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Critical Illness Cover

106 REPLIES 106
elauns
Member

Re: Critical Illness Cover

Thanks lexilou3. Yes you're right. I'm with the Halifax been with them since 2001 so not even sure where my original policy wording is. I'll just have to wait and see. I know in this other forum a lady said she was paid out with grade 1 Idc with the Halifax. But then a few messages up this other lady said she had worse grade of idc and wasn't paid because of the work issue but she never said who she was with. I might try and find it again and ask her. Will keep you posted. Thanks very much for your above and hope you are all keeping well and moving on with your recovery.
Elaine x
lexilou3
Member

Re: Critical Illness Cover

I think it is all in the wording of the policy,,, my company (Liverpool Victoria) was great, even when inirially a No,, the spokesperson was gentle, when everything changed their support in dealing with the claim was amazing. Plss dont beat youeself up for choices made that you cant change now. If once all the details are known you feel you have been treated unfairly approach something like the Money Advice Service or financial ombudsman.
Best wishes x x
elauns
Member

Re: Critical Illness Cover

Thanks for your advice guys. I am waiting on the forms and my bcn was kind enough to offer to help me fill them in so I'm going to go see her. I noticed on another forum about ci on this site that some poor girl didn't get paid out because although she had Idc she worked between chemo cycles. Can you remember if your forms had any questions about that? I made myself work between the op and the radiotherapy to try and get my mind of it. But took time off during rads. Then had to take a few month break after going back to work full time. Think the whole situation caught up with me and I realised what I went through... my psychotherapist said it's a common thing for us lassies to go into survival mode but then reality bites us on the ass. But after hearing what that poor girl said about not getting her insurances I think I've shot myself in the foot too. Xx
lexilou3
Member

Re: Critical Illness Cover

Hi,
You need to provide your company with the exact histology report, and they will look at your exact policy details. DCIS is covered by some companies and not others, just as some
companies will cover some illnesses but not
others. My biopsy that set me off on this path did not reflect the full picture revealed
once the surgery was completed.
Good luck,
LL xx
Duffer56
Member

Re: Critical Illness Cover

My policy said Breast cancer was covered unless it was 'in situ'. I had what they thought was DCIS but the pathology showed 2mm of invasive cancer. Policy paid out!
Didn't matter how big or how long it had been there - some was no longer in situ so it qualified for payout.
I hope you have the same success!
X
riversidedawn
Member

Re: Critical Illness Cover

Elaine as I understand it invasive ductal carcinoma has spread outside the milk ducts, but dcis is contained within. As you have had both I would think you can claim as you have IDC which is coveted on your policy. Good luck x
elauns
Member

Re: Critical Illness Cover

Hello,

 

I was wondering if someone has made any critical illness claims to total mortgage protection (TMP) with the Halifax.  I have read over this forum and know that many of you have managed to successfully claim CI but mentioned other insurance providers.

 

I had breast cancer in March of this year and had a wle Grade II 12mm invasive ductal carcinoma and had intermediate DCIS too which made the tumour 20mm. I had 15 SNB which was benign. Tumour was ER strongly positive and Her2 Negative and am on tamoxifen for 10 years.

 

A lot of people have said to ring the Halifax to check whether I would be entitled to claim and to be honest its been the last thing on my mind but today decided to ring up to query and they said that breast cancer is covered barring this exclusion; all tumour which histology described as pre malignant, non-invasive or cancer in situ. The advisor was very nice and said that there was no deadline to make a claim and took my telephone number to get an agent to ring me back and see if I would be elligible but it would be in the new year.

 

So I'm not sure whether a claim can be made and I have tried looking online for any info but I know what insurance companies are like if they can get away without paying out on a policy they generally will try. I know I had invasive ductal carcinoma but is it called in situ because it never spread past my breast? Are Halifax known for loopholes as I had part IDC & part DCIS? Also is Grade II 'serious' enough to be considered critical illness?

 

Lynda5165 - I'm really shocked on your insurance companies decision! To go through what you have had a to go through and not be considered critical?! I have no words!!! I hope that your recovery is going well. Sending big hugs to you and lets hope the new year brings better health fairies for us all!

 

So I guess i'm just trying to find some answers to save going mental over the weekend. 

 

Any help would really be appreicated.

