Critical illness claim

Hi, having read so much about people claiming on their critical illness policy. I decided to try too. My consultant has said that polycythemia is not a malignant cancer although she does agree it is a neoplasm. She said that she has spoken to senior haematology consultants who agree with her. My claim form says it only pays out if the cancer is malignant. Gutted. Anyone got any advice. My critical illness policy is with Aegon. Thanks!

[rubyrubyruby]

I have had a successful claim. It really doesn't matter what your consultant thinks it is!

I will try to find the report by WHO that says it is a Cancer and then your consultant won't have any choice but to sign the form.

[rubyrubyruby]

Basically the WHO report in 2008 classed MPNs as a Cancer. I can't find the exact words to say this as it is pages of medical jargon! If you google " classification of MPNs as a cancer" you will find this report comes up, it is certainly the one I quoted for my claim.

Good luck

[Hidden in reply to rubyrubyruby]

Many thanks I will try to find it today.

[Hughesf]

As Ruby has stated re Who 2008

in 2009 the ABI (association of British insurers )

Agreed that conditions such as Prv are to be included in critical illness cover.

I had pay out within 3 weeks of claiming.

Frank

[Loubielou]

Hi, I also made a successful claim 3 years ago. I was with Scottish Provident who initially said that my ET was not covered, so it was not straightforward.

What turned it around was some ABI (Association of British Insurers) advice. They had published guidelines to the insurance industry that ET and PV were classified as cancerous and should therefore be covered by CI claims. The link to the press release no longer seems to work, but I have a screen shot of the page and also the accompanying statement, both of which I can email to you if you would like?

As Rubyrubyruby mentioned - the WHO re-classified from "myeloproliferative diseases" to "myeloproliferative neoplasms" to reflect the underlying clonal genetic changes that are a key feature of these diseases.

Although my consultant was reasonably supportive, at the start of the process he didn't think I had a particularly strong case. So I shared the ABI statement with him. He filled in all the paperwork and helped with the response to two key questions from the insurers claims team: Is ET classified as malignant (yes it is, because it's a clonal disorder) and secondly is it invasive (yes it is because it's present throughout the body in the blood).

My advice is to not give up, your consultant's opinion is the only thing that is holding your valid claim back. As you have seen - there are plenty of people on here who have made successful claims.

[Hidden in reply to Loubielou]

Hi!

Could you send me the screen shots? To [e-mail]

I can't thank you enough for this I felt so frustrated after speaking to my consultant!

Ali

[Hidden in reply to Loubielou]

Would you mind telling me how long ago you took your policy out?

[Hidden in reply to Loubielou]

Hi

How long ago did you take your policy out? My Insurance guy thinks it may help if we know when people took their policy out prior to the WHo re classification

Thanks in advance!

[MarieXxx in reply to Loubielou]

Loubielou, please would you email me the screen shot and link please? I am brand new to all this and I'm a single mum to three little ones x

[MarieXxx in reply to Loubielou]

Please can you email me the link? [e-mail] thanks x

[Loubielou in reply to MarieXxx]

Hi

I just sent it over.

X

[Candicej200 in reply to Loubielou]

Hello,

Could you send me the information too? I was diagnosed last month and my claim was denied. [e-mail]

Thank you

[Saj1984 in reply to Loubielou]

Hi. My wife has been diagnosed with ET. We are also looking to claim. Please can you email me any screenshots or information you have to [e-mail].

Many thanks

[EleanorPV in reply to Saj1984]

I've had a successful claim with a policy I took out 17 years ago. My consultant completed an insurance form which stated i had MPN, PV. My policy was through Phoenix life.

Hope this helps.

Eleanor

[ericalopez80 in reply to Loubielou]

Hi!!

I know this is a very old post, but if you still have that screen shot , would you be able to email it to me too. Many thanks [e-mail]

[Loubielou in reply to ericalopez80]

HI, I just emailed.

[Mitchy1211 in reply to Loubielou]

Hi can you send me the info you used for your claim as my wife has just been diagnosed with ET.

Thank you

If anyone can help my email is [e-mail]

[Kimmy53 in reply to Loubielou]

Hi I’m thinking of claiming on my critical illness cover but can’t find supporting evidence to support my claim is it possible for you you email me your information you found thanks Kim

[e-mail]

[MPDmoose]

I claimed on my policy, but in my case the claim was on the basis that my ET had caused a stroke (albeit a minor one), so it was the stroke that was the qualifying 'condition', not the underling MPN. Perhaps that might apply to you too?

Maybe other patients have had more success with getting a doctor to provide a more helpful definition of the disease?

