Insurance company refuses to cover Auckland mum with rare illness
Three months ago Selina Linton fell out of bed, unable to move her legs. She barely remembers the following weeks spent intensive care; doctors can't say exactly when, or to what extent, she will recover.
The Auckland woman was struck by Guillain-Barre Syndrome — a mysterious, debilitating illness that attacks the nervous system. The 54-year-old dental assistant remains in a rehab centre, in nappies, unable to walk.
Her husband Nathan Linton, 53, said he was shattered to learn the trauma insurance policy they had been putting money into for over two decades didn't cover Guillain-Barre. It wouldn't pay out for what the family deemed an "incredibly traumatic" experience.
The Lintons' discovery is not unusual. Trauma insurance, also known as crisis or critical illness insurance, is a broad term for a highly specific type of coverage.
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It pays a lump sum to be used any way the insured chooses. Selina's medical bills were covered by the state, so Nathan said the money would have gone into modifying their Titirangi home for the wheelchair his wife was likely to return with. He said the family were also "getting kicked" through being one income down.
Nathan said he hoped others might temper their expectations of trauma coverage after his family's experience: "we'd have done better putting the money in a jar by the bed", he said. Ideally, he wanted Guillain-Barre put on insurance companies' trauma tick list.
A spokesman for AMP, the Lintons' insurance provider for over two decades, said trauma policies didn't cover Guillain–Barré Syndrome for several reasons, including because only 40 to 80 New Zealanders got it each year.
"Insurers can't cover every eventuality – if they did premiums would go up and cover would not be accessible or affordable," he said.
Guillain-Barre sufferers who permanently lose their ability to "perform key tasks independently" could, however, get a pay out through trauma insurance, he said. Selina was not eligible as doctors believed she would eventually recover.
Karen Stevens of the Insurance and Financial Services Ombudsman (IFSO) said she had many clients who, like the Lintons, felt misled by their trauma policy.
"Trauma in everyday language means something unexpected that happens to you and plays havoc with your life — but if it's not specifically mentioned in your policy, it won't be covered," she said.
"We recently had a woman come in who had suffered fairly horrific injuries from giving birth to a baby, for example, which left her incapacitated. She said it was the most traumatic thing that could have happened to her, but since birth wasn't mentioned in her policy there was nothing we could do."
Stevens said disgruntled heart attack victims approached the IFSO "constantly". While trauma policies typically include heart attacks, they only pay out if certain events play out.
Since being in hospital Selina has had pneumonia, a tracheotomy — doctors cut a hole in her windpipe to get air to her lungs — a flooded lung, and excruciating nerve pain. Her husband said her "good brain inside a very sick body" — which until recently could not speak — and the ever-fuzzy prognosis of Guillain-Barre had taken psychological tolls too.
She could barely keep her eyelids up at 4 o'clock in the afternoon last Tuesday, in a wheelchair at her Point Chevalier rehabilitation clinic. She held her husband and their 22-year-old daughter Lucy's hands, and cried.
"Now I should be finishing work for the day and going home to cook dinner with my family," she said. She missed the Titirangi trees, her dog, and "catching up with the girls".
Nathan promised to get their wheelchair-unfriendly house ready for her "somehow", to hasten her homecoming.
"We'll suck it up," he said. "But we thought we were responsible, taking out that insurance policy so that if something like this happened, we'd be able to look after each other comfortably."
WHAT IS GUILLAIN-BARRE?
- It is a collection of symptoms, rather than a single disease.
- They include rapidly progressive weakness, sometimes resulting in complete paralysis.
- Recovery typically takes three to six months, though two-thirds never fully recover and it can be fatal.
- It frequently follows another health problem such as food poisoning, flu, childbirth or surgery.
- Two cases were triggered by the campylobacter outbreak from contaminated drinking water in Hawke's Bay last year.
Sunday Star Times