Well woman cancer insurance

Bellabells66

Help!! I took out a well woman cancer insurance in 2002 and it was sold over the phone as covering all femail cancers. Jump forward to this year and I have been diagnosed with breast cancer dcis. Insurance company have now said this isn't covered by my insurance even though it is not a peciific written exclusion, would anyone have any advice please. Thank you

lisyloo

Did you get any documentation?

SonOf

These Well Woman plans are a basic option with lots of restrictions compared to a normal plan.

The insurer must document what is covered and if you are covered, then they will pay out. if you are not, then they wont. With conditions, they usually specify criteria that needs to be met or exceeded.

Bellabells66

This is what it says in definitions on the policy.. Female cancer. A malignant tumor characterised by the uncontrolled growth and spread of malignant cells and the invasion of tissue where a female organ is the primary site!

unforeseen

A breast is not an organ only present in females. Males also get breast cancer.

Bellabells66

The actually policy is specifically for women's breast cancer and states that it is the most common female cancer. I don't think any one disputes males have breast but I'm sure none would have taken out a policy worded this way!

lisyloo

Firstly I would be asking them for an explanation of why it’s not covered with reference to the policy documentation.
If I wasn’t happy with the explanation I’d start a formal complaint referring to the documentation.

Weighty1

I could be wrong but I'm not sure if ductal carcinoma in situ is classed as spreading and this is why it is normally treated by lumpectomy/mastectomy etc.

It sounds to me like the policy is mainly designed to cover cancers where there is a need for chemotherapy or radiotherapy.

As has been suggested, ask them to write out to you confirming why the DCIS isn't covered, in plain english. As lisyloo suggests, you could complain, however, if your diagnosis is not within the parameters of what they cover then it would never be upheld, unless there was some evidence that their advertising or marketing had mislead policyholders.

starrystarry

Weighty1 is correct. DCIS is not invasive so it won't meet the criteria quoted in the policy document.