Refusal of holiday insurance claim following ivf

bloke87

I would like to advise everyone who has had or is thinking of considering IVF treatment to check their holiday insurance following the trouble my wife and I have had as a result of the actions of DirectLineGroup acting on behalf of Nationwide.

My wife had undergone IVF treatment and had embryos implanted 08/01/14 then booked a holiday abroad 11/01/14 after checking that on the small chance the IVF was successful that we were still able to fly comfortably within the safe guideline dates for both the airline and the holiday company.

Our holiday insurance was free due to outbank account with Nationwide and after we were given the fantastic news that my wife was pregnant I called Nationwide to check that I did not have to pay for further cover due to our new circumstances. I was advised that pregnancy was not a pre-existing condition so no further payment was required.

All went well with the pregnancy and we were both looking forward to a well-earned break until we attended hospital 21/05/14 at which stage my wife was rushed to A&E from our routine appointment with the consultant after she had described symptoms that he suspected could be Deep Vein Thrombosis or even worse a Pulmonary Embolism. The consultant advised us at that stage that flying would not be advisable.

We returned to hospital for scans 22/05/14 and after only scanning her leg were advised that they were not able to find any DVT.

We had called the travel agent 21/05/14 but as we were at the hospital all day for the 21st and 22nd we could not physically confirm the cancellation of our holiday until 23/05/14.

My wife had been confirmed as expecting twins and after all that had happened we took the advice of the specialist had given.

We then submitted a claim for the cost ofthe holiday, Thomson, the holiday company we had booked with paid up immediately but when we then had to submit a claim for the balance of the holiday through Nationwide the real horror began.

We received a letter from UK Insurance, part of the DirectLineGroup stating they had declined our claim giving the reason as ‘An Anticipated Event’.

I contacted UK Insurance to find out their reasoning only to be disgusted when a member of staff stated that because my wife had IVF treatment she had a ‘high percentage chance’ of becoming pregnant. I immediately challenged and explained that my wife and I, and I am sure most people, who have undergone IVF treatment found that opinion most offensive and Iasked her to give me a percentage figure for what was considered a ‘high percentage chance’.

I have since attempted to clarify the matter with DirectLineGroup only for them to again declare their intentions not to reconsider their decision.

I have now booked to see my MP as I do aim to take the matter further, not purely to try and recover the money lost but in order to stop anyone else who has had IVF treatment from ever going through the upset that Nationwide, UK Insurance and DirectLineGroup has caused at a time when we really could have done without it.

My message is for anyone has had or is considering IVF treatment who has their travel insurance with Nationwide or any of the other companies who are underwritten by DirectLineGroup, I urge everyone to boycott their productsin the event that you should have to go through the same horrendous experience we have.

Voyager2002

Seeing your MP is unlikely to be much use: you could complain to the Insurance Ombudsman.

I am baffled about the stated reason: of course there is a 'high percentage chance' that IVF leads to pregnancy, otherwise there would not be much point in it? And it is normal for pregnant people to go on holiday at certain stages of the pregnancy, so that ought not to be an issue.

I think you need to be sure that the underwriters understand that the reason for the cancellation is not pregnancy, but an unanticipated complication of the pregnancy, and that you followed medical advice when planning and booking your holiday.

alanrowell

DomRavioli wrote: »

So let me get this right.

OP, you didn't declare that your wife was undergoing IVF, just that she was pregnant?
You were advised not to fly, but made that decision yourself after advice from a consultant (who advised not to fly, but did not tell you that you were unable to fly)?
You thought that flying with twins at 4 months pregnant after having IVF was a good idea - in fact flying after IVF, which isn't cheap, was a good idea?

If those are correct

I must be reading a different posting to you.

The recommendation not to fly came after the pregnancy complications when OP's partner was 4 months pregnant.

lea2012

Since when has it been necessary to disclose to insurers that you are trying for a baby?? What if this pregnancy had been more straightforward and the babies had been conceived naturally? If you then mentioned to the insurer that you had been intentionally trying for a baby would you then be told that you can't have a pay out as you had a higher % chance than those who were not actively trying?

I honestly don't see why the fact that you have had IVF should lead to you not being paid. Would IVF be classed as pre-existing medical condition? (Genuine question so answers appreciated please.)

If the possible DVT / embolism is just a by product of pregnancy and not particularly IVF pregnancy then I don't see how they can say no. If the issue is more likely to happen in an IVF pregnancy then I can understand it better.

Obviously the OP did not know they would be expecting twins, if expecting at all, when they booked the holiday. Did the consultant specifically say that you were unfit to fly and sign any paperwork from the insurers to that effect? I presume the higher than average figure that the insurers mean has perhaps been explained a little poorly too, obviously the success rate of IVF is not high, however those who are going through IVF should potentially have a higher chance of falling pregnant than those who are not actively trying for a baby and should be aware of the 'risks' involved.

lea2012

DomRavioli wrote: »

You could seek legal advice (seen as you have money to throw around for IVF cycles, holidays etc) but I can't see a legal reason why they would refund your holiday.

I actually find this part of your post a little bit offensive and really judgemental. 'Money to throw around on IVF cycles and holiday', really?! For all you know they could have saved for years to pay for IVF, they could have remortgaged their house, or potentially even had treatment for free on the NHS?! and the holiday could have been a cheap and cheerful short break in europe that cost next to nothing, that may well have helped them to recover from what could have been a very traumatic time had things not turned out as they hoped.

We really shouldn't judge or comment on situations that we know nothing about.

peachyprice

lea2012 wrote: »

I honestly don't see why the fact that you have had IVF should lead to you not being paid. Would IVF be classed as pre-existing medical condition? (Genuine question so answers appreciated please.)

