Help needed with BUPA Critical Illness claim - rare condition

graemeb_2

Hi All

My daughter developped a very rare neurological condition that hospitalised her for 3 months. She lost motor skills, power of speech, was fed via a nasal tube and remebled someone in a waking coma. She developed a movement disorder and endured some heavy duty treatment that included 8 operations in Paediatric Intensive Care. This all culminated in her requiring 4 months of chemotherapy. She has had to learn to walk again and my girlfriend has had to give up her job to care for her. We recieve disability living allowance also.
We have a life and critical illness policy with BUPA that covers the 3 of us however this illness is not specified on their list.
She is now recovery well and life looks as though is could return to normal. My question is; given the extent of what we went through as a family should I persue a claim inspite of the stated exclusion? If so is there anyone out there that has successfully persued a similar claim and can give me some pointers?

Any help gratefully recieved.

graeme

lisyloo

should I persue a claim inspite of the stated exclusion?

Firstly sympathies for what you all have been through.

But I'm afraid if it's not covered then it's not covered and that's it.
They don't pay on the basis of level of suffering and it's clear that her's and everyone involved has been high, but they only cover certain conditions and however sympathetic we are to that then if it's not covered by the policy, then they aren't going to pay out.

Is there any ambiguity here, or any logical reason you think the policy should pay out?
Otherwise it looks like a simply case of she didn't get an illness that is covered.

This is why I personally do not like critical illness and prefer to cover the financial risk (like lost income through not working).

Sorry to her of the illness and it's good to hear she is making a recovery,.

stephenni1971

Firstly it sounds like you have had an awful time and I am glad things seem to be improving for your daughter.

As for your question

My question is; given the extent of what we went through as a family should I persue a claim inspite of the stated exclusion?

CIC policies cover a finite list of possible conditions - if you meet the criteria - payout - if you dont - nothing.

You say in the title of the post 'rare condition' and I think thats your issue, CIC covers the most common conditions such as cancer, stroke and heart attack but its impossible to have a policy that will cover everything.

sandsy

Sorry to hear all that you've been through.
It's worth bearing in mind the original intention of critical illness policies though - which was to provide payouts for specified conditions which seriously affect a person's longterm quality of life. The fact that your daughter is recovering well indicates that this is not the right policy for making a claim.

magpiecottage

It would not have made any difference in this instance but for those in work it is worth weighing Critical Illness against Permanent Health Insurance.

CI is the more "sexy" policy because it pays a lump sum whereas PHI pays a bit each month until you are well enough to work or the policy term ends.

But PHI pays out for any illness that stops you working at all or possibly from doing your own job.

In an ideal world you would have both (actually in an ideal world you would not get ill at all but you get my drift).

Glad your daughter is improving but attempting a claim would be futile and only add stress for no purpose.

lisyloo

whereas PHI pays a bit

Where "a bit" can be 75% of your income.
My point is that "a bit" sounds insignificant, but this is basically a good income for many certainly a world away from living on benefits.
It has to be less than your previous income otherwise there would be no incentive to go back to work and a lot of fraud.

until you are well enough to work or the policy term ends

Often this is tied into your retirement date when the pension kicks in, so could be a significant period i.e. decades.

PHI is definitely the first choice in my opinion.
With CI you could get an illness and not be insured (as in this thread) or alternatively you might be insured but still able to carry on working largely unaffected and covered by sick pay.

Ideally you would have both, but this is unrealistic for the vast majority.