It sounds like you have considered claiming quite carefully, but I have had mixed feelings over the years about making my claim. On the one hand, I did manage to pay off my mortgage, but it does now mean that, since the life policy (that the CI cover was part of) is now paid out, I have no life cover, and premiums I've been quoted for life cover are exorbitant, having made a CI claim.

Jon

[Hidden]

Many thanks to you all. I have had Polycythemia for 17 years and feel as though I am so utterly worn out by it and the drugs that we have to take. I also work full time. I saw this as a way of getting a better balance of my life.

Here's hoping!

Ali

[pollyprissypants]

If you search for PV on the WHO disease classifications website you will find it is now listed as a malignant blood cancer (neoplasm). This is the standard by which all treaters should be basing their decisions. So, they're both wrong.

[JediReject]

Yeah one of my consultants described my MF as a 'Clonal Malignancy' and not cancer in the classical sense BUT that was prior to 2008 when WHO reclassified MPNS. . I would say it is up to your insurers to determine if you qualify based on your diagnosis not your med team. Best wishes JR

[TrickyDicky]

Hi

I initially rang my insurers and was told it wouldn't be covered. As a result of the feedback given on this site and then wrote to the insurers at a later date and quoted the ABI. The claim was successful.

[Hidden in reply to TrickyDicky]

Thanks. Can I ask who your cover was with and when you took it out?

Ali

[craigdarcy in reply to TrickyDicky]

HI, TRICKY DICKY.

I AM ABOUT TO HERE BFROM MY INSURANCE AND AM NERVOUS OF THE RESPONCE; I HAVE ET JACK2 POS V617 IS THIS ALSO YOUR CONDITION? CAN YOU ALSO SEND ME THE ABI QUOTE P[LEASE, DISPIT LOOKING I HAVE NOT FOUND IT. MY E-MAIL IS [e-mail] thanks...

[Calmat]

Hi AliCa, don't bother asking your consultant if you can claim as they won't know, ring Aegon and tell them you want to claim. That's the only way you'll find out. I had policy with Aviva with critical illness and I rang to claim. I was initially told the ET wasn't covered but I pushed the claim and was told it was covered and they paid no problem. I am financial adviser so knew claim would be ok😉 in response to other replies you definitely won't be able to do new critical illness policy, good luck, let us know if you are successful.....

[Hidden in reply to Calmat]

Aegon sent a form to my Haemotology Consultant. She is saying that she can't put that it's malignant. I have sent them the ABI info too but am concerned that will go with what she says rather than all the other information that I have provided. It's demoralising when you hear of others being paid out. I have had PRV since 98 and my policy since before that.

Facing the prospect of a big fat No!

[Kimmy53]

Hi Alica

Do you think I would be able to Claim on my critical illness cover , I’ve been diagnosed with mpn jak2 positive in June 2018 but they don’t know which one I have yet.

I have a splenic & portal vein thrombosis which a year on is still blocked and advised it will stay blocked , but as I don’t know which one I have should I wait until Ive been diagnosed with one or can I claim now

This is a copy of my policy do you think I’m covered , would love you opinion

Kim

CANCER – excluding less advanced cases

POLICY DEFINITION WHAT DOES THIS MEAN?

Any malignant tumour positively diagnosed with histological confirmation and characterised by the uncontrolled growth of malignant cells and invasion of tissue.

The term malignant tumour includes leukaemia, sarcoma, pseudomyxoma peritonei, merkel cell cancer and lymphoma except cutaneous lymphoma (lymphoma confined to the skin). For the above definition, the following are not covered:

• All cancers which are histologically classified as any of the following:

– pre-malignant;

– non-invasive;

– cancer in situ;

– having either borderline malignancy; or

– having low malignant potential.

· Alltumoursoftheprostateunlesshistologically classified as having a Gleason score of 7 or above or having progressed to at least clinical TNM classification T2bN0M0.

· Malignantmelanomaunlessithasbeen histologically classified as having caused invasion beyond the epidermis (outer layer of skin).

· Anyotherskincancer(includingcutaneous lymphoma) unless it has been histologically classified as having caused invasion in the lymph glands or spread to distant organs.

Cancer (also known as a malignant tumour) is a disease where normal cells change and grow in an abnormal way. If left untreated, they can destroy surrounding healthy cells and eventually destroy healthy cells in other parts of the body.

There are about 200 different types of cancer, varying widely in outlook and treatment.

Some cancers are not covered by this definition. These tend to be ones that have not yet spread or are localised and can usually be successfully treated. Examples of these include some skin cancers and early stage prostate cancer.y critical cover quotes