Insurance Query on Female Cancer Plan

Hi Everyone, Hope you don't mind me asking this questions on here. I have a very small female cancer plan which pays out in the event of me having a female cancer. I have recently had surgery for stage 3a serous borderline tumour of the ovary with non invasive implants. My insurance policy states that the following are excluded: pre-malignant, non invasive or cancer in situ. Although my tumour was non invasive it had spread to my appendix, omentum and bowel and I had extensive surgery. When I spoke to my consultant he said borderline tumours are tumours with low malignant potential. Has anyone had one of these plans and been able to claim for a borderline tumour. Many thanks x

21 Replies

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  • If you ring Ocacome helpline on 08453710554, I'm sure they'll tell you if there is any info. Also the Ovacome website has a fact sheet on borderline tumours, go to resources/fact sheets on www. Ovacome.org. uk

    All the best

    Love Wendy xx

  • If you ring Ocacome helpline on 08453710554, I'm sure they'll tell you if there is any info. Also the Ovacome website has a fact sheet on borderline tumours, go to resources/fact sheets on www. Ovacome.org. uk

    All the best

    Love Wendy xx

  • Hi it sounds like to me you have been sold a duff policy that seems to cover all angles from their perspective, my daughter had the same problem when she had a brain haemorrhage,

    and wasn't covered at all with her critical illness policy, the clue I think is in the wording. I am sorry to have a bit of a downer on this, do you know anyone that could interpret this for you? It does matter the terminology that you use when you claim for instance when her Christmas tree leaked sap all over her carpet and sofa they said it wasn't a leak but a spillage and she wasn't covered, so had a permanent bright orange stain (from sap or fertiliser) but still wasn't covered. I think insurance policies aren't worth the paper they are written on but sometimes are a necessary evil (like house insurance) I wish you success if you decide to claim.

    Love x G x

  • I meant to say if it turns out to be mis-sold you might have a claim there.

    Sorry about the paragraphs where there shouldn't be one, my iPad does this and I haven't worked out how to stop it LOL

  • Some insurance policies are ok, I had a critical illness policy dating 15 years ago. When we phoned to see if we were covered and explained the details, they immediately sent us a claim form. They have not only paid in full, but backdated it to my original diagnosis and refunded the premiums to then too. It took a couple of months, as they hd to get reports from various doctors etc, but was well worth the effort. I think they have to be mega careful over claims otherwise the ombudsman get involved, which they definitely don't want! Stick with it and good luck!

    Love Chris

  • Thankyou everyone. I'll keep you posted x

  • Dear Doodolatrice

    I think really the best people to discuss this with is your oncologist or GP to start with and the insurance company with whom the policy has been brokered. You could show your medical practitioner the policy and ask if they consider your have one of the listed conditions. At the end of the day your insurance company will need a statement from a medical practitioner and they're not going to make a false statement on your behalf. If you're not covered you're not covered.

    I'm in a similar situation in that I have a life assurance policy that pays out when I have less than one year left to live. I'm happy for the policy to remain unclaimed as long as possible and I wouldn't dream of attempting to claim unless my GP or oncologist agree it's the appropriate time.

    Good luck with a long and happy remission.

    xxx love Annie

  • Hi Annie,

    Haha! if I had that policy I would have been paid out by now...I wonder though if I would have had to have given it back...seeing as I am still here.(I shall never know)

    I think it is good advice to show it to your consultant.. they are the ones with the medical terminology,,,,and like Chris says they are more careful now than they used to be about mis-selling... Love x G x

  • It's good you can laugh about it Gwyn. Really it's impossible to say that someone's got less than a year to live. I think nearer our 'sell-by' date they can predict in terms of months or weeks.

    My solicitor's of the view that I have a life-limiting illness and I should attempt to make a claim right away. I'm not bothered. It seems like inviting trouble to me!! I might reconsider when my oncologist tells me they can't do any more for me.

    xx love Annie

  • Hi Annie Actually,

    I am inclined to agree with your solicitor, otherwise what would be the point of the policy If it is impossible to say how long you have? I stand by what I said earlier that insurance isn't worth the paper it is written on, when my daughter took out a policy to cover her if she had to lose any time off work, (so her mortgage would be paid) years after taking out the policy she had a brain haemorrhage and was off work for about twelve months, they wouldn't pay out because it didn't cover strokes etc but it was in the very small print and when you read the small print it didn't cover her for much, we were hard pushed to find any illness on the policy that would require you to be off work for long.

    The point is if you have an illness with a bad prognosis regardless of time limits they should pay up. or they shouldn't sell a policy that they know is impossible to tell how long people have.

    Love x G x

  • ah but this isn't a sickness and fatal illness cover. I had one of those policies whilst I was a single parent and stopped the payments about 2 1/2 years ago - see what I mean about inviting trouble!???

