Denied coverage on "Cancer" insurance policy

[tapkeyes]

Hi All, I have ET. I was diagnosed a while ago. I had a "Big" company cancer policy which was to help if I got cancer and couldn't work. I was DENIED coverage because they claim ET is not cancer. Has anyone else had issues or had a claim that was acknowledged as cancer and paid out? Am I the only one? Thanks

[Hidden]

Not surprised. Insurance companies make money by not paying out. I had a policy with Colonial which had been taken over by Sovereign. They paid out as a "terminal" illness under the cancer part of the contract on MF. Hemo was a bit surprised. This in New Zealand.

Take it to review if you can. In NZ there is an Insurance Ombudsman.

Good luck.

Regards

Guy

[katiewalsh]

Hi. I’m so sorry to hear what’s happened to you. Which country do you live in and do you have an MPN specialist? Katie

[Ebot]

You will see there have been a number of strands on this Forum related to critical illness cover claims in the U.K. ET certainly is a cancer and in respect of CIC there is a statement from the A.B.I (insurers association) specifically referring to ET and PV and the fact that they should be considered as cancers under the terms of the policy. It’s a very old and well hidden statement! But it has been used with success.

However, other forms of insurance are usually very specific about the kinds of cancer they will pay out for and in what circumstances. For example ‘terminal’ usually has a very immediate timeframe.

Somewhere like MPN Voice is useful if you’re looking for evidence that ET is a cancer. MPNs were reclassified by the WHO as neoplasms possibly a decade(?) ago. Having said that it’s obvious from this Forum that not all doctors accept this and that in some countries the medics still tend to view it as a disorder or condition. Good luck!

[isimmy]

I can only echo what Ebot has said.

I have recently had a Critical Illness Claim paid out in the UK with the minimum of fuss.

However, definitions of cover and guidelines for paying out could vary significantly between different countries.

Don't give up. It would be advisable to find out the exact terms and conditions of the cover that you had to see if you have grounds for appeal.

Best of luck.

[tapkeyes in reply to isimmy]

I have appealed it. It was denied again. Thanks

[isimmy in reply to tapkeyes]

Really sorry to hear this.

[lavender007]

Go to home page on ET in MPNvoice.org cancer confirmed and classified by world health organisation no higher body in the land.

[Chaz1]

Definitely check the terms, also have you seen the doctors report? This could be the key to why not paid out, you say the policy is to cover if you can't work but if the doctors report doesn't state specifically that you can't work again this could be the issue if that is the terms of the cover. Also can be an issue of timescale from diagnosis to when you notified your insurers, there isn't a lot of time allowance in most terms. Our critical life insurance paid out on hubby's ET diagnosis quickly but I'd notified them promptly after diagnosis. Definitely worth showing them WHO reclassification as well.

[tapkeyes in reply to Chaz1]

We notified them immediately. Are you in the U.S.? Thanks

[tapkeyes]

Thank you all for your super quick responses. I am in the U.S. Yes I read about the WHO reclassification and all of what is in the forum about the U.K.. However, I cannot find any of the same info for here.Yes my super qualified doctor said it's cancer. The insurance company said it doesn't meet "their" definition of cancer. Sorry I should have been more specific. I'm hoping to find out if there are any U.S. companies that have both either paid out or denied coverage on a cancer disability type policy. Thank you!

[Ebot]

Just to add that I have various insurance policies of one type or another and there was only one critical illness related policy that I could (attempt to) claim under in relation to the ET / PV. I was initially turned down because the insurer had a very narrow definition of ‘cancer’ - that it had to be a tumour. It wasn’t until some years later through this Forum that I learnt of the ABI statement and challenged the insurers. Looking at some of my other policies it’s clear that insurers don’t routinely pay out for a cancer diagnosis - the reality being that many people now go on to live long and healthy lives after diagnosis and treatment. As they say, it’s all in the small print. I would definitely establish from the insurers specifically why they have turned you down. What kind of cancers do they cover? If they cover blood cancers they should be covering MPNs. All the best.

[tapkeyes in reply to Ebot]

Thanks for responding. They will cover Leukemia but they say the cancer has to be one that can spread throughout the body!?!? I can't believe the nerve!

I was just hoping to find out if I was the only person with ET that happens to have the worst insurance carrier ever