Criticial Illness - Insurers: Aviva (claim denied)

Hello - I'm new! Does anyone have the ABI article which cites ET and PV are classified as cancers and should be covered by CI cover? I've read a lot of posts here that claims have been successful with Aviva. My claim was denied as they considered my "cancer" as non-invasive and non-malignant. I now understand this is incorrect. I have sent them the WHO article 2008 which reclassified MPNs as "cancers" but would very much appreciate if anyone has the ABI article or point me in the right direction as to where I may find it. I have tried their website but to no avail. My email address is angelalevitt@yahoo.co.uk. I have ET Jak2 neg.

Many thanks

Angela

20 Replies

oldestnewest
  • Hi

    I did find it when i claimed 3 years ago but cant now. I would try and call them if you get no luck, see if they can send it to you.

    Failing that tell aviva you are going to escalate it to the ABI and Insurance Ombudsman see if that has any effect on them.

    Good luck

    Paul

  • Thank you Paul, that's very helpful. My only concern is that I put in my claim back in June and they denied my claim end of June/early July. I only found out this recent information a month ago and my fear is that I have left it too long to have the claim reopened as 5 months has lapsed and I'm not sure if you have to appeal within a certain timeframe.

    Thank you for your reply and the information.

  • 5 months will be fine. If anything i would expect aviva to not only pay up but also pay you interest for the period of time they didnt pay you.

    I used to work in insurance and would recommend the following plan of action:

    1. Ring and ask for a supervisor/manager - explain the situation to him/her and ask for your claim to be reviewed.

    2. If you dont get anywhere ask for the Customer Relations department and tell them you intend to make a formal complaint. You may be asked to detail it in writing.

    3. If you dont get anywhere then, ask them for the name and address of the regulatory body that you can escalate the complaint too, I am not 100% sure who this is for life cover, it could actually be the FCA but they have to give it to you. Now this may well prompt them to re-evaluate your claim as if the FCA or Ombudsman have to investigate they will normally charge the insurer a sizeable fee to do so (even if that insurer is eventually proved right)

    Good luck and pursue it, i am confident you WILL get paid out. It may be worth asking for a copy of the form your consultant/gp returned to them, unfortunately there are some poorly educated health professionals out there who do not believe these conditions to be a cancer. I have heard of examples where critical illness claims have been refused because they have specifically written on the forms its not cancer.

    If you find that the root of the problem is the form you may need to pay them a visit armed with the WHO information and seek clarification from them as to why they didnt complete it properly.

  • Hello Paul,

    If I could hug you virtually I would!! I've printed off your response so I am fully armed when they respond.

    Sincere thanks again, I really appreciate all the information you provided.

    Kind regards

    Angela

  • Thats ok, hope it is of help to you.

    I would even be tempted to 'polietly' suggest to them that being diagnosed with a cancerous condition is stressful enough without the added stress of being declined payment on a claim you know full well you should be covered for and that many others in the same position you have spoken to have been paid for too.

  • It certainly is a great help Paul, I'm so grateful. As you can tell, I just accepted their answer of "no" and five months later all I've heard on my other MPN groups are people being paid out by Aviva with the exact same cancer. I'm not sure how they can argue my appeal if I'm honest with you, but you know more than anyone, they will give it their best shot! I will add in what you wrote above too. A good point regarding the hematologists, as mine describes it as a "disorder" rather than a "cancer" which I've fought him on the phrasing since I was diagnosed.

    Hopefully, this information will be enough for Aviva to settle my claim.

  • Let us know how you get on.

  • I most certainly will! Thank you

  • Don't you just love this community!

    well done Paul

    David

  • Yes, David I certainly do! A whole heap of information that I would have otherwise been none the wiser. I'm very grateful.

    Angela

  • Hi Paul

    I've just sent you quite a lengthy email, apologies in advance. I'm not sure if you will get this message so I've sent two just in case!

    Angela

  • Hello Paul

    I received a reply from Aviva this afternoon. They have said:

    "We have written to your consultant , Dr Rafaei for further medical information and have asked that he replies within the next two weeks. As soon as we have received Dr Rafaei's response,, we will then respond to you as to whether our decision has changed and also respond to your other points".

    My other points they are referring to are the points I took from this website of a lady who successfully claimed who wrote that "ET is classified as malignant as it is a clonal stem disorder and ET is classified as invasive as it is present in the body and in the blood". I quoted both of these in my email to Aviva as well as the WHO article and the ABI guidelines.

