Critical illness insurance claim - wish us luck!

Bigsmak

Any update on how you are getting on?

gadgetmind

Thanks for asking.

Letters have been sent to GP and oncologist, both of whom seem to think it'll be straight forwards, but we don't expect to hear anything back for several more weeks.

Bigsmak

gadgetmind wrote: »

Thanks for asking.

Letters have been sent to GP and oncologist, both of whom seem to think it'll be straight forwards, but we don't expect to hear anything back for several more weeks.

At least it seem to be progressing.

fadetogrey

Do insurance companies really be sympathetic when someone claims on CI? If someone who has been suffering from short term memory loss gets referred to a consultant who then gets a brain scan done and comes to the conclusion that person has early onset alzheimers would the insurance company pay out right away or insist on waiting to see how that illness progressed?

gadgetmind

fadetogrey wrote: »

would the insurance company pay out right away or insist on waiting to see how that illness progressed?

Dunno, what was the question again? :-)

Most (all?) pay out on diagnosis of certain specific conditions, as long as it meets *their* definition of the condition. They also tend to have incapacity cover, which does depend more on progression and prognosis.

kingstreet

fadetogrey wrote: »

Do insurance companies really be sympathetic when someone claims on CI? If someone who has been suffering from short term memory loss gets referred to a consultant who then gets a brain scan done and comes to the conclusion that person has early onset alzheimers would the insurance company pay out right away or insist on waiting to see how that illness progressed?

We're talking about insurance companies here. They aren't fuzzy and warm, like a blanket, they are cold and calculating and will examine every facet of a claim to ensure there is no reason not to pay it.

In the case of alzheimer's disease, the definitions have changed over the last ten years, so it's important YOU know the definition used in the policy you are trying to claim on!

This is the current definition used by one of the top providers;-

Alzheimer’s disease

Definition

A definite diagnosis of Alzheimer’s disease by a Consultant
Neurologist, Psychiatrist or Geriatrician. There must be permanent
clinical loss of the ability to do all of the following:
• remember;
• reason; and
• perceive, understand, express and give effect to ideas.
For the above definition, the following is not covered:
• other types of dementia (these are covered under the
dementia definition).

What does this mean?

Alzheimer’s disease is a progressive and degenerative disease.
The nerve cells in the brain deteriorate and the brain shrinks.
The symptoms can include a severe loss of memory and
concentration but there is an overall decline in all mental faculties.

In addition, you may also have a dementia definition;-

Dementia

Definition

A definite diagnosis of dementia by a Consultant Neurologist,
Psychiatrist or Geriatrician. There must be permanent clinical loss
of the ability to do all of the following:
• remember;
• reason; and
• perceive, understand, express and give effect to ideas.

What does this mean?

Dementia is a disorder of the mental process and results in
loss of memory and impairment of behaviour and recognition.
There is no cure and the cause is unknown. Definite diagnosis
must be established through accepted standard medical tests
and questionnaires.

Success of a claim very much depends on you having the ability to hold up a definite diagnosis by a Consultant.

Errata

Dementia

Definition

A definite diagnosis of dementia by a Consultant Neurologist,
Psychiatrist or Geriatrician. There must be permanent clinical loss
of the ability to do all of the following:
• remember;
• reason; and
• perceive, understand, express and give effect to ideas.

What does this mean?

Dementia is a disorder of the mental process and results in
loss of memory and impairment of behaviour and recognition.
There is no cure and the cause is unknown. Definite diagnosis
must be established through accepted standard medical tests
and questionnaires.

Someone should tell the Alzheimers Society they're talking rubbish !

Vascular dementia

If the oxygen supply to the brain fails, brain cells may die. The symptoms of vascular dementia can occur either suddenly, following a stroke, or over time, through a series of small strokes.
Factsheet: What is vascular dementia?




Dementia with Lewy bodies

This form of dementia gets its name from tiny spherical structures that develop inside nerve cells. Their presence in the brain leads to the degeneration of brain tissue.
Factsheet: What is dementia with Lewy bodies (DLB)?






Fronto-temporal dementia

In fronto-temporal dementia, damage is usually focused in the front part of the brain. Personality and behaviour are initially more affected than memory.
Factsheet: What is fronto-temporal dementia (including Pick's disease)?





Korsakoff's syndrome

Korsakoff's syndrome is a brain disorder that is usually associated with heavy drinking over a long period. Although it is not strictly speaking a dementia, people with the condition experience loss of short term memory.
Factsheet: What is Korsakoff's syndrome?




Creutzfeldt-Jakob disease

Prions are infectious agents that attack the central nervous system and then invade the brain, causing dementia. The best-known prion disease is Creutzfeldt-Jakob disease, or CJD.
Factsheet: What is Creutzfeldt-Jakob disease (CJD)?





HIV-related cognitive impairment

People with HIV and AIDS sometimes develop cognitive impairment, particularly in the later stages of their illness.
Factsheet: What is HIV-related cognitive impairment?



Mild cognitive impairment

Mild cognitive impairment (MCI) is a relatively recent term, used to describe people who have some problems with their memory but do not actually have dementia.
Factsheet: Mild cognitive impairment




Rarer causes of dementia

There are many other rarer causes of dementia, including progressive supranuclear palsy and Binswanger's disease. People with multiple sclerosis, motor neurone disease, Parkinson's disease and Huntington's disease can also be at an increased risk of developing dementia.
Factsheet: Rarer causes of dementia

gadgetmind

Well, the insurance company had all the paperwork back a few weeks ago but now it's all going through a number of reviews. They keep saying "five working days, update on Friday", but the update is always just that it'll be another five working days.

Anyway, it's now with the assessors and they will be an update ... on Friday.

magpiecottage

That is pushing two months now.

I would give them until the end of next week and then tell them you want it referred to their complaints procedure on the ground of unreasonable delay.

gadgetmind

The oncologist was a bit slow. We mentioned the insurance when we went to see him for a follow-up, and he denied having the paperwork, but had a hunt around and found it on top of his radiator. He said he'd do it the next day but a month later had to be nagged.