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Will my insurance pay out

hello,

need advise or help if people have experience. Been diagnosed with MS and have put a claim into my insurance for my Critical illness cover. Went through my claim and now am freaking out because wanting to be honest I told them when asked “has anyone in your family had MS” I told them about my great uncle had it. I only found this out when I got diagnosed from my mum. Never knew anything about the man till then. Looking over my original application it asked “had anyone ever had or has MS” which I said No to. What do I do? Phone them and make sure its clear that finding out my great uncle had it was fresh news or will that look worst. Does it not count if it goes so far back in your family, because who know that much medical history. Help please

I understand you said ‘no’ when asked if anyone in your family had m.s. What is not clear from your post is when and why did you tell them about your great-uncle? I would NOT contact them but wait for them to come back to you.

I understand you said ‘no’ when asked if anyone in your family had m.s. What is not clear from your post is when and why did you tell them about your great-uncle? I would NOT contact them but wait for them to come back to you.

You answered the original application question honestly to the best of your knowledge. Personally, I would be inclined to sit on my hands for now and let the process play itself out. If they accept your claim, then hurrah for that. If they reject your claim on the grounds of undisclosed FH, then’s the time to to into battle with your, perfectly truthful, explanation of the discrepancy between the information you disclosed on your application for and your claim form. But go with your instinct - if you feel you need to flag it up now, then do. There are no right answers here, and your own feelings will be your best guide.

Good luck.

Alison

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You could ring and simply say you were filling in your claim and your mum suddenly told you way back she just remembered your great uncle was supposed to have had it. However you were not aware of this on your original paperwork. Its not an hereditary disease anyway. I think if it was me, i would ring them personally. Like you said it was genuine as the knowledge about it at the time was not passed on to you. Perhaps your mum only just found out about it herself.

Genetic Factors

MS is not an inherited disease, meaning it is not a disease that is passed down from generation to generation. However, in MS there is genetic risk that may be inherited. In the general population, the risk of developing MS is about 1 in 750 - 1000. In identical twins, if one twin has MS the risk that the other twin will develop MS is about 1 in 4. The risk of developing MS is also increased when other first degree relative (parents, siblings and children) have MS, but far less than in identical twins.

About 200 genes have been identified that each contribute a small amount to the overall risk of developing MS. Research is ongoing to better understand genetic risk and other factors that contribute to the development of MS.

Personally I would sit tight at the moment. Ringing up now might muddy the waters a little whilst your claim is being looked at. As far as you are concerned you filled in the original application to the best of your knowledge at that time.

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totally agree jactac.

[quote=“Crazy Chick”]

You could ring and simply say you were filling in your claim and your mum suddenly told you way back she just remembered your great uncle was supposed to have had it. However you were not aware of this on your original paperwork. Its not an hereditary disease anyway. I think if it was me, i would ring them personally. Like you said it was genuine as the knowledge about it at the time was not passed on to you. Perhaps your mum only just found out about it herself.

Genetic Factors

MS is not an inherited disease, meaning it is not a disease that is passed down from generation to generation. However, in MS there is genetic risk that may be inherited. In the general population, the risk of developing MS is about 1 in 750 - 1000. In identical twins, if one twin has MS the risk that the other twin will develop MS is about 1 in 4. The risk of developing MS is also increased when other first degree relative (parents, siblings and children) have MS, but far less than in identical twins.

About 200 genes have been identified that each contribute a small amount to the overall risk of developing MS. Research is ongoing to better understand genetic risk and other factors that contribute to the development of MS.

[/quote] I find the whole issue of genetic risk in m.s. very interesting but it doesn’t seem to get much publicity. Or perhaps I am missing something. Has anyone with m.s. who has the misfortune to have a close relative also with m.s. ever been part of a genetic testing protocol where both people are tested.

[quote=“krakowian”] [quote=Crazy Chick]

Genetic Factors

MS is not an inherited disease, meaning it is not a disease that is passed down from generation to generation. However, in MS there is genetic risk that may be inherited. In the general population, the risk of developing MS is about 1 in 750 - 1000. In identical twins, if one twin has MS the risk that the other twin will develop MS is about 1 in 4. The risk of developing MS is also increased when other first degree relative (parents, siblings and children) have MS, but far less than in identical twins.

About 200 genes have been identified that each contribute a small amount to the overall risk of developing MS. Research is ongoing to better understand genetic risk and other factors that contribute to the development of MS.

