PSA value of 11, but I have a UTI.

[Lorry]

1 hour ago, simon43 said:

Unfortunately, April's T&Cs state that they can deny you cover/cancel the policy if you fail to disclose any health condition, whether or not it is relevant to the condition that you're claiming for.

Yes.

The question is whether this reasoning would stand up in a French court. 

I have no idea.

1 hour ago, simon43 said:

 

If it hadn't been the BPH, it would have been my bunion......

Exactly.

 

BTW I am a bit confused. You say you never got in writing that you have BPH - so why does April think so?

[scubascuba3]

6 hours ago, simon43 said:

 

In any case, BPH has nothing to do with prostate cancer at all.  That is a proven fact.  It is like being refused treatment for prostate cancer because you failed to disclose that you have a bunion on your right foot.  It is irrelevant.  Unfortunately, April's T&Cs state that they can deny you cover/cancel the policy if you fail to disclose any health condition, whether or not it is relevant to the condition that you're claiming for.

 

If it hadn't been the BPH, it would have been my bunion......

I reckon the insurer realised this could get expensive and found a way to terminate the policy. They use an alleged undisclosed preexisting condition to cancel the whole policy, their gamble is most expats won't take it further

[simon43]

[quote]

...

BTW I am a bit confused. You say you never got in writing that you have BPH - so why does April think so?

[/quote]

 

This was disclosed in the medical report that Bumrungrad sent to April after the MRI scan and DRE, which indicated 'modest BPH', (in their own words).

[nigelforbes]

6 minutes ago, simon43 said:

[quote]

...

BTW I am a bit confused. You say you never got in writing that you have BPH - so why does April think so?

[/quote]

 

This was disclosed in the medical report that Bumrungrad sent to April after the MRI scan and DRE, which indicated 'modest BPH', (in their own words).

Interesting. I was refused a medical insurance add on to a life insurance policy, a  medical report from BG, relating to one specific event, 16 years ago was the only medical report they  requested. I was very surprised, as was the agent. At the time I did not realise anything was amiss and that the problem had been dealt with, the insurer took a different view.

[Sheryl]

19 hours ago, Lorry said:

(from Art L 113-8)

 

Does the fact he didn't mention BPH diminish the insurer's opinion of the risk?

Simon thinks no. He thinks "BPH is not an illness".

I think he is wrong. But I also know of insurance companies that would not follow April's logic.

 

 Yesa, it diminshes the insurer's opinion of risk. Any insurer.

 

BPH is indeed a disease, one that usually  requires medication and often eventually surgery or other invasive treatments. It can lead to urinary retention which in turn can infection, even sepsis. Certainly any insurer knowing an applicant has BPH will either exclude prostate conditions or apply a premium load as there is greater chance of hospitalization  than in someone without this condition.

 

Being age-related does not make something not a disease; many diseases (arthritis etc) are a natural result of the aging process.

 

The reason most would exclude all prostate related problems and not just BPH is that, even though BPH does not increase the risk of prostate cancer,  the odds of needing MRIs and  biopsy to rule out cancer are higher if someone has BPH as it can be  difficult to distinguish between the two.

 

I had a somewhat analogous situation as I had mild (and well controlled) hypothyroidism at time of my insurance application. Detected on a routine physical check up and beyond that never saw a doctor for it, managed it myself with meds since they are over the counter here.

 

I declared it on the insurance application and I was given the option of either a slightly higher premium or an exclusion of all thyroid conditions, I took the latter. At the time it seemed a bit silly to me since my application was for hospitalization only cover and management of hypothyroidism is usually a simple outpatient matter, and the condition does nto increase the risk of thyroid cancer.   However while hypothyroidism seldom required hospitalization and does not increase the risk of thyroid cancer, it does increase the risk of benign thyroid nodules which may have to be biopsied to rule out malignancy...and indeed a few years later that is exactly what happened (I paid for the biopsy out of pocket. Not big money and result benign, fortunately).

