Critical illness claim: Hi all, After notifying my... - MPN Voice

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Critical illness claim

si405mon profile image
17 Replies

Hi all,

After notifying my insurers that I had been diagnosed with primary myelofibrosis I was encouraged by them to make a claim under my critical illness cover. They promptly rejected it after seeking a medical report from my consultant. now, three years later, I'm thinking that I should challenge this. Fatigue has worsened to the extent that working full time has become almost impossible. I was awarded the Personal Independence Payment having submitted a claim but could really do with getting my insurance to pay out as it would allow me to work less hours. Not sure where to start so any help re WHO classifications and info from the Association of British Insurers would be hugely welcome.

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si405mon
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17 Replies
Paul42 profile image
Paul42

Hi

Yes you want to try again. They are wrong to refuse your claim, however this may have been affected by what your consultant said on the report as some of them refuse to accept they are classified as a cancer.

I do not have a copy of the paper work, but go back armed with the date of 2008 as when WHO classifed MPN's as a neoplasm/blood cancer. Tell them you want your claim reconsidering.

I am sure someone on here might have the paper from the ABI hopefully but you could try calling them im sure they will provide it you.

Tell them you want to see a copy of the report the consultant sent 3 years ago also and any subsequent reports they now ask for.

Once they have set the wheels in motion again you want to be considering to ask for both interest in the pay out for the past 3 years and a full refund of premiums paid since then. If they do not play ball tell them you will be approaching the ABI and the Insurance Ombudsman.

If you find that the consultant is to blame for doctoring the documentation that has been sent back then I would seriously consider contacting him or her and telling them they are the reason the claim is not getting paid and referring them to the WHO classifcation of 2008 and ABI documentation if you can get it. Tell them unless they complete the paperwork correctly you will be contacting a solictor to discuss legal action against them.

It could also be worth contact a forum member called 'forwardocho' who was in the same position and appealed the claim and got paid out.

Good luck, they are wrong not to pay out hopefully you can get it sorted.

Paul

si405mon profile image
si405mon in reply toPaul42

Thanks Paul - much appreciated.

Paul42 profile image
Paul42 in reply tosi405mon

No problem let us know how you get on.

eire profile image
eire

I have MF and had my critical illness paid. Had to persevere as they were reluctant. Good luck with your claim.

tracey13 profile image
tracey13

My husband was rejected then a year later I challenged my insurer and we were paid out.

All mpn are covered by critical illness. As long as you made that first phone call in the first 3 months they will pay out.

I've got a screen shot from a website quoting the ABI mpn are classified as cancer now.

Tracey

tracey13 profile image
tracey13

I sent a photocopy of all my husbands letters from his consultant. They didn't even write to his consultant. It's only took about 5 weeks for them to pay out.

If you send me your email address I will forward you the quotes I used to the insurance.

si405mon profile image
si405mon in reply totracey13

Thanks Tracey, that's really helpful. My email address is si405@btinternet.com

Thanks again

tracey13 profile image
tracey13 in reply tosi405mon

HI I've emailed you the evidence to support your critical illness.

Solitairebtb profile image
Solitairebtb in reply totracey13

Hi Tracey, was wondering if you could email me any info you have as well if you still have. My address is solitairebtb@outlook.com

Thanks, don't worry if you don't have it available

teacher75 profile image
teacher75 in reply totracey13

Hi Tracy13,

I have recently been diagnosed with mpn/pv and, after reading some of the posts here, have realised that I may be able to claim under my specified illness cover. If you could email the quotes you used for the insurance, I would really appreciate this. Dketterick@eircom.net

Thanks

Teacher 75

tracey13 profile image
tracey13 in reply toteacher75

Hi,

I quoted that the ABI had reclassified blood cancers from blood disorders to neuroplasm as this means new growth.

When I rang up December 2012 they told me my husband wasn't covered .

Then I started reading up on this site and rang them back in January I had no problems at all.

They filled the form in over the phone sent the paperwork out and we checked and signed it and sent all copies of my husband's hemotologist reports .

I will say if you have just been diagnosed you have to ring straight away as you only have 3 months to claim from the day of diagnosis.

Hope this helps

Good luck

teacher75 profile image
teacher75 in reply totracey13

That's great! Thank you so much for your reply.

Teacher75

tracey13 profile image
tracey13 in reply toteacher75

Our critical illness cover was with Scottish provident.

Janlol profile image
Janlol

Hi, I have ET and have submitted a critical illness claim approximately 3 weeks ago, not heard anything yet. I have emailed you the ABI statement which was kindly sent to me from another member.

Good luck,

Lorraine

Wyebird profile image
Wyebird

Hi si405

Interested to hear that you’ve been awarded PIP.

I have ET. I’m 62 yrs old and after looking at the criteria thought I wouldn’t stand a chance. I cannot do my housework due to fatigue and have to pay for a cleaner. I took early retirement 5 years ago ( 3 year before diagnosis) but definately know I could not have coped with work. Did you have to attend an interview in order to qualify?

si405mon profile image
si405mon in reply toWyebird

Hi,

I found the forms quite daunting and would strongly recommend getting some support to complete them. I used a local advice centre - they guided me through the questions and knew how best to phrase the answers. I did attend an assessment - quite stressful and they put you through a series of physical and mental tasks (nothing strenuous - trying to touch toes, gripping etc). Would advocate taking someone in with you.

Wyebird profile image
Wyebird

Thank you

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