Critical illness insurance claim - wish us luck!

gadgetmind

minxy76 wrote: »

Well, we had a call this afternoon to say that Scottish Widows are paying the claim.

Woo hoo, that's great news! One less thing to worry about, and a big one too.

Thanks to everyone for your advice, this forum has been a great help to us. :beer:

I think it was more a case of helping you keep your chin up, which is all you can do in situations like this.

Meeper

Some good news in this thread - I like it!

In other news, more and more insurers are now covering things like Ductal Carcinoma in situ and other conditions which were not previously mentioned in CIC definitions, which is excellent.

For anyone currently looking at critical illness insurance, may I discreetly recommend PruProtect's Serious Illness cover, which is pretty revolutionary in the UK marketplace, covering up to 161 conditions as opposed to the standard 30-odd.

Congratulations once again to those successful claimants, and I hope the affected individuals are well on the road to recovery.

Benjiboi

I know that this is an old thread but I thought I would throw my two pennies in. As a mortgage and insurance broker I think the problem with these insurances is not in the product, after all every insurer designs the product with a certain clientelle to service. It is unsuprising that Aviva (who are often the cheapest) also have among the lowest number of conditions covered and some of the harshest definitions. Whereas Pruprotect (among the most expensive) have a very large number of conditions and more flexible definitions.

The problem lies in the method of sale of the insurances, buying these types of insurances via a comparrison site is a recipe for disaster and often the direct sales forces of the insurers themselves are woefully inept. The only answer is to then source through a broker but the industry does still have a large number of unproffessional brokers who will strong arm people into inappropriate products or sell purely based on price which is pointless since if a client is genuinely considering this type of product then quality is the name of the game. My advice to anyone is to read the literature, understand what you have bought, what the claims proceedure is, when the policy won't pay out and be careful of the traditional black holes in policies such as breast and prostate cancer coverage.

Glad to hear a successful claimant

Sloganjerry

Just wondering if anyone can offer any advice concerning a CI claim? A friend of mine has recently been diagnosed with breast cancer and is about to start chemotherapy following a mastectomy. My friend is quite confused by the forms and knowing that these claims can be refused is worrying about her wording on them. Surprisingly there doesn’t seem to be any help available to her, as Tenovus say they only deal with benefits advice. She is hoping her Macmillan nurse might advise but not sure if it’s really part of their remit? Basically she’s worrying about 2 questions in particular. One question asks her to describe her condition. The consultant did say it was ‘ductal’ but the Macmillan nurse has told her that there was an ‘invasive component’. Should she try to explain all this as obviously she’s worried about saying anything that may cause Direct Line to refuse the claim? Secondly they ask how long she had the symptoms. My friend says she became aware of the lump about 2 months before going to the doctors and only waited because she was unsure if it was just lumpiness which women sometimes get at certain times of the month. Should she have gone to the Drs sooner and will this wait affect her claim?
Thanks in advance for anyone’s help with this. I feel so annoyed that she’s having to deal with the worry of all this on top of fighting the cancer and facing the side effects of chemo shortly.:(

jeffnail

Do you know which insurance company has issued the policy? most companies have help lines to go through the claims stage, when was the policy taken out? if over 2/3 months ago then the lump does not matter as the plan was already issued. Any medical info that could be looked at as a material factor for an underwriter must be disclosed when the plan is taken out, However if the plan was issed months/years ago then not an issue. None of us are Dr's so the insurance company will always issue a GP report asking for your full medical details + any consultants reports. They will look at the medical condition and see if it is covered on the plan, some of the new plans cover +40 different conditions however some plans taken out a few years ago cover +30 conditions. Hope this helps?

Sloganjerry

Thanks for responding. The policy is with Directline and she's had it for some years. I think she was worrying in case they said 2 months is too long to wait and that she should have gone to the Drs straight away?

She also said to the Dr that she had been feeling unwell for several months and now wonders if it was the cancer. When she thought back to this worried that if the Dr writes this in his report it might sound bad to the insurer. but she definitely only became aware of the lump about 2 months ago.

Cheers for any advice :beer:

Sloganjerry

What i think what she really wants to know in a nutshell is - does it matter how long it took between spotting the lump/symptoms and visiting the doctor? Does anyone know if this could have any bearing on whether they pay out or not?

gadgetmind

Sloganjerry wrote: »

does it matter how long it took between spotting the lump/symptoms and visiting the doctor?

My guess, and it is just a guess is no, not unless it was taken to extremes. They say that women go to the doctor when a lump can be felt with their fingertips, whereas men go when it can be seen through their clothing!

If it was invasive cancer (rather than ductal carcinoma in situ), and it wasn't pre-existing, then the gears will grind for long enough for fingernails to get well-chewed and then they will probably pay out.

The key part is "invasive". My wife needed sentinel nodes removing and radiotherapy because her cancer had *just* started to spread beyond the duct. That your friend is on chemo suggests that the same is almost certainly true in her case.

Please keep us informed, but I really doubt whether anyone here can give an answer that's unequivocal enough to assuage your friend's concerns.

Sloganjerry

Thanks gadgetmind. Going to meet with the Macmillan nurse tomorrow who has kindly offered to help my friend fill out the claim forms. Let you know how we get on.