Tony Hetherington is the Financial Mail on Sunday’s star investigator, battling readers, revealing the truth behind closed doors and securing victories for those left out of pocket. Find out how to contact him below.
Affected: Margaret Thatcher had Dupuytren’s disease in her right hand
Mrs. LD writes: My husband has Dupuytren’s disease. The Mail on Sunday recently published an article about clinical trials showing a positive outcome from radiotherapy, and one specialist commented that most healthcare providers now cover this treatment.
We called my husband’s insurer, Axa Health, but were told that they would not cover the costs of the treatment. We asked them to reconsider and a week later, the Nuffield Cancer Centre in London told us that Axa had authorised the treatment.
But after five treatment sessions, and with five more to come, Axa said it had made a mistake and would recover the payment it had already made to the hospital, leaving us to pay for the ten treatments ourselves.
Tony Hetherington answers: Dupuytren’s disease is a thickening of the tissue in the hands that causes a lump or pulls the fingers inwards towards the palm. There is no simple cure for the condition (Margaret Thatcher suffered from it), but you had hoped that radiotherapy would help your husband, as it has improved the situation for others who have suffered from it.
Her doctor gave her the all-clear, the private Nuffield centre received Axa approval for its fees and everything seemed to be going well. Then, halfway through the treatment, Axa backed out. It told her it had paid for the treatment “in error” and was going back on its original decision not to fund it.
Axa said it would claim the payment already made to Nuffield, adding: “We will let you know how much you need to pay and where to send it.” As an apology, Axa offered £100, leaving it with bills of around £3,500.
Axa believes that although radiotherapy treatment would not cause any harm, there has not yet been enough research to prove that it should become a standard treatment for Dupuytren’s disease. This is why it rejected her husband’s claim in the first place.
She claimed that paying Nuffield was a mistake but, surprisingly, Axa suggested that she told her husband about her mistake 12 days before the treatment began, giving him time to cancel it unless he decided to pay the bill himself.
This made no sense, so I went back over the exact sequence of events. Her husband’s first treatment session was on 19 February. On 9 March, Axa wrote to her listing this and subsequent sessions, detailing their costs and telling her that she owed nothing because Axa had already paid Nuffield. However, Axa was now telling me that it had only discovered its mistake on 7 February, twelve days before the first treatment session. So why would it write to her on 9 March, more than a month later, confirming that it had paid Nuffield and saying that her husband owed nothing?
I raised this with Axa and they retracted their position. They said: “We understand that there was a lack of communication between Axa Health and the hospital.” And they agreed that Axa would cover the costs of the treatment already carried out.
In fact, Axa has gone further and will cover all the costs of her husband’s treatment, including the radiotherapy sessions that remain to be carried out after discovering its mistakes. There will be no bill. It was a bit of a challenge to get it, but Axa made the right decision in the end.
If you believe you have been a victim of financial crime, please write to Tony Hetherington at Financial Mail, 9 Derry Street, London W8 5HY or email tony.hetherington@mailonsunday.co.uk. Due to the high volume of enquiries, it is not possible to provide a personal reply. Please only send copies of the original documents, which unfortunately cannot be returned.