Claiming on Critical Illness Insurance following diagnosis of secondary liver cancer.

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Hi,

I have always had critical illness insurance. With my previous employer I had to make a claim after being diagnosed with tonsil cancer in early 2020. This was successful.

mid 2022 I changed employers but have opted to take critical illness insurance cover again for my husband and myself with another provider.

unfortunately I’ve just been diagnosed with liver cancer and histopatholgy shows this is very likely spread from the earlier cancer which was successfully treated in 2020.

I am not sure from the insurer’s product guide if secondary cancer is covered? There is a clause about related conditions , which I suppose a secondary cancer diagnosis is? However it does mention that a two year period of remission will be considered, I was prior to dx coming up to three years clear.

As I don’t have a huge amount of length of service with current employer the CI & therefore limited contractual sick pay a successful CI claim would make enormous difference.

finally have tried to do a bit of reading but all of the insurance providers are a little mute on their policy for those suffering recurrence.

grateful for advice.

  • Hello  ,

    Thanks for getting in touch and I am sorry to hear about your change in health. With these types of policies, the wording in the terms and conditions can vary with different providers. The policy guide can give some information but to be certain you’ll generally want to see the full terms and conditions. You should be able to request a copy of this from the provider/your employer so you can review exactly how the policy works, and whether it would be possible to claim on the insurance for your condition. 

    We could also have a look at the policy terms and conditions and if you’d like our assistance with this please get in touch on 0808 808 0000 and select option 1, then 2 and then 1 again to get through to our financial guidance team, we are open between 8am and 6pm Monday to Friday.  

    Your alternative would be just to contact your employer and ask for a claim to be submitted. As you’ve had a previous claim, I imagine you’ll be familiar with the process but just in case a reminder is helpful I’ll summarise the main steps.

    After the initial contact, the insurer will normally send a claim form for completion and return.

    The information the insurer asks for will normally relate to the cancer diagnosis, such as the date of diagnosis and cancer type. They’ll also ask for GP and oncologist details.

    Once this is sent back to the insurance company, the member of staff dealing with the claim will contact your specialist/ and or GP for confirmation of the exact diagnosis.

    It can take a few weeks for a claim to be looked at, so it might help to ask the insurer how long they think it may take them to make a decision. It may also help to chase the medical team, as delays can sometimes be due to medical reports taking some time to be returned.

    You should be kept up to date throughout the process and if more information is needed, the insurance company should let you know.

    When looking at the claim, the insurer will be assessing whether the cancer meets their criteria of a critical illness (for example, some less advanced cancers and ‘chronic’ or long-lasting conditions might not be covered).

    If the claim is successful, the payment will usually be sent to the bank account details on the claim form. If the claim is declined, the insurer will explain why and link it to the terms and conditions of the policy. If this happens and you want someone to review the decline, we would also be happy to look at the letter and the terms and conditions. If we don’t agree with the decline letter, we could help organise the next steps for you.

    Regarding your sick pay situation, we have a dedicated group of Welfare Rights Advisers who can check your state entitlements for any other benefit support. Unfortunately, the Welfare Rights Advisers don’t currently have a presence on Ask an Expert but you could speak to them by phone. You can contact them on freephone 0808 808 0000 and they’re available Monday to Friday 8am – 8pm and weekends 9am – 5pm. If you’d prefer you can also contact them via webchat here by selecting “Chat to us” and then the “Welfare Benefits & Grants” option. 

    They’ll ask you for some financial details such as your household income, amount of any savings, cost of rent/mortgage, council tax and utilities just to see if any other help is available.

    I hope this provides you with a bit of helpful information. If you have any further questions or would like to discuss things such as mortgages or pensions, then please don’t hesitate to get back in touch.

    Yours Sincerely,

     

    Chris H
    Financial Guide

     

     

     

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