BBC Watchdog: Cancer excluded from critical illness insurance

Tony

What Consumer Founder
Apr 7, 2008
18,307
3
38
Bolton
Taking out critical illness insurance might not be the most pleasing thing to go shopping for, but at least it's practical - especially if your mortgage or business depends on you being fit enough to work.

The premise is that you'll receive a pay out from your insurer, depending on how much you pay them, for a diagnosis of a critical illnesses within seven core areas; heart attack, kidney failure, major organ transplants, multiple sclerosis, stroke - and cancer.

So imagine how you'd feel if you did get cancer, but your insurer said it didn't count?

Watchdog has heard from several women this has happened to. In addition to being told they've got cancer, they also find out they're not going to receive any of the financial support they thought they'd paid for.

That's because they've been diagnosed with an early form of breast cancer called Ductal Carcinoma In Situ (DCIS). This is when a non-malignant tumour has been found, which has the potential to become malignant and spread, but because it's caught early is still contained.

Claire Carlson took two critical illness policies out with Norwich Union in 2001, costing £180 a month, because the bank wanted to make sure she'd be able to pay off her mortgages if she became too ill to work.

She was diagnosed with DCIS in March 2006, and it was explained to her that her form of cancer, while still in the 'in situ' phase, was also high-grade and therefore likely to become invasive. If this was allowed to happen she would stand a low chance of survival.

She was given immediate surgery to remove the lump, followed by radiotherapy treatment to reduce the chance of the cancer spreading.

An important factor in ensuring against this was to rest and recuperate. Fortunately Claire had taken out a critical illness policy to protect her from having to work.

Or so she thought.

Claire's claim was rejected because the type of cancer she had was excluded from her policy. Norwich Union told her that the medical information for her illness did not support a valid claim.

She told Watchdog: "When I read the policy, not knowing very much about cancer, I thought of it as one disease - I didn't know it comes in different forms - and I didn't know what in-situ meant. It was explained to me that it was a type of cancer that hasn't progressed to the type that could kill me - yet - and they don't cover you for this."

Claire took her case to the Financial Services Ombudsman, but told her they felt that the documentation was clear, and therefore were unable to uphold her complaint against Norwich Union.

Impossible position
The women that get DCIS are put in an impossible position - they need to have the necessary treatment to remove it before it invades, but in doing so won't receive the money they need, because their critical illness policy only covers them if it spreads.

That means if the cancer hadn't been detected, and had spread, she could have received a pay out.

Instead, Claire was forced back to work soon after her first diagnosis - and unfortunately was diagnosed with DCIS again in December 2007.

She said: "When I was told I had in-situ again I thought to myself, "I can't afford to have this - what's my family going to do"? I felt desperate - I was told I needed months off work. You even end up thinking if it had invaded, at least I wouldn't be a financial burden."

Because it had returned, they took no chances and removed the breast completely. However, complications with her skin healing following the mastectomy led Claire to need a further eight operations, leaving her physically unable to work.

"I feel that I've never fully gained my strength and can only do a fraction of what I could before I had my mastectomy. It's a disabling amputation - one that leaves you totally incapacitated - but I'm never going to get any money."

The fact is, it's standard across the industry to exclude carcinomas in-situ - cancers that haven't yet invaded surrounding tissue. Out of around 60 providers, offering a range of about 200 different versions of cover, there are only the following providers with products that pay out to policyholders undergoing mastectomies due to DCIS:

<ul> Skandia's Skandia Protect product pays up to £10,000.
 

Jorumian

Facilitator
Sep 1, 2008
347
3
0
Birkenhead
Absolutely scandalous.

Insurance companies are amongst the biggest con-merchants in this country. Whilst taking the money they promise the Earth, but when it comes to actually doing what they are supposed to, they will find ANY possible reason not to pay you.

Companies should hang their head in shame. Since when is a matter of life or death a technicality?
 

kris1anne

New Member
Jan 29, 2009
138
0
0
This is one of the most shocking stories you have had here in a while Tony. We consumers buy our insurances in good faith that should we need them they will be there. To put people already ill with massive turmoil in their lives through this is utterly inhuman!
 

mst007

New Member
Aug 12, 2016
1
0
0
my friend had critical illness cover. unfortunately got bowel cancer, had hid bowel removed. the insurers would not pay out. they said he would have to be dying to receive it? surely this is life insurance?