Hi wondered if anyone has any advice or can offer any help
I was diagnosed with BC with sec to liver and bones in sept 06. Was very ill and wasnt expected to survive, but I did and I am still here and surprisingly well having come through all the treatment. When I was feeling upto it, I made a claim on my endowment pol which had a terminal illness clause, stating that if I was expected to die with 12 months the policy would pay out. I discussed this with my onc, who said that he would be happy to support this as I could realistically, given my condition, die at any time (not really what i wanted to here but luckily I have managed to stay around so far!) I advised my GP of this discussion and the ins company wrote to GP and the policy paid out apr 07. We paid off the mortgage which helped considerably with finances.
As I am reasonably well I wanted to return to work (normal life!) for a while on a part time basis. My GP has said that if I do he will write to the ins company and advise them that my situation has changed, and they may well sue me for the return of the £48000 paid out.
I feel like I am being held to ransom and punished for surviving despite the odds, and I cannot see anyone lending me the £48000 to pay back the ins com, given my prognosis. My diagnosis hasnt changed and I cannot see what about my situation has changed other than I want to do something whilst I am well and able to do so, whilst fully appreciating that this dreaded diseaase could hit me again at any time.
I am now in a no win situation. My employers are going to write to my GP for a report as to why I can’t return to work yet, and he says he is going to tell them that it is because I am classed as terminally ill and that ins has paid out on that basis. I should imagine at this point I will be sacked. He suggested I do some voluntary work, so he is not opposed to me working, just getting paid for it -but I want to go where my friends are, where i know the job etc…
Don’t know if anyone can offer any help but surely I can’t be the only person that has survived despite the odds -Jane Tomlinson was always my inspiration.
Hi Debbie
I know nothing about this but it sounds absolutely reasonable that you should not be penalised for surviving! I wonder if BreastCancer Care or other charities have lawyers who could advise you?
Jo
xx
Surely your policy wording covers this? I’d take it along to your local Citizen’s Advice and ask them to have a look and see. Having worked in insurance I’m absolutely sure that the wording covers every possibility. I’m pretty appalled at the GP’s attitude and would be angry as an ant if I were you. If the CAB can’t help maybe you should consider paying for a bit of legal advice?
Really hope you get this sorted. Keep us informed.
First thing I’d do is chance my GP! You need someone on your side.
If you told no lies when making your insurance claim, they cannot ask for the money back. Any thing you said about your medical condition was true to the best of your knowledge and belief, based upon information given to you by your GP wasn’t it? You gave no cast iron guarantee that you would be dead within a certain timescale so there is nothing that GP can do to cause trouble with the insurance company. If he tries, I think it would be classed as breach of patient confidentiality and he would be in big trouble.
Stop worrying, those threats are empty. Get a more supportive GP who will say you are capable of worrking for now at least, so you can get on with your life. Any of us can go down quickly but if you can work now, you should be able to hang on to your job.
Thanx for your comments-all advice is greatly appreciated!
My GP has been really good to me whilst I have been ill, and effectively helped save my life so feel a bit funny now about having a go at him, though I have tried. I just wish the ins com had writen to my onc instead of GP. My hubby is mad about it esp as it is causing me stress. My GP is very like Doc Martin( the TV program) in his approach so you can imagine the conversations we have had!
I think you are right and I may have to pay for legal advice, or try maybe the charity sites or my union? -but its knowing who is best to approach coz I bet no other Gp has ever decided to do this! Trust it to happen to me. He has said he will need me to sign a consent form if I return to work, so he can write to ins com-and he won’t sign me off unless I do so I can’t win either way.
Im gonna ask my onc tomorrow if he can help in any way-maybe write to GP - though hes not the most talkative of consultants-he always seems to have to much to do-i may have to tie him to a chair so he will listen to me!!!
As Jo has helpfully mentioned in her post to you, please feel free to contact our helpline as our helpliners may be able to suggest ways to help you to sort this out.
The helpline is open Mon-Fri 9am-5pm and Sat 9am-2pm and the number is 0808 800 6000.
Don’t be so hard on your GP. He probably needs to inform insurers, otherwise HE could be made liable to them. This is just to cut out fraud - technically any friendly GP could sign a form so that the patient can claim money from insurers. You need to get some good advice, something which can only be given if you have all of the paperwork. I often think that Insurance Companies always have a get out clause.
Please don’t get stressed, at the end of the day you acted on legitimte information which was given to you at the time.
Best of luck.
Ruthie
No, there is no ongoing requirement upon the GP to continue supplying information to the insurance company. Anything he did to support the insurance claim was with the patient’s consent. Anything which he does now, is without patient consent and therefore a breach of confidentiality.
