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CI Expert: Getting the right policy for breast cancer

The number of partial payment enhancements to CI cover in recent years have led to some large differences between the level of cover for breast cancer.

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In recent years, we have seen a surge in critical-illness enhancements with the main focus on introducing partial payment conditions. In some instances this has involved the addition of conditions that are not likely to result in many, if any, claims.

Of all these enhancements carcinoma in situ of the breast is the most important. Unlike early stage prostate cancer it impacts mainly the under- 65s. Latest figures indicate around 5,800 annual diagnoses of which the age 50-60 group constituted 1,950.

However, this can also be the most confusing definition. This is partly because there are a number of definition variations and also because many providers have refined their definitions as competition has developed.

Legal & General only covered full mastectomy from its introduction in May 2010 until they switched to any form of surgery in August 2012. Similarly Friends Life only covered full mastectomy between February and December 2011 before additionally covering lumpectomy and segmentectomy. Ageas introduced the same upgrade in January 2013 having offered mastectomy only cover since September 2008, a period during which it was not an additional payment but reduced the main sum assured by the amount paid out.

Another area of change is what type of early stage cancer is covered. When LV= first introduced this partial payment in April 2012 it only included ductal carcinoma in situ. In May of this year its definition altered to encompass both ductal and lobular carcinoma in situ.

In the race to be best or sell most products the various insurers have developed their own variations of cover and the claims wordings can be massively different in their impact and at CIExpert we are careful to ensure that any plan comparisons fully reflect the extent of any cover limitations.

Carcinoma in situ

What does this actually mean? If you consider the Ageas plan it means ductal carcinoma but excludes lobular. Lobular carcinoma accounts for 9 per cent of all non-invasive breast cancers, with ductal carcinoma accounting for 83 per cent so any definition that limits cover to ductal and lobular will only cover 92 per cent of instances, those that simply state ‘carcinoma in situ’ will cover 100 per cent.

What Treatment Is covered?

Some plans are restrictive in various ways whilst others allow any form of surgery. Again, the importance of this cannot be over-emphasised. Latest figures confirm that full mastectomy was used in only 47 per cent of instances with lumpectomy, segmentectomy and other surgical variants being preferred for breast conserving purposes. These alternative procedures account for the remaining 53 per cent.

Of those companies offering this cover only Aegon insists on covering full mastectomy only.

What Is paid?

Payments vary from £12,500 to £25,000 and 12.5 per cent to 50 per cent.

Of the providers currently offering this cover Skandia is the only one which covers all types of early stage breast cancer and provides up to £25,000 payment.

The table highlights the current situation which will almost certainly mutate before many weeks have passed.

Level of cover for partial payments for breast cancer by provider. Source: CIExpert
  Ductal carcinoma in situ Lobular carcinoma In situ Any carcinoma in situ Mastectomy only Also Includes lumpectomy Covers any surgery Maximum payment

Aegon

Yes

Yes

Yes

Yes

No

No

£20,000/20%

Ageas

Yes

No

No

No

Yes

No

£25,000/50%

Aviva

Yes

No

No

No

Yes

Yes

£20,000/20%

Beagle Street

B Grey (Menu)

Yes

No

No

No

Yes

No

£20,000/15%

B Grey LPP

Foresters Life

Friends Life

Yes

No

No

No

Yes

No

£12,500/12.5%

HSBC

L&G

Yes

No

No

No

Yes

Yes

£25,000/25%

LV=

Yes

Yes

No

No

Yes

Yes

£12,500/12.5%

NFU Mutual

Scottish Prov

Yes

No

No

No

Yes

No

£20,000/15%

Scottish Wids

Skandia

Yes

Yes

Yes

No

Yes

Yes

£25,000/25%

Zurich (gtd)

Yes

Yes

Yes

No

Yes

No

£20,000/15%

Zurich (rev)

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