A 29-year-old woman from Whitby, Ontario needs multiple treatments because she has aplastic anemia and paroxysmal nocturnal hemoglobinuria (PNH), putting her at risk of catching an infection she cannot fight off. That is why she filed a critical insurance claim with the policy she obtained from TD Bank's insurance arm.
She has $300,000 worth of coverage but the claim was denied – TD Bank says her situation is not serious enough to be covered by her policy, even though she needs chemotherapy, radiation and a bone marrow transplant.
The 29-year-old nurse says she was healthy and active until last summer when she received her diagnosis. Aplastic anemia is a form of bone marrow failure. That is why she needs a transplant.
The condition called PNH is a rare, life-threatening disease in the blood that destroys red blood cells.
The patient's doctors from Princess Margaret Hospital in Toronto say the conditions are extremely serious as well. They have written letters in support of their position on the illnesses.
These illnesses have left the 29-year-old weak and unable to go to work. Once she is in good enough health to receive a bone marrow transplant, she may not be able to work for a year or more. Unfortunately, she does not qualify for disability benefits from her employer.
This is why she and her husband purchased the insurance policy, which costs them $2,000 each year. When they bought the policy from TD Bank, the sales representative said they would be covered if they developed a serious illness that prevented them from working. However, a list of medical conditions that were included was not provided.
Her husband had critical care insurance from another provider and the sale representative said this coverage was the same or better than the other policy.
On Monday, TD Bank issued a statement saying that its review of the claims decision, which was requested by the 29-year-old, is ongoing.
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