Critical illness claim

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.

9 Replies

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  • 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

  • Thanks Paul - much appreciated.

  • No problem let us know how you get on.

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

  • 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

  • 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.

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

    Thanks again

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

  • 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

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