Thanks Elaine

Val235
Member

Re: Critical Illness Cover

Take it up with the ombudsman. I was a broker for 46 years yes I am an oldie but you have to fight them to the end. Good luck

lynda5165
Member

Re: Critical Illness Cover

Hi  just read your comments and am pleased to hearnyour insurance has paid out. Unfortunately I have not been so lucky.  I was diagnosed with extensive grade 8  DCIS and had to have an immediate double mastectomy.  My insurance company HSBC life (which I belive is underwritten by Aviva) will not pay my claim as DCIS is not a critical illness to them. What was I supposed to do - wait for it to spread?    If I  had had low grade micro invasion and only needed a lumpectomy they would have paid but widespread  highest grade DCIS is not considered by the powers that be to be something worth paying out for.  My life has been turned upside down by cancer and I have had life changing surgery but its not good enough for them.  if you have critical illness insurance you might be better putting your money elsewhere!

Blondie223
Member

Re: Critical Illness Cover

Hi, just to encourage anyone with CI cover and not sure whether to submit a claim, I heard this morning that my claim was successful, so there's the mortgage wiped at least, and a tidy sum left over x

Blondie223
Member

Re: Critical Illness Cover

Thanks for the info andypaps, I currently have a claim in against critical illness cover included with an endowment I took out in 1996. I had DCIS low grade and IDC grade one, no lymph node involvement. Currently waiting on my consultant responding to Aviva so that they can assess my claim. 

andypaps28
Member

Re: Critical Illness Cover

I just thought I would give some information about my experiences on behalf of my Missus.

 

She was diagnosed in August 2014 with breast cancer  and it had spread to the nodes. She has now made a full recovery. (Treatment finished May 2015; Chemo and radiotherapy after a one side masectomy). 

 

She had Critical illness cover (over 10 years) initially Colonial (I think) and they were taken over my Old Mutual who were the present company.  We had no idea that this cover would be relevant until we started to move house and were told she couldn't get critical illness cover due to her illness. It was only then (11 months after diagnosis) that we checked the cover as initially we thought it was an income protection scheme. Anyhow the illness was listed but we were concerned now about claiming in a relevant period from diagnosis.

 

The original policy didn't mention anything about time to claim. Just this week the policy paid out. It actually went back to the date that the diagnosis was made , and the company even gave interest on that balance. It also repaid all the monthly premiums from diagnosis.

 

The whole process from claim to payout took 5 weeks (but only because our oncologist was on holiday for at least 2 of them and he needed to sign off the paperwork).

 

 

 

 

 

 

 

Duffer56
Member

Re: Critical Illness Cover

I would think not. You are still you. X
MrsFox
Member

Re: Critical Illness Cover

Hi my cic cover is still in my maiden name. We have tried to change it three times over the years but nothing happened. Do you think they might use this to stop any claim? We are with Zurich.
Dollie7293
Member

Re: Critical Illness Cover

So glad to hear you were successful. Takes the pressure of and you can concentrate on your recovery
Duffer56
Member

Re: Critical Illness Cover

I am so pleased for you - it makes such a difference!
Now you can concentrate on getting better!
X
Bigela46
Member

Re: Critical Illness Cover

Got my phone call iv been successful in my claim thank god I found this site as it has helped me to understand insurance claims just need to get Monday over me to get the full pathology results after my mastectomy hopefully they have removed it all and it hasn't spread thank you x
Bigela46
Member

Re: Critical Illness Cover

Hello well I got a phone call to say that I have been awarded and my claim was successful thank you glad I found this site to compare just need to get nx week over me now for all my pathology results hopefully they removed it all during mastectomy and it hasn't spread will know what treatment I will need then on road to recovery thank you everyone x
Duffer56
Member

Re: Critical Illness Cover

Hi, mine was agree in principle within 2 weeks and in my bank within 4 weeks. I only had a small amount of invasive (2mm) but the fact it was there was enough for their definition on not 'in situ'.
Hope yours go through As soon as possbile.
Dollie7293
Member

Re: Critical Illness Cover

My claim wAs settled within 4 weeks of first phone call. I sent a copy of my diagnosis letter with the form which clearly stated invasive Cancer. Hope you get paid out soon. Keep us posted
Bigela46
Member

Re: Critical Illness Cover

Hello I see your post below mine iv just had my mastectomy and I recieved a letter from legal and general saying my doctor didn't give them enough information I'm not a great believer but insurance company's always look away of not paying out I think there stalling the ball my claim is running 4 weeks now does anyone know or can give me an idea how long it takes please thanx
Dollie7293
Member

Re: Critical Illness Cover

Fantastic news Anita. I was in the same position as you, not really sure if it was worth claiming and due to all the words of encouragement from this site I am now sitting a bit more comfortably. Advice to anyone us go for it !
Bigela46
Member

Re: Critical Illness Cover

Hello I'm reading your add and yours is the same as mine I'm with legal and general and in the process of claiming I'm invasive ductal breast cancer grade 2 at the minute with a lymph node biopsy it's clear I'm going nx week for a mastectomy and will know everything then were you successful with your claim and how is your health thanks
Duffer56
Member

Re: Critical Illness Cover

I am so pleased for you! It makes such a difference to be able to not have to worry about money and just concentrate on getting through everything else. X
Anita123
Member

Re: Critical Illness Cover

Hello i just wanted to post this so it incourages others to look at there insurance policy thankyou for all the posts encourageing me to pursue a claim because the insurance company has paid up in full.

