Axa Refused to Pay for My Biopsy Despite No History of Malignant Diagnoses
About 20 days ago, I had a mammogram and an ultrasound, and a mass was detected. I made an appointment with the hospital for a biopsy of the mass 20 days later. I have supplementary Axa health insurance. I applied to the hospital with this insurance. I sent all my breast-related reports, etc., I have no previous negative diagnosis or any history of surgery. I sent documents as requested. I also sent all my radiology reports related to the breast. However, they created every possible difficulty to avoid payment. In the end, they refused the provisional payment. The problem is that no malignant nodules or harmful conditions have been detected in the breast area so far. As I mentioned, there are harmless benign cysts that appear in all women. There is no surgical procedure or malignant diagnosis in my old records. However, based on my previous screenings, the insurance company has refused payment, despite there being no malignant formation or surgical intervention in any of the reports. My latest report also does not show anything bad. My doctor just wanted to be sure and make a diagnosis. However, my insurance company has not made the payment based on unfounded reasons, and I am a victim. If I had not undergone my routine screenings (which are required for women over 35), but as a conscious woman, I had my screenings done, and thankfully, there has been no issue so far. Axa does not pay even for a simple diagnostic procedure. I am very dissatisfied with them. I am stressed and upset about having to undergo a biopsy, and now, I can't get the provision and payment for the service I paid for due to their unjust conditions. I will also file this complaint on the international platform of Axa. I need to have this biopsy done because I am 41 years old, and since I do not have a baby, I was about to start in vitro fertilization treatment. This is a significant expense, and I am distressed and aggrieved that my insurance company is not even covering a simple diagnostic procedure. This is unfair. Insurance companies have been filling their pockets for years. I have been having private health insurance for years. I am currently expecting payment for diagnosis, not treatment, and they are not even doing that. I am complaining about Axa. Axa is finished for me. I used to get my home insurance, health insurance, and car insurance from Axa. My father, mother, and spouse all had Axa, but that is over now. If they are not there for me today, they are an empty company.
Based on the application reflected on your site, an evaluation has been conducted. The start date of our insured's policy with our Company is 20/05/2022, and due to the pathology related to the subject illness dating back to before the start date of your policy, regardless of whether any diagnostic procedure/surgery or different treatment was applied during the relevant period, we inform you that a positive response to the application cannot be provided as per the relevant policy condition (*). We extend our get well wishes and wish you healthy days. Sincerely, AXA SİGORTA A.Ş. Customer Complaint Management (*) All health expenses related to the complaints and illnesses existing before the start date of the policy, and the recurrence and complications of surgeries and treatments applied before the insurance period.
In all my past diagnoses over the years, every document ultimately confirms that no pathological findings were detected. None of my reports show any such findings, and I can have this re-documented if necessary. I will present these documents to the relevant authority in the lawsuit I plan to file. There is no prior diagnosis in my medical history that would suggest a cancer case. Simple cysts, unrelated to cancer, are common in many women, who are recommended to undergo regular annual check-ups. By framing routine findings as something alarming, you are discouraging people from obtaining standard health reports or normal diagnoses out of fear. If a woman undergoes regular exams, is it realistic to expect that a simple cyst should never appear? Even the report you referred to states that no pathological findings were present. Not only did you fail to provide treatment, but you also did not cover a biopsy to establish a definitive diagnosis. Simple cysts have no connection to cancer, and if there had been any genuine cause for concern, a biopsy would have been conducted. I have never, in my life, had a biopsy from my breast. I do not forgive you in any way.
