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Critical Illness Claim - My Story

Helob
Posted by

Thanks for replying . Yes it is very upsetting i forgot to add that in addition to refusing me They reduced my cover in half because i gave them an incorrect weight at time of application  i was after having a baby the year before ended up getting septicaemia from a uti so it took a while to get back to normal and lose the weight so i gave the weight i hoped to aspire to  pre pregnancy .They checked it with my GP I had only been with her 4 days before so they had accurate information. I was mortified filling in the application with the rep a man so i knew i was well overweight so i told him the weight hoped to reach. So for anyone reading this give the correct details if you can as they investigate everything!

Braverose
Posted by

Hi!

I am sorry you are in this situation but I am glad you found my post. The whole reason I created the post was to help others in a similar situation as me :) 

The insurance company also declined mine saying it wasn't 'invasive' because it had not spread. That is not the point.. it's that it CAN spread and/or have the potential to spread. I'm sure all the surgeons and doctors across the world would love to tell their patients your cancer will or will not spread but unfortunately they cannot. 

Also I might add Cancer is defined as a malignant growth or tumour resulting from an uncontrolled division of cells. I think at some point my insurance company said maybe you have controlled cells   should write a book of all the stupid things they said!

As Clarke79 said - call Macmillan. Speak to their finance team. I wouldn't appeal it with the insurance company as they drag their heels. Just go straight to Macmillan. They are so lovely! They will be able to discuss this with you and advise you if you are in the right or not. Macmillan will act on your behalf. I personally went to the ombudsman but I'm sure Macmillan will help you with this too. Just quickly.. there is two levels to the ombudsman. The adjudicator who was about good use as a chocolate tea pot. Then someone higher who makes a final decision.

Ignore their excuses.. by the end of it I didn't know who I was talking to. They definitely were not oncologists or anyone in the medical field. They were reading old WHO classifications from the year 2000 or something. You have to question them really.. I found classifications online and read them myself haha. I was 25 years old at the time and felt like I was studying medicine by the end of it haha. 

In the end Zurich wouldn't even speak to me! Even though I still paid my premiums and have life cover with them. Which also reminds me.. your insurance company should refund you any premiums you have paid since putting in the claim. They refunded me my critical illness AND life cover and also tried to cancel my life cover with them when it should of carried on.. So be alert with them! They are very sneaky. 

Macmillan will help you with everything. Please let us know how you get on :) 

Don't give up! I am sooo glad I didn't. Also it's great when you win 

Stay positive. Love Rosie xx

Helob
Posted by

Hi Rosie

Do you think the Macmillan group will support me as im from Ireland? I contacted the Irish Cancer Society and their Advocacy group were to contact me but haven’t as yet!!

regards

helen

Braverose
Posted by

Hi Helen,

Definitely worth a try! I’m sure if they can’t they will guide you into the right direction of something who can

Love Rosie x

Helob
Posted by

Hi Rosie

i rand the Macmillan nurse yesterday she was very good she suggested i contact the nurse specialist in the hospital i had the surgery for clarification on the histology results.The issue she explained  is that GIST have pushing borders so the cell membrane is not broken so that may be deemed as non invasive!

 Did your tumour have mucousal or lymph invasion?

Regards

Hen

Braverose
Posted by

Hey,

No I had no invasion. 
the definition does not state it needs to have invasion either. They just try and wiggle out of it!!

My surgeon wrote nearly 10 letters to my insurance company explaining it all and they still didn’t listen to him either! 

love Rose x