Private insurance work cover complications

I had a mastectomy Diep reconstruction in March 2018 which was successful but unfortunately I developed a large hernia on my tummy scar. It’s grown a lot on the six months throughout chemo and radio treatment and now that I’m finished I need it repaired. My insurance say it’s not covered under my policy. Does anyone out there have any experience in this department (as a patient or someone who works in the industry) It shocks me that they can dismiss me as a patient just because I had complications.

Any suggestions on how to challenge this would be greatly appreciated

Thanks.

That was meant to read Private Insurace WONT cover complications.

Thanks for your email and I’m so sorry about your mum. ?
It turns out the line in the policy that they keep going back to is “no follow up surgery on anything relating to the reconstruction”. Which I assume is written in there to protect themselves against women who might want second and third surgeries to correct the look of their reconstructed breast. And in some ways I get that they could be caught up in multiple pay outs as we all know boobs don’t usually match after.
So I see their point that they don’t want to revisit. But I had had a brief conversation with someone there two months ago and that person said the hernia would be covered. So today I asked them to listen back to that conversation to prove my point that I was mislead. They did and they have concluded that I was mislead. So it’s back on and they will cover it now. Phew. They still stick by the line that this is a revisit of the reconstruction but I’m now beyond caring. I’m just glad it’s still going ahead next week and I can close this chapter!

Thanks for your input and good luck with all things in the future.

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