Benefit is based on Altrisk director’s personal experience

Altrisk developed its additional benefit for stage zero cancer following its underwriting director’s personal experience of pre-malignant cancer.

Dalene Allen had a check-up with a dermatologist, who discovered a mole that had to be removed.

The mole turned out to be a melanoma (tumour of melaninproducing cells) and resulted in Allen undergoing a major skin graft and making numerous visits to the dermatologist and a plastic surgeon.

Thereafter, she had numerous tests, screening procedures, scans and visits to a radiologist and a specialist oncologist.

As part of the standard screening procedure, Allen also had to have a chest X-ray, which revealed a shadow on one of her lungs. To determine if the shadow on her lung needed to be treated, Allen had to have a very expensive scan, which was not covered by her medical scheme. Fortunately, her lungs were fine. In total, Allen spent close to are increasing, and people with stage zero cancer are likely to survive the ordeal.

But Altrisk argues that receiving the treatment you need may come at a price, depending on how comprehensive your medical scheme cover is (see “What you can expect your medical scheme to cover for stage zero cancer”, below), and you may have other financial needs while you undergo treatment for stage zero cancer.

Altrisk says that screening tests for stage zero cancer are just as onerous and expensive as those for the more advanced stages of cancer, and the diagnosis may be no less emotionally devastating.

Stage zero cancer does not feature on the Standardised Critical Illness Definitions Project (Scidep) grid drawn up by the Association for Savings & Investment SA (Asisa).

Life assurers who are members of Asisa have agreed to use the grid R70 000 on tests, screenings and surgery. About 75 percent of this amount was recovered from her medical scheme, although Allen had to settle the accounts upfront and there were a good few thousand rands that were not paid by her scheme.

Allen’s critical illness policy did not pay out, because the depth of her melanoma was not severe enough to qualify for a benefit.

Allen then realised that stage zero cancer diagnoses are on the increase, but people may not be covered financially for being diligent and going for regular check-ups.

Had Allen enjoyed the benefit of Altrisk’s add-on benefit for stage zero cancer, she would have qualified for a R50 000 payout on diagnosis.

Altrisk’s stage zero cancer benefit is an ancillary benefit on its critical illness policy.

The benefit covers 17 in-situ carcinomas (cancers that begin in a tissue that lines the inner or outer surfaces of the body), which are to show you, as a policyholder or potential policyholder of a critical illness policy, what they will pay out for each of the four standardised severity levels of the four main critical illnesses. One of the four main illnesses is cancer.

‘MINIMAL INTERVENTION’

Peter Dempsey, deputy chief executive of Asisa, says the purpose of critical illness policies is to provide cover for life-changing events.

Stage zero cancers are not on the grid, because they are seen as “fully curable with minimal intervention and cost”, he says.

However, life assurers are free to offer additional benefit levels should they so choose, Dempsey says.

Dr Peter Bond, Old Mutual’s chief medical officer, says many life assurance companies do offer cover for breast cancer at stage zero in their critical illness policies, but this cover is typically at a lower typically excluded from critical illness policy benefits. It provides a sum assured of up to R100 000 – 50 percent payable on diagnosis with treatment and 100 percent if you need an organ removed.

Allen says the benefit may be improved once the claiming patterns for it are established.

Altrisk says your financial adviser should make sure that you understand what is and is not covered by a critical illness policy, and this includes making you aware that many policies do not provide cover for stage zero cancer. percentage of the sum assured.

As a result of regular check-ups, you may be diagnosed with a stage zero cancer of the breast, bladder or cervix, or a melanoma may be found, Bond says.

However, generally you would be fortunate to be diagnosed with any other cancer at stage zero, because there are no symptoms that would lead to a diagnosis, he says.

If you require surgery as a result of a diagnosis of stage zero cancer, you are likely to be covered by your medical scheme, and surgery results in 99 percent of such cases being cured, Bond says.

Dr Maritha van der Walt, chief medical officer at Discovery Life, says Discovery’s critical illness policies cover breast cancer in-situ that is treated with a mastectomy, as well as prophylactic mastectomies, because of the life-changing effect of such mastectomies.

Discovery Life’s critical illness