Critical illness cover for ET: Hi, my husband... - MPN Voice

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Critical illness cover for ET

Morris941 profile image
16 Replies

Hi,

my husband who is 50 has just been diagnosed with ET CALR following a bone marrow biopsy. Initially he went to the doctor for a well man check which revealed high platelets (917). Diagnosis was finally confirmed at the beginning of January 2023. At the moment he has been classed as low risk and all being well he will not require medication (other than aspirin) until he is 60. He has been taking aspirin once a day since August and is suffering from fatigue, occasional bleeding gums and headaches. He is able to continue his daily work. We have a critical illness policy through our employer and I have checked the conditions of the policy which are really confusing. Not sure whether this is because we do not fully understand the condition or the way the policy is worded! I have seen some posts on this site which talk about people with ET being successful with their critical illness claim so was just after any advice before we went ahead. Any bit of advice would really be appreciated.

The below is an extract from the policy:

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 and lymphoma except cutaneous lymphoma (lymphoma confined to the skin).

Note: 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.

Many thanks,



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Morris941
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16 Replies
Trocken profile image
Trocken

I would advise making a claim and seeing what happens, mine paid out 30% of the value, but the policy has continued and I can make another claim at a later date. I know others have received the full claim.

Ettu profile image
Ettu

you should definitely make a claim and push for a settlement. Et is now classed as cancer - not just a blood disorder.

there are resources elsewhere on this site which confirm that.

Good luck !

Loubielou profile image
Loubielou

Hi, I made a successful claim 10 years ago. I was with Scottish Provident who initially said ET was not covered...

What turned it around was some advice to the Insurance industry from the ABI (Association of British Insurers). They published guidelines to the industry in 2006 – confirming that ET and PV were classified as cancerous and should therefore be covered by CI claims. (Previously they were in the pre-cancerous category).

I've attached the screenshot of the Press Release, I can't seem to add more than one attachment so will send over the full Statement separately. (Any problems accessing these let me know and I can email them to you).

The change of guidance was due to the WHO re-classifying ET and PV from "myeloproliferative diseases" to "myeloproliferative neoplasms" to reflect the underlying clonal genetic changes that are a key feature of these diseases.

At the start of the process my consultant didn't think I had a particularly strong case, but when I shared the ABI statement with him he changed his view. He filled in the paperwork and helped with the response to two key questions from the insurers claims team:

1. Is ET classified as malignant? Yes it is, because it's a clonal disorder

2. Is it invasive? Yes it is, because it's present throughout the body in the blood.

There are many people on here who've made successful claims, so my advice would be to have a go!

I wish you and your husband well, ET is a fairly rare condition but many of us live with it without it causing too much bother. I have found MPN Voice to be incredibly helpful so do reach out any time you have a query, you will find a lot of support is available to you.

Let us know how you get on.

Loubie xx

Press Release
Loubielou profile image
Loubielou in reply to Loubielou

Full statement

full statement page 1
Loubielou profile image
Loubielou in reply to Loubielou

Full statement

page 2
Loubielou profile image
Loubielou in reply to Loubielou

full statement

page 3
lizzieET profile image
lizzieET in reply to Loubielou

I claimed successfully but needed the advice from ABI (mentioned here elsewhere). Our ET is classed as invasive as it affects the blood. I got 100%pay out, and because it was 2015 and still for many unknown, it took a year and i also got premiums repaid, and compensation.

ABI are INCREDIBLY heloful. You should be fine.

Liz

Cat_lady52 profile image
Cat_lady52 in reply to Loubielou

Hi Loubilou, any chance you could post a link to this document / page, i can't find it.

Thank you in advance. 😸

Loubielou profile image
Loubielou in reply to Cat_lady52

Hi, the screen shot of the press release, and the full statement are under my reply to the original post. x

LightNights profile image
LightNights

I have successfully claimed on my work provided policy, terms similar to yours. I sent a copy of the ABI statement in with my claim forms, saying, 'I've attached some infomation from the ABI in case it's helpful when assessing my claim'.

Purple-Joni profile image
Purple-Joni

I have ET (diagnosed in Nov last year). We have a policy with NFU mutual via AIG. I called them explained the diagnosis, sent my letter confirming from the hospital. Amazingly, within 10 days I had my full mortgage paid off! I would back then, explain it is a life long cancer with no cure. Good luck 🤞 x

Morris941 profile image
Morris941

Thank you all for responding especially Loubielou for attaching the information from ABI. We will give it a go and see how we get on. I will keep you posted.

We are learning more about the condition each day. My husband can’t get round the fact that he has been diagnosed with ‘cancer’ yet not receiving any treatment as such apart from the aspirin. However this is causing him a problem in itself as he suffers with a bad back and has been told he cannot take anti inflamatries so is in awful pain ☹️.

Loubielou profile image
Loubielou

You’re very welcome. I will keep my fingers crossed for you.

Sorry to hear your husband is having difficulty reconciling the diagnosis with the treatment. It took me a while to get my head round it too.

I am monitored regularly at a haematology unit with MPN specialists. For me this has meant I can follow their treatment advice and I don’t need to worry about the ET day to day.

Hopefully your husband has a good haematologist to work with?

tracey13 profile image
tracey13

Sorry to hear about your husband's diagnosis.

My husband was diagnosed 10 years ago with PV I phoned the critical illness cover straight away they told me it wasn't covered.

After 3 MTHS I joined this site and seen MPNS had been renamed by the ABI and they not classes as disorders the n stands for neuroplasms which is new growth.

So I rang back up and quoted the ABI Changes and they filled the forms in for me sent them out we added a few bits to the comments. We sent copies of my husband's hospital reviews and blood results.

Within 4 weeks they paid out in full and the money was in our bank.

Good luck .

Emhalliday profile image
Emhalliday

Hi, i got diagnosed back in 2013 and my insurance company paid out straight away for my critical illness cover once my consultant completed to form they sent

Morris941 profile image
Morris941

Hi I just wanted to give you an update following my question on here about a month or so ago. We submitted my husbands claim for critical illness just over two weeks ago. The insurance company contacted him Friday and have approved the claim!! Couldn’t fault the service. I was able to get his BMB results from his haematologist and sent the letter confirming diagnosis so that probably helped speed things up. Thank you all for your advice 😊

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