Insurance Company Denies New Mother with Melanoma

Insurance Company Denies New Mother with Melanoma

Nadira is a 40-year-old mother of two, currently managing a beachfront restaurant in cottage country.

After getting pregnant with her third child, Nadira planned to get by on both her husband’s salary and the maternity benefits she would be receiving through the Ontario government’s maternity program. She was set to receive these benefits for twelve months.

During the fourth month of her pregnancy, Nadira noticed a tiny freckle on her tummy for the first time ever. A month later, she noticed the freckle was growing as her stomach grew. Nadira’s mother had had skin cancer, which taught Nadira to look out for any irregular occurrence and to bring it up with her doctor. After taking a look, Nadira’s doctor assured her that she had nothing to worry about – that the growth was due to her skin stretching. The doctor even mentioned that pigment changes are a normal part of pregnancy.

After recovering from her childbirth, Nadira booked a routine physical check-up with her doctor. She was concerned that her freckle had still not reduced in size, even though her stomach size had already decreased significantly. Her doctor agreed that the freckle should have reduced and conducted several tests.

Nadira’s freckle biopsy did not come back clean. She was diagnosed with skin cancer – specifically melanoma. After waiting almost twelve months since first noticing the freckle, the cancer had spread into her bowels. She would need to have surgery before undergoing chemotherapy and radiation treatments.

Following her surgery, Nadira determined that she would need to take more time off, as she only had three months left in her maternity leave. Her employer told her she could take as much time as she needed to recover and would be able to assume her position again in the future.

Relieved, she gathered the necessary documents to apply for short and long-term disability benefits. To her surprise, the insurance company declined her claim, accusing her of wanting to stay home and spend time with her baby. Nadira went back to her cancer doctor and got her to write a detailed report about the surgery and other treatment that she needed. The insurance company again denied her claim. She was thinking of giving up, but in a last-ditch effort, she did some research online and stumbled on the Share Lawyers Facebook page. Nadira called for a free consultation and the intake team at Share Lawyers answered her questions and arranged a consult with one of the lawyers. It was important to get the insurance company’s decision reversed as quickly as possible so that Nadira could focus on taking care of both herself and the baby. The lawyers explained that these cases take time and that Nadira and her husband would have to manage for a while until they could help her resolve the case.

Nadira and her husband agreed that the insurance company should not be allowed to get away with denying her the benefits that she is entitled to and decided to fight. With the Share Lawyers team behind her and great doctors helping her with her treatment, Nadira felt that she was on a good path. After a big fight with the insurance company, a mediation was scheduled, and Nadira received the back benefits that the insurance company had refused to pay and benefits going into the future to give her time to recover and regain her strength. Nadira may not be able to return to managing the restaurant for quite some time, but she knows that she didn’t let the insurance company walk all over her. She stood up and fought for her rights with a great team of lawyers by her side.

 

[All names and identifying details have been changed to protect the confidentiality of all involved.]

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