November 4, 2013

Claim paid imageCase study – Critical illness claim story

This story has been written by our client who’s critical illness claim was paid last week. She took out a decreasing term life or earlier critical illness policy with Ageas Protect in August 2009 with an original sum assured of £175,000 over a term of 25 years and was paying a premium of £34.69 per month.

My story:

A happy 36 year old, met someone special in January 2011.  Everything was going well, I couldn’t have been happier.  I had bought my house in 2009, and had to be grown up and responsible with doing this and taking out a mortgage, so I took out Life and Critical Illness cover along with income protection.

I had a routine biopsy late December 2011, to check the cells of the uterus, since I had PCOS (Polycystic Ovary Syndrome) from my teenage years.  The results seemed to take a while, they sent me a follow up appointment to see the doctor, then cancelled it and rebooked it for the week after – mid January 2012.

I went along to the appointment on my own, since I was expecting it to be just a routine Gynaecological appointment.  The hospital went about things in a quite a unprofessional manner, there was some sort of nurse/specialist nurse running around, checking a file, running off, going to see the doctor, running off again. Usually it is just a regular nurse that sees me so I thought there was something not right!

I saw the consultant along with a junior doctor and the specialist nurse and the consultant just said that I had cancer just like that.  I was quite matter of fact about it all, asked what the results had shown, and what I did next.  They said the cells had shown to be cancerous, but they were to refer me to UCLH and I would be under their care.  I was constantly asked if I was ok, since I hadn’t broken down on the floor.

I had my referral within a week, the longest week ever, during this time, had the MRI too.  This didn’t show anything, but I was given 2 options at UCLH to either take tablets to try to reverse or the extreme hysterectomy.  I had a week to think about what I wanted to do, chose the latter option, since I couldn’t wait to see if the tablets were working or not, and then have to take that option regardless.  Luckily I made the right decision, there was a 3cm tumour growing in the middle of the womb, and the MRI hadn’t picked this up!  I had the op mid Febuary 2012, off work for 6 weeks then back.

The Outcome

I did dig out my policy, read through it, thought it had to be terminal and since mine wasn’t, put it away and forgot all about it.  Until I had a call from Future Proof a few months ago to review my policy etc.  All was going well until I was asked about my current health, when I mentioned last year I wasn’t too good but was fine now, and explained what had happened.  The advisor – Alex – went through my current policy and explained that many people thought it had to be terminal to claim, that the life insurance does have to be but the critical illness did not have to, since that cover is for Critical Illnesses which fall into the scope of those covered.

I rang up my CI claims team, explained the situation, they sent me out a claim form to complete in a few days, I completed it and sent it back signed for post.  I spoke to them again, they had written to both my GP and consultant, the GP had responded but they were awaiting reports from the consultant.  This finally got to them last week and today I had a call to say my claim had been successful.  I cannot thank Alex enough, if he hadn’t explained and clarified what I had thought that both had to be terminal, I wouldn’t have had such an outstanding outcome.

Please note that any premiums mentioned are indicative only and based on this specific case study/ example, which is shown for information purposes only. Your own circumstances will determine whether the amount payable is more or less than the figure quoted.

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