Critical illness insurance claim - wish us luck!

Errata

Clearly you've had to develop an in depth understanding of both CI cover and your wife's health problem, and my best wishes to her. I would be grateful if you could expand a little on this -

Yes, when reading the forms maybe people should ask what DCIS is, and why the CI companies don't regard a carcinoma as being the same thing as cancer, but people generally aren't experts in either medical terminology nor critical illness insurance.

gadgetmind

Errata wrote: »

Clearly you've had to develop an in depth understanding of both CI cover and your wife's health problem, and my best wishes to her. I would be grateful if you could expand a little on this -

CI insurance usually covers cancer, but also specifically excludes DCIS, which is Ductal Carcinoma In Situ. This is cancer that has been caught before it has spread, which is good, however, preventing it spreading involves surgery (often drastic, perhaps even full mastectomy), radiotherapy and perhaps chemotherapy.

Critical Illness insurance WILL NOT usually cover cancer caught this early because it hasn't yet spread and thus doesn't meet their *very* narrow definition of cancer.

My wife was lucky. The cancer was invasive, but her sentinel nodes were clear. This means it had spread but the spread was localised. As a result, her prognosis is *very* good, and the CI should pay out.

Sadly, some women need far more drastic surgery, but because the cancer is still "In Situ" the critical illness insurers will reject the claim because it doesn't meet their definition of cancer.

Of course, when applying for insurance ever after, there is *zero* doubt as to whether you have had cancer.

Morgywotsit

I also wanted to post on your thread and say a huge thank you for all the information you've posted here, and mostly good luck with your wife. Humour can keep you sane I know, I laughed a lot at the higher earnings through one boob - if I ask my husband where anything is he says 'don't ask me, I'm a stroke victim' (his memory has always been v bad!). I know we're lucky in some respects that stroke is listed there clear as day. I honestly had no idea that there would be any debate about breast cancer at all, unbelievable. I really hope you get a cheque through the post very soon. We have already picked the restaurant to go to the night any cheque arrives! And I also wanted to say, I only got this insurance through the knowledge of my parents in law - one is a PE teacher, doesn't smoke or drink, the other smokes and drinks. When the smoker got made redundant years ago they dropped to cover only him as times were tight - and yes, you got it, she got cancer. She's going strong 16 years after the all clear from leukaemia.
Really wishing you all the best, you've really given me strength and one of only a couple of genuine laughs this week
jenny
x

gadgetmind

Morgywotsit wrote: »

When the smoker got made redundant years ago they dropped to cover only him as times were tight - and yes, you got it, she got cancer. She's going strong 16 years after the all clear from leukaemia.

CI is expensive and we were about to review ours. Glad we didn't!

If our pays out, it will immediately be cancelled. Getting future insurance for my wife will be hard, but I have "one year's salary on diagnosis" CI via my employer.

Morgywotsit

It souds like you have a good job there - or good benefits at least. I presumed my husband would be uninsurable after this, do you not think so? I was going to look at getting a single policy for myself but I'd be itnerested if you have a different grand plan. Ours was only £36 a month, and whilst it would be a big amount for us now, it would cover 2/3 of our current mortgage - still good but not huge. I was going to update it last year but the forms were so long and it seemed so remote... I'm really not looking back though in that way.
I really do wish your wife the best, and that her treatment doesn't go on for too long
x

gadgetmind

Morgywotsit wrote: »

It souds like you have a good job there - or good benefits at least.

I'm lucky: it's both.

What's interesting is how when we describe our pensions, CI, permanent disability, health, and life insurance, lots of prospective employees (mainly younger ones) glaze over and perhaps even yawn. I reckon it would cost me at least £250pcm to buy the insurances, and the sal sac + employer contribution pension is solid gold.

I presumed my husband would be uninsurable after this, do you not think so?

It's worth trying to get quotes. They might weight, or they will exclude anything related to his existing conditions, but I'm no expert on this. We're currently wondering whether we might want to get additional CI for my wife, but between her own issues, and the wide variety of ailments that her parent have had recently, I doubt it would be worthwhile.

Ours was only £36 a month, and whilst it would be a big amount for us now

Ours is/was £160 a month, which is a big old chunk of change, hence as looking long and hard at it before all of this.

the forms were so long and it seemed so remote...

IKWYM.

I really do wish your wife the best, and that her treatment doesn't go on for too long

Treatment is (touch wood) now over. The radiotherapy has left her with one sunburnt boob and the other still "white British", which looks most odd.

Morgywotsit

Thank you (again). I am definitely going to look into all this tomorrow. It's only been a few days but I feel I need to answer every question to help clear my mind.
I work for a charity so get no benefits whatsoever!!
Sounds like your wife is coming out of the other end, long may that continue. My husband still has double vision and he says the appearance of 4 boobs everywhere is the only benefit he can think of
J*

magpiecottage

It is a problem with CI that it does only cover exactly what it says it covers in the policy document. It does not cover something that looks like the illness covered but is actually something different and it does not cover something that does not meet the relevant severity requirement.

It is therefore important to understand exactly what it does cover when you buy the policy, not when you claim on it.

Cover for cancer in situ is not common. You may not like that but insurers are entitled to offer what they want to offer, provided they do so in a way that is clear, fair and not misleading. Customers cannot force them to offer a product that they do not wish to offer. So you must make your own informed decision whether or not to purchase and stand by it, for better or worse.

Unfortunately, unlike a life policy (where you are either still alive or dead) it is not always clear whether a claimable event has taken place under CI and insurers will still need to verify this - no matter how well the cover was explained when it was bought.

gadgetmind

magpiecottage wrote: »

It is therefore important to understand exactly what it does cover when you buy the policy, not when you claim on it.

I think part of the problem is that it says "cancer" on the front page, and then defines what *they* think the word means several pages later.

While such wordplay may be standard legal/insurance practice, it doesn't tally with the expectations of the people taking out the policies nor does it match any medical usage of the word.

weighty1_2

Pedro,

Who knows that the chance is of making a CI claim. Whilst ACG's link shows the likelihood of being diagnosed with a CI before the age of 65, most of the policies I have arranged expire before a client is in their 60's, which is definitely going to lessen the likelihood of making a claim.

All I know is this..... Insurance is a waste of money until the one day that you need the plan and suddenly it becomes the policyholders lifeline. Don't take cover if you don't want to, but then again, don't moan either when you're left financially destitute.