written by Tim_Earnshaw on 09/01/2015
I purchased a full policy for myself and family, 2 adults, 2 children in total, and selected the full package at a cost of around £2,500.
First time I put in a claim, which was when my 18 month old daughter was diagnosed with a serious heart condition, it was rejected. The basis for the rejection? She had a slow heart rate when she was in the womb which is a SYMPTOM of the condition she now has, even though at birth the condition she now has was ruled-out.
At birth it was confirmed that she had a hole to her heart and the heart rate self-corrected and became normal again. She saw multiple specialists, had every test under the sun, all on the NHS, and was confirmed as having no problem other than the hole. Multiple ECG's were all normal, including thrice daily ones done in intensive care for 5 days straight, after birth.
Two weeks ago, her heart rate was spotted as being very low and ECG's were run and she was diagnosed with a condition called heartblock which is to do with electrical system of the heart. It is totally unrelated to the hole but does manifest itself as a slow heart rate.
I have been told that a slow heart rate was a symptom previously noted and as such anything that relates to a slow heart rate is excluded. Exact words were that they determine eligibility based on SYMPTOMS as well as DIAGNOSES. And since she had shown the SYMPTOM of a slow heart rate, treatment of any CONDITION of which a slow rate is a symptom is excluded. I said that was like me going to the doctors with a headache and being told I had flu and take aspirin, then going back to doctors 2 years later with headache, being diagnosed with a brain tumour and treatment being excluded on the basis I had previously shown the SYMPTOM of a headache. Their response? Won't comment on hypotheticals, but if I want to submit further medical opinion they will review. I asked them to put in writing the basis for their rejecting my claim so I could have an appropriate response written by our consultant, to which they said that due to data protection they can't do that. So I am supposed to get a consultant to respond without actually seeing the basis for their rejection.
So my experience has not been positive at all - typical insurance company behaviour, quick to take your money and when you need it they seek to wriggle out of paying up. For my money, this policy is not worth the paper it is written on.
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