Ask the Doctor
July 1, 2014

Can I challenge decisions of my insurer?

Dear Doc,

I was diagnosed with cancer but my insurance carrier refused to pay the charges for my treatment, claiming that I had only recently gotten the policy; but I know of persons who are receiving treatment for cancer for many years with the same company. Can I challenge their decision?{{more}}


Dear Joel,

It is always important to read the policy that you are about to purchase and make sure that upon purchase, the terms and conditions are clearly noted. In most cases it turns out that it is poor communication between the insurance agent and the policyholder that causes problems.

It must also be noted that insurance companies are in a business to make a profit and when they sell insurance policies they are taking a risk that you would not get sick. It means therefore that they would have clauses stating that if you develop certain conditions within a specified time limit it is deemed that you had it at time of purchase and hence you would not be covered for that illness. The latter is a called a pre-existing condition.

It is always a wise move to purchase insurance at a young age when your health is generally better and thus without any pre-existing condition that can hinder your chance of getting health insurance coverage.

You can challenge the insurer, but read your policy document properly and then seek advice before undertaking what can be an expensive and long legal battle.

Always read your policy. The prints are not always fine.


SVG Cancer Society,

P.O. Box 709, Kingstown.