    Mine is a life assurance. It used to get paid after death but it's so much cleaner all-round to have it just before so you can pay off mortgages, settle everything, etc. It's valid till my 65th birthday. If Iast that long I'll have defied the statistics!!

    Had a great meeting in London today meeting new faces from the Ovacome site and catching up with friends. xxx

    love Annie xx

  • Well that explains it, I had a friend (elderly) who took out death insurance on her husband and he died just after, she thought that it was invalid, but the insurance company paid up, of course she'd rather her husband had lived, but they hardly paid any payments on the insurance so I know what you mean about pushing things, he was as fit as a fiddle when they took out the insurance.

    Glad you had a good saying London love x G x :-)

  • That was "day" by the way, don't know why or how it changed to "saying" odd!! :-/ ;-)

  • I meant to say that the lady that took out the insurance had hardly paid anything in to the insurance company (after reading this it seemed as if I was saying they didn't get much back)but this wasn't the case she received the full amount as if she had been paying it for years... :-)

  • Thanks again everyone. I've submiited a claim and I've also emailed my Consultant tonight to ask his opinion. I'm pretty sure the Insurance Company will use the "non invasive" exclusion to reject my claim. My tumour was sitting on other organs but hadn't actually invaded them. I'll keep you posted. x

  • Hi I personally would make the claim and go further if they say no . I agree with a lot of the comments that these critical illness plans/female cancer plans are small print/small print and then more small print !! i had one for the mortgage and thankfully has paid but i had another one and cancelled it a few years ago as there seemed to be so many exclusions and criteria (ie if you had a heart attack you needed to have a certain surgery) it did not seem worth having

    Hope you get on ok

    Ally

  • Hi there Dood. It wouldn't matter how much the amount insured was, the thinking behind a large or small payout is the same. Your cancer is 3a which means that the tumours are small and can only be seen under a microscope. (This is what I read on the MacMillan site as regards the staging of your disease.) You say that you have serous borderline tumour of the ovary. There is a difference between borderline cancer and low grade. Low grade is now seen as a separate entity to high grade cancer. It is now believed to follow a different pathway to high grade and the overall survival for this grade is longer, but chemotherapy is less effective. If you have any disease which is low grade rather than borderline, your insurers may have to pay out. I can see why the insurers would have this proviso because many people have growths of low malignant potential removed and they are fine. MacMillan Cancer Support have a financial arm which is funded by the Royal Bank of Scotland. Their number is 0808 808 00 00. They were extremely helpful in my case and supported me through my claim. I'd ring this number rather than the usual MacMillan ones as you'll be put through to an office where there are qualified financial people who deal with insurance claims on behalf of cancer patients all the time. If I were you, I would call them and ask for their advice. They may be prepared to write to your consultant on your behalf asking whether your illness is totally borderline or whether there may be serous low grade micropapillary ovarian cancer in the abdomen which has spread to the peritoneum or other places (so not in situ) from the ovary. If your consultant charges and you do get paid out, then the insurance company will refund this cost and any premiums you make from the date of the claim to payout. Anyway, it's just a thought. One thing I would do is keep paying the premium. Hope this helps.

  • Hi Tina....this is such good advice :-) love x G x

  • Hi

    I had one of those female cancer plans and they paid out without any fuss. Hope they do the same for you.

    I was sold the plan many years ago through my union, ATL, and as they recommended it I took it up. I also paid extra to have my husband covered for gender specific cancers.

    It was the sort of thing you never wanted to claim on but I was so glad I did as at least I didn't have to worry about money as well as everything else and I knew I didn't have to rush back to work.

    Love

    Anne

  • Thankyou everyone. I telephoned the MacMillan Cancer Support helpline today and the lady I spoke to confirmed what you had already said TinaB. As my tumour had spread then it is considered invasive. Now its just a question of whether they consider it cancer or not. I also received a letter from the Insurance Company confirming that they are going to write to my Consulant. A bit annoying really because they have a copy of my letter from the Hospital confirming my diagnosis and my Consultant has got better things to do that write to Insurance Companies. Watch this space x

  • Hi Dood... yes, it's frustrating but the insurers need to know everything about the claim in order to make a decision and it has to come straight from the horse's mouth which in this case, is your consultant's. They may request other information like copies of scans and reports but don't be put off by this. To be fair, insurers have to make sure what they cover a person for is what they are paying out for. They do this in the interests of their business and for the insured population as a whole. The financial arm of Macmillan was a major form of support to me and I so hope the Royal Bank of Scotland continues to support this very worthwhile undertaking. Initially, the bank funded this Macmillan financial project for 3 years so here's hoping we have this facility for years to come. It's lovely to see such a caring element in banking when most banks get so much criticism. Once I'd made a claim, I tried to put the whole thing out of my mind but, if I'm honest, being able to proactively sort out my papers was a major source of strengh when I thought I hadn't any. I wish you well ... very much x

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