Possible Critical Illness claim - Cauda equina syndrome

isie1980

Apologies for epic post, especially as I am not a regular forum user but I need advise please!!

Mid-December my sciatica (approx 2 months history of, not a long standing condition) suddenly got excruciating. I stepped out of the shower and couldn't move. Hubby helped me onto bed and got underwear on me whilst I was screaming in agony. The short version - taken by ambulance to A&E, diagnosed sciatica, sent home with painkillers. One hour after arriving home I went numb from the waist down and couldn't pass urine. Ambulance back to A&E, eventually squeezed out a wee (lots of effort) and was sent home.
Next morning I'm still numb and can't go the toilet. Hubby at work so I call for a GP home visit. Nurse says ring 999. I say no, I'm not having them send me home again. Hubby comes home from work to take me to GP as an emergency - within 5 minutes he had diagnosed cauda equina syndrome, called hospital to arrange my admission and MRI scan. MRI confirms major prolapsed disc pressing on spinal nerves causing the numbness. 24 hours later I had emergency surgery to remove the disc.
2 weeks on I am at home and recovering very well (IMO). I can potter about the house, I can go to the toilet but not remotely normally (urine retention and need laxatives to pass stools) as I have numbness in my bladder and bowel areas. Numb/weak left foot makes walking any distance slow and exhausting, and climbing stairs I manage on all 4's.

So, I checked my critical illness policy as this remaining nerve damage can be permanent. I haven't yet contacted Legal & General but note on their website that CES is not covered (it is by the Pru by hey ho). What L&G do cover is 'permanent disability'. BUT, it appears their measures relate to my ability to continue in my present occupation.

Sorry for long post, here's the question:

Do I call L&G now and ask if CES is covered? If I then have to wait to see if I do have a permanent disability do I tell them now I 'may' later be claiming on this depending on how my recovery goes?
Regardless of how my foot/leg numbness/weakness and toileting issues go I WILL return to work because I like my job and I like my salary. Will my positive attitude and keenness to work minimise my chances of a successful claim??

I don't want to view my CES as an opportunity to 'make' money but if I am permanently disabled I will apply for DLA (need an automatic car as left foot can't depress clutch), and obviously at present my hubby does all the housework and helps care for me, and our 5 month old son (my maternity leave ends today, and I was returning to work tomorrow but now on SSP, my son will start nursery tomorrow as planned). I would also need us to move to a bungalow as crawling up stairs is not a long-term sustainable position esp. with a small child to look after. If we sold our modest 2 bed semi we could not afford a bungalow without an additional £60k+ borrowing (which the bank probably wouldn't loan).

Thanks in advance for any guidance or other people's experiences.

Isie

ACG

a lot will depend on the actual wording when you took your policy out.

Put a claim in anyway, you have nothing to lose. They will look over the notes and see what the prognosis is from the relelvant surgeon.

Also on a side note - pru offer serious illness benefit not critical illness, chances are they would not have paid you the full amount of your insurance claim but anywhere from 10% upwards. That could be better or worse than L&G but atleast you know if L&G payout you knwo what you will be getting.

lisyloo

Do I call L&G now and ask if CES is covered?

Yes, just beacuase it says it's not covered on the website does not mean it's not covered on your policy.
Usually the website shows current information and if you took out your policy some time ago it's possible this exclusion does not apply.
You could also call your broker if you used one or read your policy documentation.

isie1980

Thanks for responding.
Not sure why I feel nervous, but I'll dig out my policy information and give L&G a call - no harm in asking after all.