It will help me moving forward in the future.

Thanks again anita

Dollie7293
Member

Re: Critical Illness Cover

Good luck, let us know how you get on.
Anita123
Member

Re: Critical Illness Cover

Thanks for your replys the insurance forms are on the way after so many years of paying for it and the journey im on with the cancer it would be a great weight of our shoulders to receive some finacial help.

Thanks again anita.

Dollie7293
Member

Re: Critical Illness Cover

Yes. It's only after surgery that final diagnoses is possible. You should have no problem mine was only confirmed as idc after surgery. I was paid out just 3 weeks from original phone call
Dollie7293
Member

Re: Critical Illness Cover

Be aware that there may be a limited time for you to register your claim
Lakeslover
Member

Re: Critical Illness Cover

Yes, even a small area of invasive cancer will be enough to trigger a valid claim.

Duffer56
Member

Re: Critical Illness Cover

It sounds exactly like mine. If there is any element which is not 'in Situ' then they should pay out.
When i had my mastectomy they thought it was all DCIS until they did the pathology and found a tiny area of 2mm which was not 'In Situ' and that was enough for my policy to pay out.
Good luck. X
Anita123
Member

Re: Critical Illness Cover

Thanks for your reply 

I was first diagnosed with just the DCIS 1CM high grade but told it was more extensive after the MRI scan.

Then when i had my op it was 3CM and 6MM was IDC,

So the IDC was found once they operated on me and not diagnosed right at the start do you think i will still be able to claim.

Thanks anita 

Dollie7293
Member

Re: Critical Illness Cover

So long as your diagnosis states "invasive" then you should be covered no matter what size the lump is. I was originally diagnosed with DCIS 3mm and idc 9mm. Following surgery it changed to idc 3mm and 20mm. My insurance company paid out immediately. You need to ensure you use the words invasive when calling your insurance company. Good luck
Anita123
Member

Re: Critical Illness Cover

Hello could anyone give me some advice/hope, I was diagnosied with breast cancer in sept i was told it was DCIS and about 1cm and was a high grade,i was then sent for a mri scan to get a better picture of it which showed it to be more extensive than first thought.

I have now had a mastectomy and immediate reconstruction which i am recovering from now.

I have since been back to the hospital to see the consultant who told me it was 3cm in total 2cm on the turn and 1cm full cancer.

I received a letter yesterday saying my surgery had revealed high grade DCIS with a 6mm focus of IDC II,30mm in total the sentinel node biopsy was negative.

My policy was oringnal with colonial but has been taken over by a couple of comanys over the 16 years i had it freinds life are the company now.

My policy says no cover for DCIS but does cover invasive cancer do you think i would have a claim because of the 6mm of IDC.

Thanks for any replys 

Duffer56
Member

Re: Critical Illness Cover

It is so nice to hear! It helps so much to have the financial worry removed so you can concentrate on getting through everything else. x
Dollie7293
Member

Re: Critical Illness Cover

I'm amazed!, within two weeks of putting in my claim I received a phone call from HSBC to say I was successful ! I am now mortgage free with money in the bank. Thank you to everybody in the thread who gave me the hope to put in the claim in the first place x
Duffer56
Member

Re: Critical Illness Cover

I was sent 2 forms - one to give the name of my consultant and the other to give my bank details.
No fuss, no hassle and paid out with three weeks!
Go for it!
Carol
Mel66
Member

Re: Critical Illness Cover

I had critical illness cover on my mortgage and business loan. Took about a month from first phone call to pay out. Not much hassle at all. I gave them the name and contact details of my BCN and they liaised with her to get all the information they needed. As soon as they had the final, post surgery path report they paid up.

