Brownlegs - diagnosed with DCIS for second time and insurance company refused to pay out again

Morning 

I was diagnosed with DCIS for the second time -and had to have my breast removed and now on chemo tablets . Legal and general refused to payout again approached the ombudsman who sided with legal an general. What more can I do? Just get diagnosed with terminal illnesses?  It really has affected my state of mind on anti depressants which is not helping either 

  • Hello Brownlegs and welcome to the forum.

    I'm really sorry to hear you have been diagnosed with DCIS for a second time and of the troubles you've had with your insurance claim. It sounds like things have been tough but I'm glad you've reached out to us as our community is full of very supportive and understanding members who will have some knowledge of what you are going through, so you are not alone, and hopefully you won't have to wait too long to hear from them.

    Although you don’t mention the type of insurance, it sounds like you may be talking about critical illness insurance? In short, it all depends on the terms of your policy. Usually, if a valid claim is made they will pay out your amount of critical illness cover in full, once. After this happens, the policy will end and you’ll no longer have any cover. There are some types of critical illness insurance policies that will make partial payments if the illness is still treatable. These are called scaled critical illness insurance policies. Usually, you can still make another claim. It will just deduct the amount that has already been partially paid.

    I am not sure what sort of policy you had, and as we don’t have insurance experts here at Cancer Research, it might be worth contacting Citizens Advice if you still feel you have been unfairly treated as this is an area they would have more knowledge of. I hope this information I've found about critical illness insurance and what is generally covered will be useful. The cancer charity Macmillan do have benefits advisers so you might want to give them a call to talk things through as well.

    Given everything that has happened, it's completely understandable, and natural, for this to have an impact on your mental health. I'm not sure from your post how long you have been on anti depressants but they can take a little while before you start seeing the benefits of taking them. Hopefully this will happen sooner rather than later, but in the meantime, I do hope this information and advice on coping with your mental health will help you during this difficult time.

    We're thinking of you Brownlegs and sending our strength and support your way.

    Kind regards,

    Steph, Cancer Chat Moderator

  • Hi, thanks for your reply, I first was diagnosed with DCIS and had part of my breast removed . Have critical illness cover with legal and general , they refused to pay out  as they said it wasn’t covered . To scared to cancel policy I kept on paying it. Ten years DCIS returned and I had to get mastectomy and was put on chemo tablets. Went back to legal and general only to be told no again . 

  • Hi there,

    Ductal carcinoma in situ is sometimes excluded under critical illness policies as it means the tumour is contained and hasn't invaded surrounding tissue. I'm a financial adviser and I've seen this exclusion on CI policies before. If the ombudsman agrees with L&G it must be because DCIS was excluded on your policy. Sorry to hear about your situation, very frustrating. 

    Jane x

  • I appreciate your reply however to loose my breast and to be on chemo tablets for the rest of my life is so unfair