Cancer Definition

[BlueRobin]

Did a self review of what I have, specifically coverage of critical/terminal illnesses. As many of the policies I purchased were many years ago (for e.g. bought in 1993), the concept of stages of cancers were less definitive at that time.

I have one such policy that has the following definition:

Cancer - A disease manifested by the presence of a malignant tumour characterized by the uncontrolled growth and spread of malignant cells and the invasion of tissue. The term Cancer also includes Leukaemia (other than chronic lymphocytic leukaemia) and Hodgkin's Disease.

Terminal Illness - In the opinion of the medical specialist involved and subject to the acceptance of the Company's Chief Medical Officer the advent of death is likely within 12 months.

Modern policies now has terms such as "carcinoma in situ" which basically means it was found in an organ and has not spread (hence early stage cancer), etc.

I know it is best to clarify with the insurance company (which I will) but I would like to hear from fellow MM forumers what would be your interpretation of my cancer coverage?

Based on the definition above, it would means the cancer had to spread to more than 1 organs before it is claimable?

Appreciate your opinion.

 

[soneat]

Did a self review of what I have, specifically coverage of critical/terminal illnesses. As many of the policies I purchased were many years ago (for e.g. bought in 1993), the concept of stages of cancers were less definitive at that time.

I have one such policy that has the following definition:



Modern policies now has terms such as "carcinoma in situ" which basically means it was found in an organ and has not spread (hence early stage cancer), etc.

I know it is best to clarify with the insurance company (which I will) but I would like to hear from fellow MM forumers what would be your interpretation of my cancer coverage?

Based on the definition above, it would means the cancer had to spread to more than 1 organs before it is claimable?

Appreciate your opinion.

Ok, I shall attempt this question. =)

1. First of all, it really depend on the policy wordings and the insurance company decision whether to admit the claim or not.
2. Spread of malignant cells means spread to lymph nodes or distant parts of the body. Therefore the short/simple answer to your question is "Yes". However, in some policy contracts, this is not required if the cancer is first diagnosed after the policy is in force for two years from issue/endorsement/reinstatement date whichever is latest.

 

[oceanicmanta]

I also find "carcinoma in situ" (CIS) term very technical for the lay person

drawing from 1 recent cancer diagnosis and claim experience by a relative, my impression was it seems quite improbable to get a CIS diagnosis ... which is making me question the relevance of Early CI policies

also, once a claim is made, Cancer could be excluded from the CI policy going forward (other 36+ CIs still covered, Premium still payable) - a situation which may not be obvious to many

just sharing .. not in medicine or insurance

 

[boredboiboi]

I also find "carcinoma in situ" (CIS) term very technical for the lay person

drawing from 1 recent cancer diagnosis and claim experience by a relative, my impression was it seems quite improbable to get a CIS diagnosis ... which is making me question the relevance of Early CI policies

also, once a claim is made, Cancer could be excluded from the CI policy going forward (other 36+ CIs still covered, Premium still payable) - a situation which may not be obvious to many

just sharing .. not in medicine or insurance

Depends on what ur riders are. If u got both eci and ci rider. U claim early ci. Late stage ci cancer is still claimable, will not be excluded.
and if only eci rider, the eci rider will cease because its already payout, and if there is remaining death/tpd. U only need to pay pro rated premium for death/tpd only, no longer need to pay the eci rider premium.

 

[blurpandasg2014]

I also find "carcinoma in situ" (CIS) term very technical for the lay person

drawing from 1 recent cancer diagnosis and claim experience by a relative, my impression was it seems quite improbable to get a CIS diagnosis ... which is making me question the relevance of Early CI policies

also, once a claim is made, Cancer could be excluded from the CI policy going forward (other 36+ CIs still covered, Premium still payable) - a situation which may not be obvious to many

just sharing .. not in medicine or insurance

CIS is still possible, in the aspect of breast cancer. Ductal carcinoma in situ do not spread beyond the duct

 

[BlueRobin]

Thanks to those who replied. Appreciate it.

I got reply from the insurance company as follows:

The policy did not specify any stage of Cancer. You may submit your claim upon diagnosis of specified dread disease.

Oh well.

 

[soneat]

Thanks to those who replied. Appreciate it.

I got reply from the insurance company as follows:



Oh well.

The person who replied is probably from their customer service side.
The person who is going to process the claim will be from the claims department.

So in this sense, the CSO is just telling you to go ahead and submit the claims. If the claims officer rejects the claim, you can try to appeal. It's quite a SOP response.

IMHO, the old CI definition is not as strict as the current ones. Policy T&Cs are also unique to the policy itself as you can see from the example I gave earlier, where they explicitly mention that as long as the policy is in-force for more than 2 years, the spreading need not have occurred before the claim is admitted.

 

[BlueRobin]

Thanks Soneat.

I wasn't looking to claim but just preparing for my retirement which I am hoping to happen next year. So I am going through self review of my insurance coverage and be aware of where my holes are.