Recommendations for a medical lawyer

[Boylston]

Hi All,

I'm looking for some recommendations for a medical lawyer to provide some advice. Background is that I had a large (3lb) tumor removed from my chest last year. It's a very rare type. Via my employer I have 2X annual salary group critical illness insurance (via Canada Life) that covers a range of serious medical conditions with very prescriptive definitions. The insurance company has just rejected my claim, for reasons that look to an amateur, as a technicality.

It would be great to get some expert advice on this matter, thus asking the PH for recommendations.

Cheers

Simon

[Nezquick]

I think you need more of a contract lawyer, not a medical lawyer.

[Boylston]

OK, fair enough, but it's looks like it's going to come down to a difference of medical opinions and splitting hairs on medical definitions. Hence the request for someone who has experience in this realm of medical experts and how to appeal the verdict.

Open to suggestions!

Cheers

Simon

[syl]

I suspect that if the tumour was malignant they will pay out, but if it was benign, they won’t, no matter the size.

[Boylston]

Not to go into too may details, but it was an extremely rare type of tumor (maybe 300 cases in total) that doesn't fit the normal aggressive cancer profile and thus the boundaries set in the insurance scheme document. A consultant pathologist has provided a report stating it was malignant. Oh and I'm having CT scans ever six months for 5 years.

So any recommendations of a legal expert to help guide me would be very helpful.

Simon

[Voldemort]

https://www.irwinmitchell.com/

[jm doc]

Boylston said:

Not to go into too may details, but it was an extremely rare type of tumor (maybe 300 cases in total) that doesn't fit the normal aggressive cancer profile and thus the boundaries set in the insurance scheme document. A consultant pathologist has provided a report stating it was malignant. Oh and I'm having CT scans ever six months for 5 years.

So any recommendations of a legal expert to help guide me would be very helpful.

Simon

I am not a lawyer but have a lot of experience of insurance in a medical capacity. I would suspect they are just playing hardball and hoping you will go away. In my experience they will do anything to try and get out of a claim. If at the end of the day an independent (especially working in his NHS role) pathologist has said the tumour is malignant and as the follow up is typical of that for a malignant tumour, I can't see them wriggling out of it in a court if it even gets that far.

Stick to your guns, get a half decent lawyer and I would be very surprised if they don't fold. Good luck.

[Boylston]

Thank you Paul for the recommendation. Looking at their website now.

JM - Thanks for the encouragement. I'll come back to the thread at some point and let you know how I get on.

Cheers

Simon

[martinbiz]

Boylston said:

Thank you Paul for the recommendation. Looking at their website now.

JM - Thanks for the encouragement. I'll come back to the thread at some point and let you know how I get on.

Cheers

Simon

There’s a surprise an insurance company trying to abrogate their responsibilities, a bunch of robbing immoral c***s 99% of them

[barian]

One way forward, if you have not already considered it, would be to make a complaint to the Financial Ombudsman Service (https://www.financial-ombudsman.org.uk/ ). Normally, you would have made a formal complaint to the insurance company and received their final response. You would need to raise the matter with the FOS within 6 months of the date of the final response.

[Boylston]

barian said:

One way forward, if you have not already considered it, would be to make a complaint to the Financial Ombudsman Service (https://www.financial-ombudsman.org.uk/ ). Normally, you would have made a formal complaint to the insurance company and received their final response. You would need to raise the matter with the FOS within 6 months of the date of the final response.

Thanks. That is a good suggestion!

It's not a surprise they are fighting this, as its a chunky amount of money!

Simon