Yes, read through all the claims paperwork, but I am 100% sure there is no need to appoint a solicitor. Just firmly tell your GP he is out of line and you will take appropriate action if he does anything detrimental to your best interests without legal authority.
The only grounds he has for not confirming you are fit to work is if he truly believes you are not fit to work. That is a professional opinion he has to make and he cannot make it conditional on you giving him permission to write to the insurance company (see - he knows he cannot write to the insurance company without your consent and you’ll never give it).
If your GP isn’t the senior partner in the practice, make a complaint over his head and watch him crumble.
Your Doctor has NO right to do this. My suggestion, if the insurance company tries to take the money back is to go to the FSA
( www.fsa.gov.uk )
They will definitely let you know your exact rights.
I fully understand that you have a good relationship with your GP and don’t wish to jeopardise this - however you do have to look after your own wishes… I am sure the CAB will prob be able to help.
On the matter of work - they can’t just sack you cos youare terminally ill… I am still working as are several of us with a terminal prognosis. The money thing is differnet and as above - they have paid out and if all the answers you gave were true and they have no reason to look at any undisclosed items…? Even then you should keep fighting. Hope fully you can keep yourself destressed take a deep breath and hang in there and be firm and stick to it.
Thankyou again for all your comments -obviously I wish the info supplied was incorrect coz then I wouldnt be ill but yes all info supplied to ins com was correct at the time, and still applies now unfortunately. I had hoped to see onc last week but he is on hols and so saw registrar and she was effectively no help. Im gona try and ring the FSA as suggested. I still have the copy policy but it doesnt mention this situation in any of the wording as far as I can see, so I may have to seek further advice if FSA can’t help. To be honest I when i saw regsitrar she said that I stil have small spot (7mmx5mm) on liver though it has shrunk since last scan, and I have mets on pelvis and lower spine, which explains my bad back when I do too much! Now my family are saying maybe I shouldn’t return to work given this info -GOD this having cancer is so hard I really don’t know what to do for the best-it really takes over life doesnt it!!!
Sack the GP. Sorry but I can’t get my head around why he would do this, he sounds like a complete jobsworth to me. Definately go over his head, he’s pathetic!
My husband is a GP and I asked him about your situatiion. He says the GP has no business to report anything to the insurance company and to do so would represent a serious breach of patient confidentiality that could get him into very serious trouble with the GMC.
If you want to go back to work then get back to your GP and put him straight, in the nicest possible way. Tell him to check the situation with the GMC.
He would probably do this because he has been paid by the insurance company to complete a medical report (why not, it’s a time-consuming task which the NHS doesn’t pay him for) and the insurance company has put in the contract that he has to report to them any material change, or something like that.
One way round it would be to get your onc to write your GP a letter saying something like, this lady is a bit better at the moment but nothing has occurred to make me change the prognosis I gave in my letter of x date (ie the original letter he would probably have written when the GP had to do the report). Then your GP can send that letter to your ins co if he wants to, and it is very unlikely that they would start messing around with trying to get the money back when they would have to argue with your own specialist’s opinion. (Actually, IMHO it is pretty unlikely anyhow and if your GP really said they ‘may well’ sue you he is just an alarmist. They really just want to know from him if you somehow turn out to be a total fraud, especially if they are a mainstream ins co).
The FSA won’t get involved or offer advice until you have a dispute with an insurance company and have exhausted the usual dispute procedure.
The GP will not have agreed to report back any changes to the insurance company. He can’t without patient consent as I’ve already said.
This can all be resolved very simply, by telling the GP you won’t be bullied as you fully understand the legal position. If he witholds a certificate saying you are fit to return to work, then it has to be based on a belief that you are unfit to return to work.
No, of course the GP can’t report back to the ins co without patient consent. But he still might have something from the ins co telling him that he has to, which might form a contract between him and the ins co if he was paid for the report. He might easily have got into this situation accidentally. It just struck me as a plausible explanation for why he is now behaving as he is, which otherwise seems rather inexplicable.
I was just trying to think of a way out for Debbie which also helps out her GP, as she says that she doesn’t really want to have a go at him as he has been good to her. (And changing one’s GP is not always easy, and can be impossible, dependng where one lives and the policies of one’s PCT).
I also have a policy which pays out in the case of terminal illness when the patient is not expected, in the view of their medical expert, to live longer than 12 months.
Anyone have any experience of how flexible insurance companies are on this? Sounds morbid, but my policy runs out in 5 years and while I dearly hope I manage to last longer than this I’d hate to miss out on the insurance after paying in all these years - I’m banking on it to take care of nursing/homecare costs. I have mets to the liver and the lungs and although they have responded to chemo so far I don’t think any of us can count on a firm prognosis. Or should I just ask my GP what they would put in a report?