 

I think Simon could make a plausible case that he did not act in bad faith (if he words it right) and thereby get part of his premium refunded. That's the best that can be hoped for from an appeal but since the appeals process is pretty simple no reason not to do it unless the amount he'd get back is really small, which depends on how much time was left under the premium payment.

 

If Simon  had declared the BPH on his application, unless they offered and he accepted a premium load rather than exclusion, he'd still not have cover for the care he needs now- but his policy would still be in effect covering him for other things and he'd have known from the start that he wasn't covered for prostate which would likely have altered his choice in where to seek care.

[Sheryl]

6 hours ago, scubascuba3 said:

I reckon the insurer realised this could get expensive and found a way to terminate the policy. They use an alleged undisclosed preexisting condition to cancel the whole policy, their gamble is most expats won't take it further

Not "alleged". He has the condition and had it at the time of application.

 

In any insurance policy, if it is found your application contained falsehoods or omissions, it invalidates the entire policy. Sometimes insurers will not invoke that, but they always can. And yes, the knowledge that he may have cancer may have influenced the decision to invoke their right to nullify the policy.

[Tedkhon]

It could be the insurance company asked about the BPH symptoms because the op stated it in the very first posting on this thread.

 

This is a world wide public message forum. Nothing is private. Is it not possible april international has searches running to find when the company is being discussed on the internet.

 

Many companies do that.

 

Have you considered the insurance company is reading what you write ?

 

[BritManToo]

10 minutes ago, Tedkhon said:

This is a world wide public message forum. Nothing is private. Is it not possible april international has searches running to find when the company is being discussed on the internet.

Wondering how much money April will lose from this thread Vs the money they would have gained from new customers?

 

6,200 views so far, can't imagine anyone who read this thread buying April insurance in the future.

Edited January 29, 2023 by BritManToo

[Lorry]

1 hour ago, simon43 said:

[quote]

...

BTW I am a bit confused. You say you never got in writing that you have BPH - so why does April think so?

[/quote]

 

This was disclosed in the medical report that Bumrungrad sent to April after the MRI scan and DRE, which indicated 'modest BPH', (in their own words).

You say Bumrungrad found BPH.

So, why does April  think it was an existing condition at the time you bought the policy?

And why do they think you knew about BPH at the time you bought the policy?

Really confused. 

 

PS Oh, Sheryl just answered my question in her next post.

Looks not good for Simon IMO

Edited January 29, 2023 by Lorry

[Sheryl]

9 minutes ago, Tedkhon said:

It could be the insurance company asked about the BPH symptoms because the op stated it in the very first posting on this thread.

 

This is a world wide public message forum. Nothing is private. Is it not possible april international has searches running to find when the company is being discussed on the internet.

 

Many companies do that.

 

Have you considered the insurance company is reading what you write ?

 

 

I very much doubt the compan reads this website or runs searches of fi=orums. Hardy worth their time and tey are very busy.

 

As OP has already stated, BPH was mentioned on the form submitted by the hospital in the first place. The insurer then contacted OP asking for more information and OP sent them copies of lab tests dating back to before he got his policy.

[Lorry]

2 minutes ago, BritManToo said:

Wondering how much money April will lose from this thread Vs the money they would have gained from new customers?

 

6,200 views so far, can't imagine anyone who read this thread buying April insurance in the future.

555

I was thinking about buying April :)

Quote: "was"

[Sheryl]

Just now, Lorry said:

You say Bumrungrad found BPH.

So, why does April  think it was an existing condition at the time you bought the policy?

And why do they think you knew about BPH at the time you bought the policy?

Really confused. 

They contacted him and asked for more info and he sent him all his prior lab results etc.

 

That is how they know it existed at the time of application.

 

(On the other hand the fact that he readily sent them those reports  can be used to support the argument that the omission on the application form was inadvertant and not an act if bad faith).

[Sheryl]

Just now, Lorry said:

555

I was thinking about buying April ????

Quote: "was"

 I have it and it has been fine for me. Claims all paid with no problems.

 

Just be sure to fully disclose any and all conditions, meds taken etc  on the health questionnaire.

 

There will be problems with any insurer if one does nto do that and they later find out.