Two obvious reason. With natural conception it's hit ans miss whether you will become pregnant in any given month, with IVF there's a specific % chance you will become pregnant in a pre-determined month.

Also, a woman conceiving through IVF will have a higher chance of miscarriage and other complications and multiple pregnancies than a woman who conceived naturally.

(Text removed by MSE Forum Team)

rustyboy21

To be fair to the insurance company, were they actually told by the OP in his phone call that the partner was pregnant through IVF, or just that she was pregnant?

Googling it , It looks like they may have fell foul of a couple of points in declaration. They always ask you if you have attended hospital as an in patient, even as a day case in the past 2 years. This would be including the IVF implant.

You should not take notice of anyone who says you are covered, unless you get it in writing. You can easily print off the policy docs online with all banks who sell this type of insurance. You were not even sold it, you were given it. You should know it will only cover certain things. If you have any medical issues, you should always either declare it to the company, or get further insurance which will cover you whilst away.

IVF is not like a normal pregnancy, you have gone through a big ordeal in obtaining the eggs, fertilising them and implantation. You are told to be careful for a time and if you are having IVF, I would think that you would take as much care as possible. The insurance co will take this into account and you are at a higher risk of issues than you are with a normal pregnancy. Having twins, just adds to that.

Maybe in hindsight, you may have been better telling them that your wife/partner was unable to fly due to Increased DVT and not mentioned the pregnancy. The doctor could supply the details they wanted and you would have got your money back.

At the end of the day, You are going to be a Dad of twins, which you have fought long and hard for. Don't let this tarnish that achievement. You have had most of the money back, put it down to experience and move on.

In future though, If you have a spot on your behind and are getting travel insurance, then DECLARE IT ! I have 2 bank accounts, with Free Travel insurance on them. I still buy my Insurance and tell them mine and my partners medical issues, so they have no room to reject any claim.

George_Michael

lea2012 wrote: »

Since when has it been necessary to disclose to insurers that you are trying for a baby?

There is no requirement to disclose the fact that you are trying for a baby if you are doing so naturally, but as IVF is a medical procedure, this should be declared.

lea2012 wrote: »

What if this pregnancy had been more straightforward and the babies had been conceived naturally?

What ifs don't matter with insurance companies. They only deal with what is.
It would be a bit like me trying to claim for an injury that didn't happen but saying "what if I was injured?".

jonesMUFCforever

I think the term about having to declare any treatment or medication is where OP will come unstuck.

DomRavioli

lea2012 wrote: »

Since when has it been necessary to disclose to insurers that you are trying for a baby?? What if this pregnancy had been more straightforward and the babies had been conceived naturally? If you then mentioned to the insurer that you had been intentionally trying for a baby would you then be told that you can't have a pay out as you had a higher % chance than those who were not actively trying? IVF carries a higher risk of all complications, not just miscarriage due to the huge amount of drugs used. It also constitutes having day surgery which is a disclosable material fact on all basic travel policies, including nationwide.

Is that a bit clearer? I'm not great at explaining sometimes.

I honestly don't see why the fact that you have had IVF should lead to you not being paid. Would IVF be classed as pre-existing medical condition? (Genuine question so answers appreciated please.) Technically no, but the implantation and taking of prescribed drugs can both be reportable material facts which change the policy as they change the risk profile.

If the possible DVT / embolism is just a by product of pregnancy and not particularly IVF pregnancy then I don't see how they can say no. If the issue is more likely to happen in an IVF pregnancy then I can understand it better. It is far more likely in IVF due to the drugs taken by the mother. emboli can develop in anyone, at any time, but are more frequent whilst flying, and more frequent again in IVF pregnant mothers.

Obviously the OP did not know they would be expecting twins, if expecting at all, when they booked the holiday. Did the consultant specifically say that you were unfit to fly and sign any paperwork from the insurers to that effect? I presume the higher than average figure that the insurers mean has perhaps been explained a little poorly too, obviously the success rate of IVF is not high, however those who are going through IVF should potentially have a higher chance of falling pregnant than those who are not actively trying for a baby and should be aware of the 'risks' involved.The OP states they were advised not to fly, but not specifically told she was unfit to fly. This is a major sticking point tbh, but from a basic interpretation the consultant would have advised that flying would increase the risk of further complications such as emboli, but not gone as far as saying unfit to fly. Thats how I read it anyway.

Hi

Sorry it didn't come across clear before - I do get muddled with words sometimes! I hope the above is a bit clearer and I didn't mean to be offensive, I just say it how it is and sometimes that hurts feelings.

PeacefulWaters

I am really struggling with booking an overseas holiday during an IVF treatment period.

Did you really do this? Why?

I believe the odds of getting pregnant are something like 7/2. Shorter if Mrs Bloke is under 30. It's a big risk to expect an insurer to take on.

I have now booked to see my MP

Google "Financial Ombudsman". The basis of your complaint will be around "I called Nationwide to check that I did not have to pay for further cover due to our new circumstances. I was advised that pregnancy was not a pre-existing condition so no further payment was required".

Fingers crossed they recorded the call or you can prove it took place. Had they provided the information at this point you could have taken cover elsewhere. A search by me found this policy:
http://medicaltravelshield.com/application/downloads/IVF_policywording.pdf

My message is for anyone has had or is considering IVF treatment who has their travel insurance with Nationwide or any of the other companies who are underwritten by DirectLineGroup, I urge everyone to boycott their productsin the event that you should have to go through the same horrendous experience we have.

I urge anybody going through IVF not to book holidays until they know if it's been successful or not.