t agree. My GP, audiologist and an Occupational Health doctor support my position.
This has wrecked my mental health. I have mountains of evidence but no payout — and I can’t afford a £40,000 court case. I’m writing because I don’t want anyone else to go through this.
Jessie responds…
Dear Nina,
You have had a brutal few years. In March 2020 your brother died by suicide. Fourteen months later you woke up to find the hearing in your “good” ear had gone. This event left you deaf. Overnight your world shrank from carrying out leadership training and noisy meeting rooms to lip-reading in quiet spaces hoping you could keep up.
You had one comfort: a Life & Critical Illness policy with Aviva, plus a Total & Permanent Disability (TPD) benefit on an “own-occupation” basis. The policies were sold to you on the promise that if your health leaves you permanently unable to do the main duties of your job, the policy should pay out. On your reading of the paperwork, and with your audiologist’s report saying the role wasn’t realistic even with aids, you thought you had a fair case.
Aviva thought otherwise. First it said you didn’t meet the policy’s Critical Illness definition for deafness as you have moderate to severe hearing loss in your “good” ear, which is below their severity threshold. Then it declined TPD too, saying there wasn’t evidence you were totally and permanently unable to perform your sales-manager role. Had it gone the other way, the payout would have been around £140,000.
You escalated things, and so did the stress. Aviva put you under covert surveillance and raised that you submitted your claim the day after learning you were at risk of redundancy. Aviva regards that timing as significant: a sign, it says, that redundancy rather than incapacity may have driven the claim. You say the job had already become impossible — that being made redundant and being unable to do your role are not mutually exclusive.
You later set up a much smaller, related business as managing director, doing limited, supported work on far lower earnings; not, you argue, the same thing as taking charge of large meetings, managing staff and frequently overseas travel.
You took the case to the Financial Ombudsman. An adjudicator in early 2025 agreed — at that time — that the specialist evidence then on file didn’t meet the TPD test. You were concerned that the evidence included the viewpoint of experts you had never met and so paid for an Occupational Health report in May 2025, after the Ombudsman’s ruling. That doctor concluded a return to your old role would be “extremely difficult” even with adjustments.
At your request for a fair hearing, Aviva arranged a face-to-face meeting this March with a third-party investigator. I’ve listened to an hour of the recording and it made me uncomfortable. More than once you say you’re not following what’s being said. Your daughter, Halle, re-states questions so you can keep up — while being robustly questioned herself. Aviva provided a nurse “for support”, but on the audio I heard there’s no intervention even as you become distressed and say you can’t understand. Whatever one’s view of the claim, it didn’t sound like an accessible setup for someone with severe hearing loss.
Afterwards the investigator compiled a lengthy, damning report. Only you weren’t sent it at the time. You only obtained it after you filed a Data Subject Access Request. Buried in the document was a line claiming you had emailed the next day admitting a “false/fictitious” claim. Only you hadn’t. Aviva has since written to accept that this sentence was the investigator’s opinion, not fact, and offered you £250 compensation. You also say that the report had none of your context or explanations.
I assumed that admission would be a turning point. If a professional investigator confuses personal opinion with a claimant’s confession, how on earth can the rest of that report be treated as reliable? But Aviva has not shifted. It maintains the interview was “appropriate and professional” and that, taken together with other information, the evidence does not meet the policy test.
It points to what it sees as misrepresentations — for example, your attending events when you had previously said you could not go to network events — while you say such appearances were brief, heavily supported, and part of a messy, human process of working out new limits after sudden disability and profound stress.
Meanwhile, the medical evidence from people who examined you in person is stark. Your audiologist recorded severe loss and stated you could not perform the material and substantial duties of a national sales manager even with aids and a digital microphone system. The occupational health physician later said a return would be “extremely difficult” even with adjustments.
Two sector recruiters told me they wouldn’t place you back into that role. Aviva’s view is that the tasks you perform as MD of your small company demonstrate you can do the sales-manager duties with adjustments, and that an earlier ombudsman adjudicator agreed with the evidence at that time.
What is beyond doubt is that TPD comes with a very high bar. On paper it looks like a safety net for serious conditions that don’t tick the critical-illness boxes. In practice the permanence test and burden of proof can feel punishing, and the process adversarial – exactly when claimants are least able to cope. You can be severely hearing-impaired in both ears and still be told you’re not “disabled enough” for a payout. When I asked Aviva for its firm-level TPD acceptance rates, it declined to provide them.
I asked Aviva to do one of two things: pay the TPD claim; or commission a fresh, independent occupational health assessment if it wasn’t going to accept the findings of your doctors — and reopen the case. As of now, it’s not doing either of these things.
My view is that once Aviva accepted that a key line in its investigator’s report was opinion presented as confession, there should have been a pause for thought. A check of confidence in the rest of the file. A recognition that a profoundly hard-of-hearing woman, grieving a brother and wrestling with depression magnified by the stress of the claim, might not advocate perfectly at every step. Instead, what I’ve seen is digging-in.
I’ve spent months on this: long emails, recordings, hundreds of pages of reports and correspondence. I’ve drafted a detailed submission to the ombudsman setting out the new evidence and why the accessibility of that meeting matters. I wish I could say Aviva had shifted. I can’t. What I can say is that your case shows how opaque and horrendously stressful insurance investigations can be — and why, when serious illness strikes, insurance policies can be sometimes harder to claim than we expect.
I’ll keep everything crossed that the evidence we’ve presented to the ombudsman moves the dial, and you can put these awful recent years behind you.
Statement from Aviva
The customer made a claim on her critical illness policy in July 2022 which was initially assessed against her policy’s definition for deafness. As the medical evidence indicated her condition did not meet the severity definition, we then assessed her claim against the policy’s criteria for total and permanent disability benefit.
The claim was declined as there was no evidence to support the required criteria of being totally and permanently unable to work in her role as sales manager in any capacity. A vocational specialist confirmed that the skills she is using as MD of her own sales company demonstrates that she is able to do the material and substantial duties of her occupation, with suitable adjustments in place to accommodate her hearing loss.
In their independent adjudication, the Financial Ombudsman Service also agreed that the claim had been correctly declined, as there was no evidence from any relevant specialist to confirm she meets the criteria to qualify for the benefit.
While we understand that the customer’s hearing loss has had a significant effect on her in the past few years, we have carefully and fairly assessed and re-assessed her claim and cannot agree that there is a valid claim under the total and permanent disability definition.
Based on the information gathered during the claim and during a third-party claims’ validation meeting, we have determined that the customer provided us with incorrect and misleading information from the start of her claim in respect of her symptoms, work activity and reasons for claim. As detailed in the policy’s terms and conditions for this scenario, we have removed some elements of her cover. We do not take these decisions lightly and would not take such action unless we were satisfied with the evidence we have.
We do recognise that attending such meetings to review claim information can be difficult and uncomfortable for a customer and we are very sorry for any upset caused. However, we are satisfied that the meeting was carried out in an appropriate and professional way to discuss the information we held and that suitable safeguards were in place for our customer’s wellbeing. We take all feedback seriously in order to continuously improve customers’ experiences.