[Lorry]

54 minutes ago, Sheryl said:

Yesa, it diminshes the insurer's opinion of risk. Any insurer.

Generally true, but not "any" insurerer.

 

5 minutes ago, Sheryl said:

There will be problems with any insurer if one does nto do that and they later find out.

No, not "any" insurer.

 

As I repeatedly mentioned,  there are insurances with a different model of contract. 

But I don't know of any that would be suitable for most board members (ie old Anglo-American expats living full-time in Thailand on a tight budget).

 

They are mostly European. Many require European residence or nationality. 

 

Some require regular ( eg once a year or once every couple of years) trips home (most Snowbirds use this kind of insurance).

 

Some are subsidized (but they require a certain nationality,  or residence in a certain country,  or membership in Social Security there).

 

Some use a moratorium: if you haven't got sick for a certain time after buying the policy all preexisting conditions are covered. These policies are not cheap, though (usually far more than 10,000 baht per month).

 

Some really just don't care about preexisting conditions older than a certain number of years (5 years is common,  can be more or less than that). But often,  their policies are a bit ambiguous, so it's risky. 

 

[Lorry]

Two more things:

 

The really important thing is: how far will the insurer go to dig out preexisting conditions?

Some will ask on the phone  "Otherwise you were ok, I suppose?" So you say yes, and that's it.

Others will require all previous medical records of the patient.  They will contact all Thai hospitals  the patient may have visited, and ask about this patient. This can take many months.

Some insurances deny every claim over 50,000 or 100,000 USD, wait for the patient to sue, and then settle out of court (at a discount,  of course).

 

You get what you pay for. On average,  the premiums have to equal the cost of treatment.  And private medical care in Thailand is not cheap. 

Many TV members expect a monthly premium of less than 10,000. That just can't cover Bumrungrad, BPH etc (it may if you exclude outpatient treatment, dentistry, eye care, pregnancy etc). 20,000 would be cheap. 

A friend has an insurance that really covers everything,  they paid millions already.  But when the premium went up to 70,000 per month,  even he switched to a cheaper policy. 

 

 

Edited January 29, 2023 by Lorry

[scubascuba3]

1 hour ago, Sheryl said:

 I have it and it has been fine for me. Claims all paid with no problems.

 

Just be sure to fully disclose any and all conditions, meds taken etc  on the health questionnaire.

 

There will be problems with any insurer if one does nto do that and they later find out.

Shady though an insurance company cancelling insurance, they could have just denied the claim. Sounds like they are allowed to do it but shady all the same

[scubascuba3]

1 hour ago, BritManToo said:

Wondering how much money April will lose from this thread Vs the money they would have gained from new customers?

 

6,200 views so far, can't imagine anyone who read this thread buying April insurance in the future.

Yep and if Simon hadn't had the insurance in the first place he could have used the savings to pay for treatment. He would have needed to self insure even if BPH was disclosed

Edited January 29, 2023 by scubascuba3

[jerrymahoney]

23 hours ago, scubascuba3 said:

Yep and if Simon hadn't had the insurance in the first place he could have used the savings to pay for treatment. He would have needed to self insure even if BPH was disclosed

From https://www.cancer.gov/types/prostate/understanding-prostate-changes

 

Are BPH and prostate cancer related?

 

BPH stands for benign prostatic hyperplasia. Benign means "not cancer," and hyperplasia means abnormal cell growth. The result is that the prostate becomes enlarged. 
BPH is not linked to cancer and does not increase your risk of getting prostate cancer—yet the symptoms for BPH and prostate cancer can be similar.

***************

So maybe a different  insurer might have excluded treatment, analyses, and possible surgery for BPH but not for prostate cancer.

Edited January 30, 2023 by jerrymahoney

[Sheryl]

3 hours ago, jerrymahoney said:

From https://www.cancer.gov/types/prostate/understanding-prostate-changes

 

Are BPH and prostate cancer related?

 

BPH stands for benign prostatic hyperplasia. Benign means "not cancer," and hyperplasia means abnormal cell growth. The result is that the prostate becomes enlarged. 
BPH is not linked to cancer and does not increase your risk of getting prostate cancer—yet the symptoms for BPH and prostate cancer can be similar.

