Private medical insurance should be clearer about cancer cover

13 June 2008 / by Joy Tibbs
Private medical insurance providers have been criticised by Mercer and cancer charity Cancerbackup for not offering enough transparency on cancer insurance policies.

Entitled ‘Covering Cancer: Survey of Corporate healthcare Private Medical Insurance(PMI) providers', the study surveyed 11 major PMI providers in the UK to assess each firm's main corporate medical insurance policies for cancer. This covered issues such as the scope and standard of cover, treatments included within the cover, and limits on cover.

Principal in Mercer's health and benefits team, Steve Clements, said: "One in three people in the UK will be diagnosed with cancer at some stage in their life. Some of the new and sometimes expensive treatments which are now emerging are, as yet, unavailable through the NHS. So, understandably, cancer cover is an area of focus for companies purchasing private healthcare.

"PMI providers are using it to differentiate themselves from their competitors. Whilst there have been substantial improvements, there is continued ambiguity over what is and isn't covered in some cases. Eligibility rules for chronic conditions, for example, can sometimes mean cancer treatments will effectively be excluded or cut short. Transparency and clarity must be improved."

He added: "New therapies are coming into the market. Some of these will lead to long-term treatments where the goal is to slow the spread of the disease, prolong life or improve the quality of life by easing the symptoms, rather than to cure. PMI providers must be clearer about whether or not these will be covered in their policies."

Most of the PMI providers surveyed said they did not cover palliative care or treatment for terminal cancer. Some, however, were less specific; instead of terminating cover when the cancer reaches a certain stage, they apply eligibility rules to specific cancer treatments so they fall under the chronic rules and are therefore not covered. Most PMI providers did not actually define cancer as a chronic condition.

Head of cancer support services at Cancerbackup, Derryn Borley, said: "It's not imperative to buy the most expensive cover but there should be total clarity on what is and isn't covered.

"There should be clear and seamless mechanisms in place to transfer the treatment from private care into public care and back into private when necessary. Ultimately, the patients' treatment should not be compromised."

©Fair Investment Company Ltd