Medical insurance

halzar

Hi, I wonder if anybody has any advice, my family and I are going to USA on holiday, my issue is with the insurance, my wife 9 years ago had a astrocytoma brain tumour, she had two operations, the first removed the tumour the second removed the cells around it, she still has yearly scans(nothing since) the insurance asked if the tumour had been totally removed, so to be sure I asked her neurologist, who said "yes, well, I can't say that the scar tissue that is left has no cells in them as it's impossible to see the difference between scar tissue and any of the tumour cells, but I can tell you that in the years since there has been no signs of anything other than scar tissue, but as I say I can't say absolutely 100%, I know that's probably not helpful"

My questions are(the premiums are very very different depending on the answer)
1) if something very strange happened and she had a problem I.e. A seizure would the insurance be invalid(she had her scan last week and it's the same nothing showing?
2) if something completely unrelated, say food poisoning or we're in a car crash and she's injured, will this invalidate her insurance?

I know it's obvious to just pay the higher premium but it over £400 more!!

Thanks for any advice

InsideInsurance

I am no medical expert but my understanding was that after a tumour was removed it went to the labs and they checked if the complete tumour was removed or not? ie they'd expect the cut edges all to be normal cells

1) If it links back to the tumour then there is a significant chance that a claim could be declined if you say yes it was fully removed but when given the binary yes/ no your GP or consultant ticked no. You really need a binary answer from him or be cautious and tick the no option

2) Unlikely unless the insurers considered that you had attempted to defraud them rather than it being an honest mistake etc. If there was an unrelated claim its fairly unlikely they'd even make queries into the other areas anyway.

littlereddevil

Knowing the USA I would rather pay the extra £400

richardw

Perhaps e mail them with the neurologist's exact words and see what they say.

halzar

richardw wrote: »

Perhaps e mail them with the neurologist's exact words and see what they say.

I tried that, but apparently unless the neurologist says it is has been completely removed I have to say yes!

I just wonder if I say no and she trips over and breaks her leg, will they say it was/could have been caused by a seizure?

Then we're in trouble!!

InsideInsurance

halzar wrote: »

I just wonder if I say no and she trips over and breaks her leg, will they say it was/could have been caused by a seizure?

That comes down to a combination of what you tell the Dr in the ER and what the Dr thinks happened

halzar

InsideInsurance wrote: »

That comes down to a combination of what you tell the Dr in the ER and what the Dr thinks happened

Will the insurance not want her medical notes before they pay out??

InsideInsurance

halzar wrote: »

Will the insurance not want her medical notes before they pay out??

Potentially.

If you go to ER and say that you tripped over your laces and fell over and cut your hand they hopefully would just stitch up your hand and send you a big bill (though with some hospitals in the USA they'll want to do x-rays/ cat scan and or MRI just to make sure the "jolt" of falling didnt damage your shoulder etc)

Your insurers get the explanation of that, a bill for $3,000 for being seen at the ER and some stitches then theres a good chance thats going to be the end of it.

Go to the ER room with a cut hand and say you dont know what happened, you were just standing there and then you were on the floor and so you may have had a seizure as you've had them in the past etc and then the ER Dr is going to look into things more, the hospital will give you a much bigger bill and the insurers will poke and probe the claim more particularly if you've declared your prior brain issues are all now resolved.