Critical Illness Cover - DECLINED

I remember using my TNM data on mine, perhaps the form I used asked for that.  This makes me angry, any excuse not to pay. Sorry you've had to go through all this. 

Hi,

I was diagnosed with a Neuroendocrine tumour in the pancreas. However due to other medical conditions, it is not possible to have a biopsy and my insurer refused to pay the Critical Illness policy under the cancer definition, insisting I must have a biopsy...I am discussing the issue currently with the Ombudsman but would really like to talk with you to share information and experience in this. Our cases seem similar. Could we chat by email or phone?

Hi Simon, 

sorry to to hear about your neuroendocrine. 

Yes definitely. I have added you as a friend on here so think I can message you once you have accepted 

For anyone else reading the ombudsman made a provisional decision that my insurance should pay. I will get the final decision in February but things are finally looking up!!

Rosie x

Hi everyone,

just to to let you know Zurich finally paid my claim!!! 

A year later but they had to pay interest on top. I will be writing a separate blog post about it all and hope it may help anyone else in a similar position.

Rosie 1 Zurich 0

love Rosie x

Hi Rosie.

So glad they paid out.

I am in a similar position and am not sure whether I will get my insurance claim either.

Working on the theory that insurers try to avoid paying out somehow.

I would be interested in what made them change their minds and your blog..

Regards

Hi guitarfunkster,

I doubted it for a very long time. Up until the end. 

I definitely think they do - not with everything / everyone but with me they did. They did not like the fact I was young and only had the policy a few months - but that's the gamble we all take!

They dug themselves into a bit of a hole and couldn't keep up with the excuses they were making. 

The ombudsman made the provisional decision with me and they agreed with him before it got to the final decision stage. 

When they changed their minds they said - having looked through the medical evidence on file I can confirm the claim will be paid.

Not quite sure what medical evidence this was.. maybe the stuff everyone else provided or the original evidence provided at the start of all of it!! Who knows.. 

I have wrote another blog:

https://community.macmillan.org.uk/cancer_experiences/general_cancer_discussions/f/general_cancer_discussions-13/177188/critical-illness-claim---my-story

Thanks

Rosie x

Hi Rosie

Thanks for the reply.

I am not sure whether I will be quite as lucky though as I can't see this defined in my policy when I took it out..

However I would think it might be difficult for them to argue that a condition where the fix is having half the pancreas and spleen removed is not a crticial illness.

Also the principle that insurance is based on good faith.

They have added it to their policy since I took it out so this would imply that they do consider it a critical illness.

I will post the result of my claim when I have finished this.

I do hope all is well with you.

Regards

Hi guitarfunkster,

Don't give up hope - you never know.

My policy didn't say anything about NETS. 

I hope you get the result you want / deserve. If you want to ask anything in the meantime ask away

I would hate it if other people had to go through what I did. I never thought I would beat a company like that but shows it is possible. Keep going

Hope you are feeling OK too

I would just like to say that the very same thing that happened to Bravrose happened to me.

After I read this thread I contacted the awesome people at Macmillan and Braverose and they both really helped me out! I no longer felt alone it felt like I had a team.

My insurance were dragging their heals but seemed to pay straight away once I reached out to Macmillan.

Call these guys for help they are a force! Im hoping to volunteer a lot for Macmillan in the future to show my appreciation. Thanks Guys!!!

Hi

Just to let you know that my insurance also paid out in full for the neuro endocrine tumor that I had in the pancreas.

This tumour has now been removed. My insurance company is Aviva - critical health benefit.

I suspect that the wording in the letter that the surgeon's secretary writes to support your claim can also have a big influence.

Unfortunately I don't have a copy of this letter.

Regards

Dave