Critical illness cover and breast cancer: What do I need to know?
Statistics on Breast Cancer
- Close to 50,000 women and 400 men were diagnosed with invasive breast cancer and 5,700 with non-invasive breast cancer in the UK in 2010.
- For the period 2005 – 2009, women in England who survived invasive breast cancer for more than five years comprised 85%.
*CancerResearchUK.org
According to the Scottish Provident Critical Illness Claims Paid for the first half of 2012, breast cancer comprised 20.7% of all serious illness claims. This illustrates the prevalence of this kind of cancer.
But the question is, is breast cancer covered by critical illness insurance? The answer is both yes and no. Yes, it is often included in the cover. But no, it is not covered as part of the main benefit. More often than not, it is treated as a partial payment.
Don't miss:
- Top 5 reasons why a critical illness claim is denied
- Do critical illness insurers really pay out: what the statistics shows
- Top 10 critical illnesses that will pay out
- When are you suspected to get critically ill?
Not considered a severe type of cancer
According to the Association of British Insurers’ definition of cancer as a critical illness, it only covers cancers, excluding less advanced cases. Read more about what kinds of cancers are covered in the article Will critical illness insurance cover any kind of cancer?
For cancer to be payable, it should be one that is marked by “any malignant tumour positively diagnosed with histological confirmation and characterized by the uncontrolled growth of malignant cells and invasion of tissue.”
If you are diagnosed with an early stage of breast cancer, this may not be payable under the critical illness policy. This is because this type of cancer does not fall under the category of “critical” since the new medical technology can now provide you with effective strategies to treat the cancer. Thus, you have a high change of surviving this cancer.
This means that non-malignant tumours (which when undetected and untreated can become malignant tumours) may not be payable under the policy. This includes the form of breast cancer called ductal carcinoma in situ (DCIS), which is easily detectable and treatable.
The sad thing is that even with a non-malignant tumour, you will still have to spend a goodly amount of money on regular lab tests, medications and treatments. Thus, it is important to be aware of the level of coverage your policy can offer.
Can you receive something from your critical illness cover for breast cancer?
If your policy includes partial payments for breast cancer, then yes, you can make a claim for breast cancer.
The bad news. Since breast cancer is mostly covered as one that pays a partial benefit, you may stand to receive 20% to 25% of the main benefit amount. This is for a one-time payment only.
The good news. You get to keep your critical illness policy. Your policy will remain effective (for as long as you pay the premiums and for the rest of the policy’s term). This means that you can still claim for the main benefit if you are diagnosed with a covered serious illness.
Getting Cover When Breast Cancer Is a Concern
If you still don’t have critical illness cover, one question you should ask would be: Is there a history of breast cancer in my family? This can affect the way your application is evaluated and how the critical illness policy will be issued. When you inform the provider that you have relative/s that have breast cancer, here are some possible scenarios:
| Age of applicant | No. Of relatives with breast cancer | Age of relative that have breast cancer | Effect on the policy |
|---|---|---|---|
|
<40 |
1 - 2 |
<40 |
Coverage for breast and ovarian tumours, as with as ductal carcinoma in situ are excluded |
|
1
|
40 – 49 |
Additional 50% on standard premium |
|
|
≥50 |
Policy may be issued on standard rates |
||
|
2 |
40 – 49 |
Coverage for breast and ovarian tumours, as with as ductal carcinoma in situ are excluded |
|
|
≥50 |
Additional 100% on standard premium |
||
|
3 or more relatives |
Any age |
Policy application evaluated on an individual basis |
|
|
≥40 |
1 |
<40 |
Coverage for breast and ovarian tumours, as with as ductal carcinoma in situ are excluded |
|
40 – 49 |
Additional 50% on standard premium |
||
|
≥50 |
Policy may be issued on standard rates |
||
|
2 |
<40 |
Coverage for breast and ovarian tumours, as with as ductal carcinoma in situ are excluded |
|
|
≥50 for both |
Additional 75% on standard premium |
||
|
3 or more relatives |
Any age |
Policy application evaluated on an individual basis |
*Based on the LV= Underwriting Guide
Read the Fine Print!
Before you even get your critical illness policy, you should make your own research and comparison among the different insurance policies in the market. Remember, various policies define various critical illnesses differently. Indeed, there are some insurance companies that will pay for non-malignant cancers.
You should also check whether your policy may pay partial lump sums for cancers that are not considered non-critical. The rationale behind this is that the insurance companies should consider paying a partial amount to ensure that the cancer does not worsen and become a critical illness.
Last updated on: 18.1.2013
To protect yourself and your family, save up to 35%, please fill the critical illness cover + life insurance form on the right now.
Recommended useful information to read:
- Dos and Don’ts when making critical illness insurance claims
- What you should know about your critical illness cover: the exclusions to your policy
- Things to consider before getting a critical illness insurance policy
- Are you at risk? Critical illnesses you may be susceptible to
- Save up on premiums: factors that affect your critical illness insurance premiums