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Insurance payout for sah declined


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Hi my wife suffered from a SAH in February this year and had to have surgery again last week to coil and stent another aneurysm , we have life insurance and critical illness cover with Scottish Provident and have been with them for a number of years , but when we tried to claim they turned us down - stating that my wife had to have permanent neurological deficit in order to be paid out .

 

Its been a long road to recovery for my wife and a very stressful time as a family . I'm disgusted with Scottish Provident , whats the point in paying for policies when they aren't there to help you when you need them most ? Anyone else in the same boat , or anyone can give me any advice on how to get a payout from them ?

 

Many thanks Johnboy .

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Hi Johnboy :)

A very warm welcome to BTG to you and your wife.

I am so sorry you are having this added stress.

Please find these links and hope they help :

http://web.behindthegray.net/index.php?/topic/1529-personal-accident-insurance/

http://web.behindthegray.net/index.php?/topic/1202-critical-illness-cover-subarachnoid-haemorrhage/

http://web.behindthegray.net/index.php?/topic/1502-life-cover/

There maybe others that can offer advice.

I wish you both well.

Take care

Tina.

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Hi there warm welcome.

 

Sorry to hear what your going through, we never claimed when I had my SAH (maybe should have it would have helped) so sorry cant help but usually someone comes along at some point that can help.

 

I'm not surprised your disgusted with them I would be, (my first instint is to say go to the papers/watch dog) because you take the insurance out in good faith thinking that when needed your covered...

 

take care all the best.

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Hi, you could try the Citizens Advice Bureau for free, practical help? .... they might be able to point you in the right direction.

 

Don't give up, Insurance companies seem to be notorious for not wanting to pay out for any type of policy.

 

I've had a SAH and would I say that I've had permanent neurological deficit? I would say that yes I have in layman's terms ... I haven't been able to return to work. I'm still having a lot of problems that I would rather not have to deal with. Luckily, I wasn't the major wage earner in the household.

 

A SAH is a type of haemorrhagic stroke ... I would advise you to do some research on the subject of SAH/stroke if you haven't already done so and also may be find other online forums that can specifically help you with your Insurance claim? .... they may have professional people on there that will help you out or point you in the right direction as what you need to do next.

 

Don't give up and become such a pain in the backside to the Insurance company that they will be sick of hearing your name .... it shouldn't have to be that way, but unfortunately it seems to be a battle of wills.  

 

Wishing your Wife well again ... and the very best of luck. I would definitely contact the Citizens Advice Bureau as your first port of call.... https://www.citizensadvice.org.uk/

 

xx

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If you get no joy from any of the suggestions above I would suggest that you consider contacting your MP. Sometimes, when they get involved there is a sudden change of heart and they pay out.

 

As Karen says insurance companies are quick to take your money off you but try every trick in the book not to part with any.

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I wish you good luck Johnboy,

 

Now get out there with gun blazing j/k,  but it's annoying when they don't pay out.  Take your money quick enough.

 

Good luck and put it on Face Book about them name and shame them xx

 

Winb143 xx

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Good Luck BUPA did this to my aunt who was battling metastasising cancer for years. They paid so much money to the health plan over decades that seeing the insurers try to bully her when she needed them was outrageous, afterwards they had to obtain permission before committing to any (necessary or urgent) scans, the stress and waiting for permission was putting her in danger.

 

Don't let them get away with anything. As Karen says, become a pain in the backside, keep at them all the time, try to keep calm and you'll finish up getting the upper hand again. All my good wishes for your wife, best keep her outside the loop on the stressful considerations of health insurance if you can, stress is to be avoided as much as humanly possible after an SAH. 

 

Best wishes,

Sammy Anne

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I would be surprised if the critical illness doesn't cover stroke and as Karen says I think that's the angle to go for. Also an offer of a letter from Gp consultant may well change opinions. Ask them to clarify exactly why an SAH and bleed on the brain is not considered a critical illness , there's not much more that is critical than that and most don't survive it . Go back to them. Don't accept the first answer.

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I would check the policy for terms and definitions. Then get a letter from your consultant that, hopefully, compares favourably with those terms and conditions, in particular with regard to long term effects and re-submit.

 

Choose your words very carefully and even consider consulting/using a solicitor specialising in medical cases if necessary.if only to get an opinion.

 

It may cost a little in the short term but the longer term benefits may make it worth it.

 

Good luck,

 

Macca

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Welcome Johnboy, to you and you wife,

According to my neurologist ( in USA) SAH causes brain cells to die and even those of us who come through with very good outcomes have some sort of permanent damage. The particular deficits depend upon where the bleed occurred ( that is, what functions are governed by that part of the brain). I'm not familiar with medical systems in other countries, but perhaps your wife's neuro can help support your case.

Good luck.

Colleen

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  • 3 months later...
Ask them to clarify exactly why an SAH and bleed on the brain is not considered a critical illness , there's not much more that is critical than that and most don't survive it . Go back to them. Don't accept the first answer.

 

I am having the same trouble with my claim here in the US, awaiting a hearing that I am hopeful when my case is reviewed by the "ALJ aka Administrative Law Judge. I like this information. I am currently printing case studies and highlighting the areas I have disabilities with.

I was point blank told by my Neuro to file when I asked him if all this is for real.

I hope you have success with the suggestions you've received. I retained legal help a year in after I filed.

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