If you don’t already know it, you should. There will be a major change in how insurers define various critical illness conditions for all life (wholelife and term) policies from 26 Aug 2020, which is barely 2 months away. So how do these changes impact you?
The changes in CI definitions are mainly to address ambiguities in how various conditions are defined and deemed payable. This arose out of medical advances, which revealed certain vagueness in previous definitions. However, this change will only impact new policies issued after 26 Aug 2020. All plans issued before that will not be affected and existing clients will still be subject to the old definition.
There are certainly pros and cons to this change for clients and consumers.
PROS
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1. Clients will have greater clarity on what their policies will or will not cover. This should lead to less arguments over why various claims are not payable.
2. Additional CI cover conditions not covered previously.
CONS
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1. With increased clarity, it also means that claimable criteria is more stringent or more specific. With the old definitions, it can be more easily argued why a certain claim should be allowed as the definitions were not so specific. With the new definitions, what could potentially be covered now, may not covered anymore.
2. Claimable criteria can be considered as having shrunk since the conditions for claims are spelt out more specifically and anything not within the more narrow definition, will not be covered.
3. Some additional exclusions made to reflect less serious conditions which should not be covered.
Some examples of the major changes that will be made include:
| Category | New added definitions | New Exclusions | Rationale |
|---|---|---|---|
| Cancer | "Major Cancer diagnosed on the basis of finding tumour cells and/or tumour-associated molecules in blood, saliva, faeces, urine or any other bodily fluid in the absence of further definitive and clinically verifiable evidence does not meet the above definition" added to the definition." | Skin confined primary cutaneous lymphoma and dermatofibrosarcoma protuberans" is specifically excluded now. All Neuroendocrine tumours histologically classified as T1N0M0 (TNM Classification) or below; All bone marrow malignancies which do not require recurrent blood transfusions, chemotherapy, targeted cancer therapies, bone marrow transplant, haematopoietic stem cell transplant or other major interventionist treatment | Excluded conditions are not severe enough to meet criteria of severe stage coverage. |
| Heart Attack | Death of heart muscle due to ischaemia. | Replaced “obstruction of blood flow” with “ischaemia” to reflect the intent to cover Type 1 MI and Type 2 MI. | |
| Stroke | Stroke with Permanent Neurological Deficit | Secondary haemorrhage within a pre-existing cerebral lesion. | Changed to reflect intent. |
| Kidney Failure | End Stage Kidney Failure | Changed to reflect intent. | |
| Aplastic Anaemia | Irreversible Aplastic Anaemia | Changed to reflect intent. | |
| Coma | Medically induced coma and coma resulting directly from alcohol or drug abuse are excluded. | For clarity. | |
| Deafness | Deafness (Irreversible Loss of Hearing) Irreversible means “cannot be reasonably restored to at least 40 decibels by medical treatment, hearing aid and/or surgical procedures consistent with the current standard of the medical services available in Singapore after a period of 6 months from the date of intervention.” | Changed to reflect intent. | |
| Heart Valve Surgery | Open Chest Heart Valve Surgery | Changed to reflect intent. | |
| Loss of Speech | Irreversible Loss of Speech | Changed to reflect intent. | |
| Parkinson’s Disease | Idiopathic Parkinson’s Disease | Changed to reflect intent. | |
| Surgery to Aorta | Open Chest Surgery to Aorta | Changed to reflect intent. |
Generally consensus for people in the industry is that while the new definitions provide greater clarity, sometimes ambiguity can work to the client’s favour. And this may be one of those times. The old definitions of CI are a lot broader and encompassing, which means coverage is more. Thus, it might be favorable for those who needs to get additional CI cover to do it quickly before the new definitions kick in.
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