Top 10 Critical Illnesses that Will Pay Out
Insurance is often linked to an umbrella. You hope it doesn’t rain but you’re glad you have your umbrella with you when it does. Critical Illness insurance is like that. You hope you don’t have to use it, but will surely feel relieved when you are diagnosed with a critical illness and you know that your critical illness claim will be paid out to help you fund your treatment.
As you consider getting critical illness cover, it will be helpful to look into the critical illnesses claims that commonly pay out. Below is a table of the most commonly paid critical illness claims, based on a Scottish Provident Critical Illness Claims Report for the first half of 2012:
| Female Claims | Male Claims |
|---|---|
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*Percentages are for total paid out claims per gender.
The critical illnesses with the most number of claims paid are:
Cancer. This comprises a whopping 60% of all paid out claims! These include full and partial claims payments. Cancers such as Breast Cancer and Prostate cancer are usually included in the cover, but only for a portion of the full critical illness cover. The most commonly paid out cancers are: breast cancer (34%), bowel/colon cancer (11%), malignant melanoma (8%), prostate cancer (7%), thyroid cancer (4%), leukaemia (4%), testicular cancer (3%), cervical cancer (3%), lung cancer (2.6%) and ear/nose/throat (2.6%). When the insurance company evaluates a critical illness claim involving cancer, they will usually look into the severity of the cancer. For it to be payable, it should be marked by a malignancy. Often, these are cancers that are difficult to treat. Cancers that are non-invasive and pre-malignant are usually excluded in the cover. 59% of the cancer claims were paid out to females and 41% to males.
Heart Attack. This makes up 16% of all claims paid out. For this to be payable, it should be characterized by the death of heart muscle due to inadequate blood supply. The ABI definition requires that evidence of typical clinical symptoms (i.e. chest pains) be present. This seems to be a prevalent critical illness among males, where 91% of all heart attack claims were made by males and only 7% by females.
Stroke. 6% of all claims paid out are for stroke. Stroke refers to the death of brain tissue due to inadequate blood supply or haemorrhage within the skull that results to permanent symptoms in the claimant. Again, this is a male-predominant Critical Illness, with 85% of the claims paid out to males and only 15% paid out to females.
Multiple sclerosis. Making up 5% of the total claims paid, this should be diagnosed by a Consultant Neurologist and should be marked by a continuous clinical impairment of the sensory or motor function.
Benign brain tumour. Comprising 3% of the claims paid out, benign brain tumour is defined as a non-malignant tumour or cyst in the brain, cranial nerves or meninges within the skull. The critical illness should result in permanent neurological deficit.
Coronary artery by-pass grafts. 3% of paid out critical illness claims are for surgery aimed towards correcting blockages or narrowed coronary arteries with the use of by-pass grafts. Based on the ABI definition, this surgery should divide the breastbone for it to be payable. For some companies, such as Scottish Provident, the definition is further extended so that keyhole surgery is allowed.
Parkinson’s disease. This is 1.7% of total paid out claims. For this claim to be payable, it has to be diagnosed by a Consultant Neurologist. The critical illness must be marked by permanent clinical impairment of motor function with associated tremor, muscle rigidity of movement and postural instability.
Other critical illness. The last of the top 3 comprise 3% of the total paid out claims. These include heart valve replacement or repair, angioplasty and aorta graft surgery.
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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