Meet the Other Phone. Only the apps you allow.

Meet the Other Phone.
Only the apps you allow.

Buy now

Please or to access all these features

AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

WWYD -lying to medical insurance.

105 replies

Sleepswithbutterflies · 18/09/2014 12:15

Well. Not exactly lying, more exaggerating. Please stick with me, it's quite involved.

So we have ds conceived easily and naturally but have been TTC dc2 for 2 years, our issue is extreme male factor (hardly any sperm usual shape).

We've had two failed rounds of icsi Ivf where we got to transfer but have never had any embryos survive to blastocyst. However both times they gave us about a 35% chance of success.

Both failed and at my follow up appointment the consultant advised me to have a laparoscopy to see if the c section I had with ds has caused endometriosis. I did have some problems following my c section (retained product, sorry tmi) and the consultant said that scar tissue may be stopping embryos from implanting. I personally think that the embryos have just stopped developing since none of the ones we didn't transfer did brilliantly but he's the expert I guess.

Anyway a laparoscopy costs £4k privately. The only symptom I have of endo is extremely painful ovulation which I have been to the gp for previously even when we weren't TTC. It is much much worse since having ds and sometimes makes me cry with pain and lasts for several days. Other months not so bad but definitely painful every month. The gp basically said that the nhs would just give me progesterone treatment to stop me ovulating and hence stop the pain but that is no good when TTC. The nhs won't help me with anything fertility wise because we already have one child. Fair enough.

We have private medical insurance which we've paid for a long time but they won't pay out understandably for fertility issues or I think for problems caused by childbirth, which possibly mine is. I have to be honest and say I probably wouldn't go for a laparoscopy if we weren't TTC and I wasn't worried about scar tissue affecting implantation, we will never get pregnant naturally because dh's sperm is so poor.

The private consultant has advised me to tell the gp that Im suffering painful periods, bleeding between periods, painful sex and pain on ovulation. It just doesn't sit well with me and I'm a crap liar. The only bit that's true is the painfuld ovulation. He said to ask the gp to refer back to him and as long as the insurance don't get wind of fertility issues it'll be ok. I've spoken to the insurance and told them that we've had fertility treatment for male factor infertility and they said that was ok, it wouldn't affect this claim. But it still feels wrong.

Otoh god I want a baby and we've already spent £10k on treatment and don't really want to spend another £4k on something that may or may not help. The sensible thing would just be to except I've got one child and live with it but it's so hard. I'm only 31. I don't want to feel sad about this for the rest of my life.

WWYD?

OP posts:
Sleepswithbutterflies · 18/09/2014 18:56

It does look like it doesn't it?

That makes me feel slightly better. I will see what the insurers say, as long as I'm truthful then they can't hit me with a massive bill at the end and I can sleep easy having not lied.
Will also see if the nhs can refer me. I think if I didn't have any symptoms it would be very different but the painful ovulation bothered me enough to see the gp even when we weren't ttc. They fobbed me off with 'it can be normal' but I'm pretty sure it isn't. Still at least that's on my records from a few years back.

OP posts:
maddening · 18/09/2014 19:26

Did he explain why known infertility treatment would impact the claim?

Sleepswithbutterflies · 18/09/2014 19:35

My understanding was it would only invalidate it if we were exploring the endo as a cause of infertility.
Which I guess we are sort of...I mean we know the main reason we are infertile but really wondered if the endo was stopping the ivf from working. As I said we've zero chance of a natural conception anyway.

OP posts:
MyFairyKing · 18/09/2014 20:21

"I think your need for a second child is completely souring your experience of family life. You come across as way too focused on a second child, to the detriment of your current child. If you cannot find any pleasure in your life then I think you've got bigger problems than insurance fraud."

I agree with this. I think you are focusing on having a second child and ignoring the real problem; your dissatisfaction with life. You've made some incredibly loaded statements about your only child. It will be rubbing off on him, albeit unconsciously.

FiloFunky · 18/09/2014 20:30

Are you wanting adhesiolysis? Or are you sure it's endo?

Either way. Sounds like fraud to me

iK8 · 18/09/2014 20:32

I think the arm chair diagnoses on this thread are very insulting to the op. Secondary infertility is horrible. Op you have my sympathy and I hope things work out for you.

Ignore the cod psychiatrists on here.

Sleepswithbutterflies · 18/09/2014 20:34

In what way is it fraud if I'm honest with the gp and the insurance people??
I.e. don't embellish any symptoms as suggested by consultant but just tell the truth??

OP posts:
Sleepswithbutterflies · 18/09/2014 20:35

The real problem is that I'm desperate for a second child but can't have one!

OP posts:
FiloFunky · 18/09/2014 20:36

Your title says lying to the insurance.

I had a hysterectomy at 27 due to adhesions. I had pain just as you are describing. I will not get any chance to have a second child so I do understand how you feel to some extent.

Sleepswithbutterflies · 18/09/2014 20:38

Yes it does but if you read through you will see my conclusion is that I will tell the truth and see if I can make a genuine claim and if not then so be it.
At least I will know. And if I can make a genuine claim then I may as well as surely that's what it is there for?