***************

So maybe a different  insurer might have excluded treatment, analyses, and possible surgery for BPH but not for prostate cancer.

Except that BPH does increase the likelihood of needing costly work up (MRI, biopsy) to exclude prostate cancer. 

 

But there is no knowing for sure what April would have done had he declared it on his application. Just an informed guess on my part that they would have excluded all prostate conditions.

 

At least one Thai insurer routinely excludes all prostate conditions on policies issued to older men regardless of whether or not they have BPH at time of application. 

 

[jerrymahoney]

Well I was just offering a hypothetical.

 

However this all gets back to the problem for many expats here in the Kingdom that they initiate medical coverage as an expat when they are +/- 60 instead of +/- 35.

Edited January 30, 2023 by jerrymahoney

[scubascuba3]

6 minutes ago, jerrymahoney said:

Well I was just offering a hypothetical.

 

However this all gets back to the problem for many expats here in the Kingdom that they initiate medical coverage as an expat when they are +/- 60 instead of +/- 35.

I'll be interested to hear what WR Life does for similar prostate claims as they seem quite laid back about pre-existing conditions

[Sheryl]

51 minutes ago, jerrymahoney said:

 

However this all gets back to the problem for many expats here in the Kingdom that they initiate medical coverage as an expat when they are +/- 60 instead of +/- 35.

 Unfortunately in the case of retirees they usually come here when already older. It is indeed a problem.

[jerrymahoney]

13 hours ago, scubascuba3 said:

I'll be interested to hear what WR Life does for similar prostate claims as they seem quite laid back about pre-existing conditions

The Main Insured must, when joining, complete and sign online on the web site: www.wrlife.net the application
form can include a medical questionnaire validated by the Insurer. An additional medical examination, paid by
the Insured, may be requested.

 

The Insurer reserves the right to make acceptance conditional upon the production of any additional information it considers necessary.

 

1. For any pre-existing, chronic conditions and injury before the start date of the policy, the condition has to be
studied and can either been covered with or without moratorium, or loading, or excluded.

 

2. For aged under 65: Health checkup is not required: there is a three month waiting period for specific
diseases.

3. For aged 65 and over: 2 choices
3.1 Health checkup required prior to coverage to determine pre-existing conditions. (or)
3.2 A six month waiting period prior to coverage for specific diseases.
Specific diseases: Hypertension & Cardiovascular Disease, All Tumors, Polyp or Cyst, Hernias, Hemorrhoids,
Prostate Disease, Diabetes, Cancer, Cholecystitis, Cholelithiasis, Calculi of the Urinary Organs.

 

From https://www.wrlife.net/documents/WRLIFE POLICY ENGLISH.pdf

[simon43]

Big is not always better!

 

My PSA number was about 5 for many years (slightly high because my prostate was enlarged). Then last September it was 11.5 and then 14.6 by November. Since then, (whilst waiting for the MRI scan, biopsy etc), I have been eating food that is meant to slow down prostate cancer growth (eg chilli peppers, broccoli, pomegranite juice etc). I have also been downing cannabaloid oil every day and human deworming tablets!! (Not a gimmick - see here https://www.worldwidecancerresearch.org/news-opinion/2020/january/game-changing-treatment-for-prostate-cancer-could-be-available-to-patients-within-4-years/#:~:text=The researchers found that mebendazole,drastically increase cancer cell death.

 

Anyway, on Monday (yesterday) I had a PSA check again and the number is .... 10.5, down from 14.6. It still means that the likely cancer is present, but hopefully my weird diet has helped to slow down its growth.

 

(Also Metformin tablets for diabetics also are shown to slow cancer cell growth.  Both those and the deworming medication has no toxicity for humans when taken in standard dosage)

Edited January 31, 2023 by simon43

[mstevens]

7 hours ago, simon43 said:

 

Anyway, on Monday (yesterday) I had a PSA check again and the number is .... 10.5, down from 14.6. It still means that the likely cancer is present, but hopefully my weird diet has helped to slow down its growth.

