Breast Cancer and life / critical illness cover

inspectorlund

Breast cancer and life / critical illness cover

Hi all

A question if I may, which may actually be 2, so I have also posted in the Insurance section.

My partner was last week diagnosed with breast cancer. In August, she had taken out a life / critical illness mortgage protection policy. By a brief reading of the policy, she looks to be covered.

However - a complication. In March she had gone to her GP to complain of the lump in her breast. A locum saw her in place of the usual doctor and said the lump wasn't anything to worry about. Only when this same lump started hurting in November or so did she go back to her GP and was immediately referred to the hospital for tests resulting in the diagnosis; the tumour is already 57mm across. It was disquieting in the extreme to be told by the hospital that it wasn't that common for breast cancer to be painful, so if that lump in her breast hadn't started hurting then armed with what she'd been told in March it wouldn't have occurred to my partner to seek a second opinion.

Main question - has that locum screwed up? Second question - if the answer to this is yes, does the above mean she had a pre-existing condition at the time of taking out the policy in August?

Thanks in advance for any thoughts / advice.

ellay864

She almost certainly had the condition at the time of taking out the policy but surely the important thing is that she wasn't aware of it. As long as she answered any questions truthfully at the time she should be OK. Some policies ask for details of any consultations/tests/treatments in a certain period prior to taking out the policy - if she was asked and said she'd had none that might be tricky as she did have a consultation with the locum GP, but she was given an all-clear so had no condition to the best of her knowledge there. It could all depend on the wording of the questions she answered and what is in the policy itself.
As for the question about whether the locum screwed up...possibly yes, I and most people I know of with breast lumps have been referred for scans/mammograms/biopsies so it would be interesting to know why the locum was confidently able to rule out by simple examination in the clinic

inspectorlund

Have looked at the (Aviva) proposal form and it didn't ask for any details of any GP visits. But yes, it DOES ask 'Within the last 5 years have you experienced.......a lump, growth or cyst of any kind, or any mole of freckle that has bled, become painful, changed in colour or increased in size', to which partner answered 'NO'.

The reason she did this is that, having seen the locum in March and been told it was nothing to worry about, she didn't think it was anything significant. So she may have made a mistake in what she put on the form in August, but definitely did so in an honest belief and in her position I might even have done the same.

Her breasts have always been a bit lumpy and the offending one is, and always was, slightly larger than the other one, so when it started hurting a bit in March and she was told it was nothing to worry about, she merely assumed it was a result of the strenuous physical exercise she was doing at the time. Since March, it's been hurting on and off and only when it started hurting more significantly in November did she go back to her regular GP - and got referred.

Any thoughts?

FBaby

I'm very sorry to say but not declaring it when the question was asked clearly, and that so soon before completing the form means that her chances of them accepting her reasons are just about none. Unfortunately, it is not for the customer to decide what is significant to declare or not, but the insurance company medical advisors. What she was asked to do is declare anything they asked for and she didn't. It is hard enough to declare a payout when everything has been declared, when it hasn't, you stand no chance at all.

A friend of mine was diagnosed with MS. At the time of taking out the insurance, more than 15 years earlier, she had no symptoms whatsoever so she was sure the claim would be processed without issues. Like many, she had completed the form in 5 minutes as she and her husband were signing many papers to process their mortgage application without that much thought to it. However the insurance turned it down because about 4 years before she took out the insurance, she'd had an MRI following suddenly losing her sight in one eye. It only lasted a couple of days and she had truly totally forgotten about it. What she didn't know is that this was the first symptom of her MS. She appealed, battled on the ground that she had totally forgotten about it and that she had no idea at the time of the direct relevance, she even tried to make a claim of being pressured by her financial advisor to complete the form in a hurry without fully explaining the relevance of it, but they would have none of it. She only managed to get back what she'd paid in, a few thousands rather than the £150,000 that was supposed to pay her mortgage.

I am really sorry for you wife and hope she gets excellent treatment and an all clear asap.