    My concerns are:

    1. Can Aviva base their decision dependent on my consultant's "wording in his report"? He does not refer to ET as a "cancer". He refers to ET as a "blood disorder". I don't think he will confirm it is a cancer, even though it is! Clearly, I cannot force him to say it is a cancer. Do you think I still have a chance to fight this if he refuses to do so based on the fact that Aviva have paid out to other ET sufferers?

    2. I do not have, and cannot find, the article from ABI stating that "ET and PV are classified as cancers and should be covered by CI cover". I think I may have to ring up ABI direct and ask if they could forward their article.

    3. I don't think I have enough ammo to be honest Paul as I only have the WHO (2008) article which, as far as I can see on a quick browse does not specifically state that "ET and PV are cancers".

    I will continue to fight as it still does not alter the fact that I know of at least 3 people who have successfully been paid out by Aviva after being diagnosed with ET without any of this stress that they are putting me through.

    Any words of advice would be greatly appreciated. Apologies for the length of this message. I could find my messages at first and was having a panic attack!!

    Kind regards

    Angela

  • Hi Angela,

    I have the information from ABI. Ian and Marie had sent it to me recently as my wife has submitted a claim with Aviva.

    What's your email and I can send it to you.

    Regards

    Saj

  • Hello Saj. thank you very much for your reply. I'll give you my work email so I can print it off. it's alevitt@shb.com.

    Kind regards

    Angela

  • Hi

    It sounds positive that you have got the information from ABI that Saj1984 is kindly sending you, that will help a lot.

    Re point 1, i don' know what is in the reports, if it specifically mentions ET then I cannot see it being an issue, if it mentions cancer (not ET) then you may have to consider different options. I know the free prescriptions form mentions cancer only and that has caused some people issues.

    Regarding the WHO article found this link which describes it if its any help rarediseases.org/rare-disea... but you hopefully have the ABI link so that will be very useful. Its the reference to 'neoplasm' which is the important bit, by definiation a neoplasm is a cancer.

    I think you have done a good job in getting the ball rolling. I dont think you should let it drop, post back and let us know what they say.

    I think you may be in a sit and wait mode right now, but, if they refuse ask to see the form your consultant completed. It may be a case of having it referred to an MPN specialist even if that is what the sticking point us. I am sure someone here, maybe even Maz will be able to help with that if needs be.

    All the best

    Paul

  • Thanks Paul.

    I do have the option to see a copy of my consultant's report before its submitted but I usually decline as I have to go to the clinic to see him to see the report. He is a heamotologist and did confirm my diagnosis as ET and doesn't like to use the word "cancer" so I'm hoping he's put ET on my report!!

    I'll let you know but I am going to write to him to let him know that Aviva will be in contact with him again. he was very helpful and supportive when I made my initial claim.

    Regards

    Angela

  • Hi Angela,

    I was recently diagnosed with ET and JAK 2 positive and have submitted a claim with Aviva.

    I have had no response yet so fingers cross it will go through.

    Do you have a copy of the WHO article which reclassified MPNs as cancer.

    Please can you email it to me at saj1984@hotmail.com.

    Many thanks

    Yasmin

  • Hi Yasmin

    I don't have a copy of it but if you google "classification of MPNs as a cancer" it will bring up the WHO 2008 article.

    I have already had my claim denied by Aviva but have appealed against it stating the WHO article and the ABI insurance guidelines. They have paid out over 9 claims that I have been told about!

    Let me know how you get on.

    Angela

  • Hi Angela,

    Great replies Paul, really useful to us all.

    The world health organisation most definitely classified MPN's as blood cancers in 2008 but I can't find the article either....must be out there somewhere.

    Maz do you know?

    This is a really good site Angela, welcome. Have you also looked at mpnvoice.org.uk? Great website.

    All the very best.

    xx

  • Hello Lou (?) Apologies if I have addressed you incorrectly. Thank you for the warm welcome.

    I do not have a copy of the Article but you can either Google "classification of MPNs as a cancer" or click on this link bloodjournal.org/content/11... and it will bring up the WHO 2008 Article mentioned.

    Thank you for the heads up regarding the other website. I spoke to Aviva this morning and they were slightly "stumped" to put it politely when I asked them to reopen my claim! They told they were sending my email to their clinical team and would revert to me next week. As per Paul's great advice, I intend to fight this all the way.

    Kind regards

    Angela

You may also like...