[/quote] I find the whole issue of genetic risk in m.s. very interesting but it doesn’t seem to get much publicity. Or perhaps I am missing something.

"Has anyone with m.s. who has the misfortune to have a close relative also with m.s. ever been part of a genetic testing protocol where both people are tested".[/quote]

Myself, sister and first cousin all have MS, we all attend the same MS clinic and actually have the same consultant, but if we ask about a genetic link it’s not really taken on board or looked into.

if 2 people in the same family have m.s. then I would think it would make sense for the to have some genetic testing - and also to check other family members who don’t have m.s. to see what the difference is? I wonder if the possibility of there being a genetic cause threatens the medical profession and the all powerful drug companies.

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Totally agree with jactac

Just as said they will try anything to get out of paying a claim.

Please confirm with the Neurologisst the diagnosis. Most policies state you must show symptoms for 6 months. You probably qualify now but if not it’s only time.

You may have to fight your corner; don’t give up; see below; different circumstances but just to show you must not take no for an answer.

MS patient wins cash battle with insurer
A woman with multiple sclerosis has won a legal battle with an insurance firm that refused to pay out under critical illness policies after she was diagnosed with the illness.

The exact worth of Valerie Cuthbertson’s Court of Session victory over Friends Provident has still to be finalised, but she should receive about a £50,000 lump sum and a weekly payment of £139.

The court heard that the firm had used questionable methods in its search for evidence to invalidate the policies and had latched on to entries in Ms Cuthbertson’s medical records. She had not disclosed a handful of appointments with her doctor in the application forms for the insurance, but the judge ruled that she had no reason to believe those were of any importance.

Ms Cuthbertson said: “It has been a long time, five and a half years, but I felt I had to take it all the way because they were wrong. I felt I had a really good case, and I think for anybody else going through this sort of thing, they will take heart from this.”

Ms Cuthbertson, 39, a theatre manager from Glasgow, took out the cover in 1994. Nearly two years later, she was diagnosed with MS but did not appreciate that the policies covered her condition and made no claim.

Then, in 1999, a representative of Friends Provident called on her to review her financial affairs. He arranged for a claim form to be sent to her and Ms Cuthbertson submitted it.

Friends Provident obtained a report from her consultant neurologist, who confirmed an unequivocal diagnosis of MS. A request was then made to her GP for sight of her medical records.

In his judgment yesterday, Lord Eassie said: "The letter referred to the notes being required to help [the firm’s] chief medical officer in the assessment of the claim and stated that they would be given ‘careful and sympathetic consideration’.

“However … [the firm] had already obtained all the information they required to satisfy themselves that [Ms Cuthbertson] had multiple sclerosis, and the only purpose of recovering the GP records was to see whether … there was any entry which might give grounds for avoiding or invalidating the policy under which the claim was being made.”

Friends Provident did reject the claim on the ground that Ms Cuthbertson had failed to disclose her full medical history.
In its defences, Friends Provident cited five consultations with the GP which, it claimed, ought to have been disclosed. Those took place between 1990 and 1994 and involved complaints about eye pain, an ear problem and tingling in a leg.

Ms Cuthbertson’s neurologist said that, with the benefit of hindsight, and knowing her now to have MS, it might be possible “to discern in some of the entries a possible indication that she was developing the unfortunate disorder”. However, he would not have expected a GP to have been alerted to the possible significance of the incidents.
Lord Eassie said: “I am satisfied that, at the time of answering the matters raised in the application forms, she did not think that the consultations with her GP were of any materiality.”

Source: The Scotsman ©2006 Scotsman.com

Although it is not precedence in the UK because of EU laws a judge will take this into consideration.

This ‘deferral period’ is probably referring to your claim time. I seem to remember a person who’s Insurance Company would not pay him as there is a difference in getting your CI through your work or privately. Through your work have I believe a 2 year period before you can claim; I may be wrong on this.

Also see http://www.thisismoney.co.uk/money/news/article-2287035/Financial-Mail-wins-280k-payout-MS-sufferer-spent-3-years-battling-L-G.html

This means it’s a precedent in England.

Hello all,

thank you so much for all your advise and time in advising me. The insurance company phone the next day to tell me the progress of my case. Waiting on confirmation from the specialist. I took the opportunity to be clear when I was told about my great uncle. Hard to get a true reading as it is not the person making the decision on the phone but she thanked me for making it clear and told me that it would be added to the record. I told my Nuroligisr and incase it was in his file I didn’t want it to seem like I withheld information.

Thanks again everyone