Critical Illness Claim for Rare Diagnosis

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I am looking for advice when claiming for a critical illness - I know the insurance company are looking to see that I match the definition but with a rare diagnosis I don't exactly match the definition. 

I have a rare Neuroendocrine Tumour called a paraganglioma, which is staged/graded with something called a GAPP score. My insurance company only pay-out for Neuroendocrine tumours Grade 2 (intermediate risk) or above. My tumour is GAPP scored at 5 which puts it a intermediate risk level 2. I just don't know if this is considered the 'same' grading and because the Paragangliomas are rare and complicated there is very little information out there about it. Both Neuroendocrine Grades and GAPP scores are rated 1-3, low, intermediate and high risk. Both the grade and GAPP take the same types of information into account it is just that the GAPP includes a little more detail. 

I am just trying to work out if there is any information out there to help me. 

I have also had Genetic mutation found and have further CT/MRI and blood tests to see if it has spread anywhere - should I wait for these results?

  • Hello Hanlinn,

    Thanks for getting in touch and welcome to our online community. My name is Carole and I’m one of the Cancer Information Nurse Specialists on the Macmillan Support Line.

    It’s difficult for us to say whether you should wait for the results of further tests before getting back in touch with the insurance company.

    It might give them more information, but it may help also to ask your consultant to provide a letter which explains the grading of this rare type of tumour. They should be able to provide both GAPP Score and Risk Stratification (low, intermediate, or high).

    Sometimes Citizens Advice can help with questions about critical illness insurance. It might be worth giving them a call.

    I’m not sure if you are aware of the charity that has been set up to support people with paragangliomas. Phaeo Para Support UK has a Facebook page and provides counselling. This might be a good place to ask questions, and if you’d like to talk about insurance with one of our Financial Guides, please don’t hesitate to get back in touch.

    Please don’t hesitate to get back in contact by email, webchat or phone, if you need further information or support.

    The Macmillan Support Line offers practical, clinical, financial and emotional support. You can call us free from landlines and from most mobile phone networks on 0808 808 00 00, 7 days a week, 8am – 8pm.

    Best wishes,

    Carole

    Our ref: DC