Chef Simon Gault pays for skin cancer surgery after insurance denial

Celebrity chef Simon Gault has paid for skin cancer surgery out of pocket after Southern Cross declined to fund the Mohs procedure recommended by his specialist. Gault, who has held health insurance with Southern Cross since 1970, said he was forced to use his savings to pay for the surgery. He stated that the insurer offered to cover a standard excision instead, but refused his request to pay the difference between that and the recommended Mohs surgery.

Gault said he chose to pay for the procedure privately because his specialist advised him to have it done quickly and he did not want to wait for the public health system. He expressed concern that changes to eligibility criteria could affect other policyholders. Gault noted that the insurer's website lists changes to coverage criteria.

Southern Cross stated that Mohs surgery is covered when it is clinically appropriate and meets specific eligibility criteria. Regan Savage, Southern Cross Health Insurance chief sales, marketing and customer experience officer, said eligibility criteria are reviewed regularly to ensure they reflect evolving medical technology and clinical practice. Savage noted that standard surgical excision remains available for skin cancer subject to a member's policy.

How it developed

• Fri 16 Oct, 3:14pmThe report provides specific details regarding the Southern Cross eligibility criteria for Mohs surgery and the specific location of Gault's lesions.

Where reports differ

• One report mentions Gault had surgery on his hand, while another specifies the cancer was on his cheek.

Compiled from reports by Stuff, NZ Herald and Otago Daily Times.