Log In

Reset Password

Cancer victim: Insurer won't pay for surgery

Diane DismontPhoto by Tamell Simons

Cancer patient Diane Dismont has been denied a potentially life-saving operation because her insurance company refuses to pay for it.

Ms Dismont, 59, was diagnosed with chronic myeloid leukaemia three years ago but has been unable to find a matching live blood cell donor.

?If I don?t have this transplant my only option is to sit and wait to die,? Ms Dismont said yesterday.

Leukaemia is a cancer affecting the bone marrow and blood which creates too many white blood cells which compromises the immune system, attacking the liver and spleen.

With no blood cell donors found and her medication no longer keeping her stable, a tiny piece of frozen umbilical cord offers a last resort chance for life.

However, her insurance company Bermuda Fire & Marine (BF&M) said it will not pay for the operation because it is not approved by the United States Food & Drug Administration (FDA).

Although the umbilical cord?s blood cells only match four of her six cell components she said ?these are young cells and can grow into whatever they want to be?.

Her doctors at Dana Farber Cancer Institute in Boston told her using the umbilical cord cells would have less side effects and was ?not quite as drastic, that?s why have chosen to go with the cord?.

Ms Dismont?s doctors are ready to go ahead with her transplant and insist that it must happen soon because of her deteriorating health.

?The medication is no longer keeping me stable,? she said.

But her doctors were shocked, she said, when they heard BF&M refused to pay for the life-saving surgery: ?Especially after BF&M had been informed and educated about the procedure?, increasingly being performed at major hospitals.

Her family had contacted the FDA, she said, who admitted that hospitals use cord blood ?all the time? as 90 percent of the cord blood procedure was the same as a blood cell transplant.

BF&M also refused to pay for the associated costs of the operation, believed to be in the neighbourhood of $250,000, such as testing and housing in a sterilised hospital environment for up to three months.

She questioned the ethics of BF&M?s stance when ?a life is hanging in the balance?.

?Quite often, an insurance company?s decision about whether or not to pay for a procedure is open to evaluation and interpretation,? she said. ?After paying these high insurance premiums for years, when you need the backing of your insurance company for an expensive operation, they end up making a decision that favours their own financial position instead of truly considering what?s best for the health of the patient.

?It is a very expensive procedure. I don?t have any other options.?

However, president and CEO of BF&M, John Wight, said in a company statement yesterday: ?Our practice is not to comment on individual cases but what we can say is that our medical team in Bermuda and overseas has worked and continue to work closely with Ms Dismont. The broad issue is that our health policy does not cover procedures and drugs that are not approved by the FDA. This exclusion ? not covering for experimental drug procedures ? is not unique to BF&M.?