I'm sorry you've been through this too. It's crappy.

OP posts:
MyFairyKing · 18/09/2014 20:39

Sleeps Do you not even recognise what you've said? Read back in a calm, relaxed environment. You've made some very pointed and loaded comments about your DS being an only child. Honestly, to an outsider, this is so much more than your infertility which is obviously beyond painful. I'm not doubting that. I think you are blind to what this will do to your family.

Sleepswithbutterflies · 18/09/2014 20:42

In what way do you mean?
If I don't pursue it now then I think I might regret it. And the older I get the less chance I have?

OP posts:
FiloFunky · 18/09/2014 20:42

If you are sure it genuine. I guess sometimes you have to play the system. Suppose it's down to how you feel about it really

It is crappy. I am now 30 as DS is 12. I consider myself very lucky to have had the chance to have one. Please enjoy your first child. They really do grow up so quickly. I hope the investigations help you I truly do.

But if not - it's really not the be all and end all. You still have a family even of its not quite as you planned x

WeirdCatLady · 18/09/2014 20:43

Sleeps, I am so sorry that you are having to go through this but I have to say, after reading your posts about how substandard your family feels to you with only one child I would say that your real problem isn't wanting a second child...it's that you don't seem to find any joy with the one that you already have.

FiloFunky · 18/09/2014 20:44

I think you may risk your child feeling he wasn't enough to make you happy. And that's an awful thing for a child to realise and be aware of.

I'm not saying that's the case. Only going on this thread and what's written here.

Sleepswithbutterflies · 18/09/2014 20:53

But it's partly because I love him so much that I want a second one.
Firstly and selfishly because I want the chance to do it all again and secondly because I feel like I've let him down. You see threads on here quite regularly about how bad it is to have just one child and I've had people say that's it's very selfish to have only one. I remember a thread where someone said they thought it better to have none than one as that one would suffer so much.
I don't exactly agree with that...as I said I'm an only one... But I do feel he's not getting a proper family.
We go out loads of places, I do lots of stuff with him but it feels forced. He must get fed up of not having any other children for company the majority of the time.

OP posts:
FiloFunky · 18/09/2014 20:55

Did you feel you didn't have a proper family?

Sleepswithbutterflies · 18/09/2014 20:59

No but I did feel lonely. I'm quite close to my parents and always have been but do think it's different for a girl too. My mom and I are very close and can do stuff together in a way a mother and son probably don't.
I did look at friends with siblings and feel jealous but I know the grass is always greener. Now I'm older I don't mind so much about not having a sibling but I always had imaginary ones (sad but true) when I was little.
I was very different to ds though in that I was good at playing alone. Ds not so much. Wants someone to play with ALL THE TIME.

OP posts:
XiCi · 18/09/2014 21:01

You have said some horrible things OP on here about families with one child. Not proper families? Less important families? Fucking hell do you think before you spout all this crap?

Your life sounds incredibly sad, not because of your fertility problems, but because of your inability to live in the present, to enjoy the childhood years of your ds. All this angst and talk of not being a proper family will affect him and I'm sure this isn't a walk in the park for your DH either. You sound like you need therapy tbh. Have you spoken to your GP about the way you are feeling?

WeirdCatLady · 18/09/2014 21:01

You also see plenty of threads where people talk about how fab it is to only have one. You are seeing only what you want to see.

Unfortunately your son will be picking up on your dissatisfaction and it is highly likely that that will have a detrimental affect upon him.

I'm going to bow out of this thread now and hide it as we were only able to have one child and your comments about that making a family less worthy, not proper etc have upset me and I don't want to derail your thread.

I hope you can find some joy in your life and family...however it works out for you.

FiloFunky · 18/09/2014 21:01

My son and I are very close. More so than I was to my mum. (I have 7 siblings)

Sleepswithbutterflies · 18/09/2014 21:04

I'm sorry if I've upset anyone.
I know plenty of families with only one and have never considered them anything less than a proper family.
I know it's to do with my feelings and having this decision forced on me. A choice would have felt different. My parents chose to only have one child.

I just constantly feel like it's not good enough for ds. He's so kind and gentle with small children. He'd make such a fantastic big brother and I've deprived him of that.

OP posts:
FiloFunky · 18/09/2014 21:06

You don't know that! He could loathe his sibling! At the moment these small children are a novelty!

Really do consider the fun and love you can in your family unit of three. If it becomes 4 enjoy that too!

But your DS will not be scarred for life by this!

Sleepswithbutterflies · 18/09/2014 21:07

I also feel that everyone I know with more than one child judges me for just having one. Ridiculous I know.
Yes to me my family does feel inferior. I'm talking about my family personally, not other families with only one.
People say it don't they 'have you just got the one?'

OP posts:
parallax80 · 18/09/2014 21:09

I also feel that everyone I know with more than one child judges me for just having one.

I would put money on them not actually caring. Most people are fairly self absorbed and don't pay more than a passing interest in other people's life set-ups.