 

As you seem willing to try something different - which is to be applauded - why not try broccoli sprouts which are essentially the baby broccoli plants. They contain extremely high amounts of sulforaphane, 10 - 100 x more than a mature broccoli plant. I don't know where you'd find them in Bangkok but it should not be too hard them somewhere. They'll be cheap and are worth a go. Google broccoli sprouts sulforaphane for more details!

[cobra]

PSA increases with age, if you're in late late 60's, or in your 70's you'll see an elevation, especially with BPH,

Doesn't mean you necessarily have prostrate cancer, but in all likely hood you problem will or already have a slow developing form.

 

Many physicians will tell you you're more likely to die with prostrate cancer then of it.

 

Heart disease, stroke or something else will likely take you out first.

 

[jerrymahoney]

4 hours ago, cobra said:

PSA increases with age, if you're in late late 60's, or in your 70's you'll see an elevation, especially with BPH,

Doesn't mean you necessarily have prostrate cancer, but in all likely hood you problem will or already have a slow developing form.

 

Many physicians will tell you you're more likely to die with prostrate cancer then of it.

 

Heart disease, stroke or something else will likely take you out first.

 

From: https://www.nhs.uk/conditions/prostate-enlargement/

 

Many men worry that having an enlarged prostate means they have an increased risk of developing prostate cancer.

This is not the case.

 

The risk of prostate cancer is no greater for men with an enlarged prostate than it is for men without an enlarged prostate.

 

 

[Sheryl]

5 hours ago, cobra said:

PSA increases with age, if you're in late late 60's, or in your 70's you'll see an elevation, especially with BPH,

Doesn't mean you necessarily have prostrate cancer, but in all likely hood you problem will or already have a slow developing form.

 

Many physicians will tell you you're more likely to die with prostrate cancer then of it.

 

Heart disease, stroke or something else will likely take you out first.

 

OP's PSA more than doubled in a comparatively short time. This is not consistent with BPH and neither is a level of 10 and above.

 

In addition OP's manual prostate exam found  what felt like discrete growth in addition to an enlarged prostate (if only BPH, the manual exam will find enlarged but smooth and even  prostate).

 

Lastly his multiparametric MRI also found 2 masses within the prostate highly suspicious of malignancy. This too is not a normal finding of BPH.

 

There is no question that OP needs a biopsy and the sooner the better. 

 

Prostate cancers can be slow growing OR aggressive. Not all prostate cancers are the same.

 

While it is true that many men with prostate cancer die of other natural causes before the cancer becomes a serious issue, it is also true that prostate cancer is the 5th leading cause of death from cancer in men and more than 2 men out if 100 will die of prostate cancer (of, not with).

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8888523/#:~:text=Prostate cancer is the second,and 375%2C304 deaths in 2020.

 

So it is not appropriate to promote a casual attitude towards prostate cancer.

 

Biopsy can distinguish between slow growing vs aggressive prostate cancer and that in turn, together with patient's age and overall state of health, can help inform treatment choices.  Active surveillance instead of treatment is an option for men with slow growing prostate cancer. It is not a reasonable option for men with aggressive type of prostate cancer. 

 

Regarding elevated PSA that finding always needs to corollated with other findings especially that of the manual exam and any indications of infection. in addition the trajectory (how quickly it has risen) is of diagnostic significance 

 

Generally speakling about 25% of men with PSA in the range of 4 - 10 have cancer and over 50% of men with PSA over 10 do.

 

https://www.cancer.org/cancer/prostate-cancer/detection-diagnosis-staging/tests.html

 

[frantick]

Not to be a back seat Dr, or trigger anyone, but some studies on horse-paste (ivermectin) have shown results (NIH) . Google it. 

[simon43]

Update: I'm now back in the UK, staying in romantic (!) Blackpool.  It's freezing cold.  I have already registered with a local doctor and will be referred to the Blackpool Victoria Hospital for the biopsy, and then to The Christie NHS in Manchester for prostatectomy surgery.

 

I'll keep the forum updated with my progress ????