A husband who claimed his penis was too bent to have sex with his wife has lost a case against his insurance firm to pay for a straightening procedure.
The man, named only as Mr W, was suffering from a condition called Peyronie’s Disease, which causes the male organ to curve when erect.
He wanted his private health insurance AXA to foot the bill of around £10,000, for him to have an operation to have it straightened.
Mr W said although he could get an erection the bend in his organ meant he was unable to have normal sex with his wife.
AXA paid for his initial consultations and tests but refused to pay for the operation, known as a Lue procedure, claiming it was excluded from the policy as it was a ‘sexual dysfunction’.
A man who claimed his penis was too bent to have sex with his wife has lost a case to have an operation covered by his private medical insurance (file photo)
His insurer, AXA refused to cover him on the grounds that his condition, Peyronie’s disease, was a ‘sexual dysfunction’ and was not causing him ‘pain or discomfort’
It also rejected his claim the operation was ‘medically necessary’ as although he couldn’t have sex with his wife he was not in any ‘pain or discomfort’.
Mr W disagreed with the decision, saying his problem was not a dysfunction because he was still able to get an erection, but it was the kink that made sex impossible.
He took the case to the Financial Ombudsman Service (FOS) claiming AXA had acted unfairly in refusing to pay for his operation under his private medical insurance policy.
But an ombudsman agreed with AXA, ruling that Mr W’s ailment did was excluded under the terms of his policy.
Peyronie’s disease is sometimes called the ‘Clinton Kink’ after being reportedly suffered by former US president Bill Clinton.
It is caused by a build up of collagen or fibrous tissue on one side which causes the penis to bend up to 90 degrees. Sexual intercourse is difficult, painful or even impossible.
The Ombudsman’s ruling said: ‘I understand Mr W’s comments that his difficulty with sexual activity isn’t due to function.
‘I agree his doctor documented he has good erectile function. So I can appreciate why he feels his condition should not fall under the heading ‘sexual dysfunction’.’
But the Ombudsman said it did fall under the policy exclusion as Mr W’s inability to have penetrative sex with his wife was a ‘dysfunction’ as it was causing his distress.
Medics gave Mr W four different treatment options, one of which prescribed no course of action. AXA said this showed the operation to straighten his member was not ‘medically necessary’.
A financial ombudsman agreed with the insurance company’s claim that Mr W’s operation was not ‘medically necessary’ (file photo)
The FOS ruling said: ‘Mr W said this option, of doing nothing, would not be ideal because he can’t have sexual activity with his wife.
‘But I haven’t seen any evidence to show that not carrying out the procedure would cause medical harm to Mr W.’
In their ruling the Ombudsman said: ‘On balance it was fair to AXA to decline cover for Mr W’s claim based on the available medical evidence.
‘I think they fairly applied the exclusion for sexual dysfunction and there isn’t enough evidence to support the treatment is medically necessary.
‘I know this will be disappointing to Mr W, but overall, I don’t think there are reasonable grounds upon which I could fairly ask AXA to accept his claim for this procedure.’