It's a hell of a way to get debt free but it certainly eases the stress and financial burden of dealing with it all. I'm so glad I took the critical illness cover out, although I never really thought I'd ever have to claim on it!
Dollie7293
Member

Re: Critical Illness Cover

I have just discovered this thread. I was wondering whether to go through the hassle trying to make a claim at the same time as trying to deal with treatment. Reading your accounts has given me the hope that I may be successful . Fingers crossed
Duffer56
Member

Re: Critical Illness Cover

I second that!

X

Debibay
Member

Re: Critical Illness Cover

Hi everybody, I started this thread last year and thanks to all your advice I made the claim, I sent it in January 2013, my claim took 5 months to go through as my Consultant lost my notes and after a lot of telephone conversations my claim was finally successful.  I have been mortgage free since July last year, and I can tell you it was a great relief.  So if you have critical illness and you are not sure whether to claim, do it because I didn't think I would be covered and I was.  To be mortgage free makes all the difference to your recovery and your life.

So go for it if you have it.

Lakeslover
Member

Re: Critical Illness Cover

I had full node clearance too, and it did take me some time to recover. It does get better in time though.....but I know it can seem to take forever.

You must be more tired too as you are only just getting over the last op.

Thank goodness you decided to have the reconstruction though.

Lakeslover
Member

Re: Critical Illness Cover

I had full node clearance too, and it did take me some time to recover. It does get better in time though.....but I know it can seem to take forever.

tulamo
Member

Re: Critical Illness Cover

Hi Lakeslover, thanks for taking the time to reply.

I still dont know whats going to happen with the insurance company as my consultant hasnt sent them his report yet. I had ANC surgery on Tuesday and he is waiting for the histology from that so he can give them the full picture.

He has told me the lymph node was missed last year as apparently the procedure for identifying the SLN is only 95% accurate and he believes the channel to the affected node had become blocked so the radioactive dye  couldnt drain into it. 

If I had had lumpectomy/ WLE I think I would struggle to get the claim backdated as an invasive cancer could have developed post surgery but as it is breast cancer in the node and I had a mastectomy in Feb 2013 I have not had any breast tissue there for a new breast cancer to develop. Then again what do i know about how this disease works !

Anyway I will just have to wait and see, its not  my main priority just now as I am feeling so sore and exhausted from this last surgery I just want to start feeling better. Ive found this worse than the mastectomy and the reconstruction.

Lakeslover
Member

Re: Critical Illness Cover

Hi,

I noticed you haven't had any replies.

Your situation sounds very unusual, and not straightforward.

Providing the histology of the lymph node now shows invasive cancer you should have a valid claim. I suspect the company will date that claim from the histology date as they have no proof that the invasive cancer was present before then. The only way I can see that they might backdate it is if there are any scan results which might show an abnormal node originally........I doubt there will be though.

with respect to your mortgage although the cover will have decreased over the year hopefully the outstanding mortgage has too as you make repayments.

Good luck with your treatment.

June_BCC
Member

Re: Critical Illness Cover

Hello Tulamo

 

Welcome to the forums, I'm sure other users will be along to support you soon.

 

In addition to the support here we have a free helpline where the staff are on hand weekdays 9-5 and Sat 10-2 with a listening ear for you.  The freephnone number is 0808 800 6000.

 

best wishes

June, moderator

tulamo
Member

Re: Critical Illness Cover

Hi,

I am new here I had a mastectomy in January 2013 but my critical illness claim was refused when the pathology report confirmed the tumour was DCIS.

I had a DIEP reconstruction 3 weeks ago and have just learned that a lymph node removed during that surgery has cancer cells in it.

I have seen my original consultant who said the node been missed during the mastectomy last year.

I have contacted the insurance company and have to complete a new claim form but they have not indicated if they will treat this as a new claim or backdate it to Jan 2013. The policy value decreases annually so it will affect the amount I am paid if this is now deemed to be a qualifying cancer.

I worry they will say the tumour removed was DCIS so cant be what has now been found in the lymph node. I cant find any reference to a situation where a DCIS has progressed to an invasive cancer so am not even sure how it spread to the lymph node.

I am having to deal with so much at the moment recovering from the reconstruction and now facing prospect of treatment for an invasive cancef which could have spread anywhere in the last 13 months. But at least if my mortgage is paid off I can relax a bit re the finances.

PoppyS
Member

Re: Critical Illness Cover

Paid of my mortgage today - thank you guys and what a relief not to hav a mortgage.

 

Best wishes for all your help and support

PoppyS
Member

Re: Critical Illness Cover

Thank you - its certainly will, no more worrying about a mortgage xxx thanks guys this is a fab forum 

Lakeslover
Member

Re: Critical Illness Cover

That's great news. Hope it takes some of the pressure off.