“Secondly, there are stipulations for 'pre-cancerous conditions'. The rise in cancer screening and more cancers being picked up at an early stage has led to insurers providing separate wordings for these conditions. Where covered, these are listed as additional payment conditions, as the potential health implications tend to be much less severe than those seen with an invasive cancer.”
Across the market, all critical illness plans will pay 100 per cent of the sum assured if a client meets its main cancer definition.
Vitality’s Serious Illness Cover (SIC) is slightly different as the amount paid depends on the severity of the diagnosis.
Unless the plan includes booster or is based on Mortgage SIC (which will both result in 100 per cent of the sum assured being paid for stage one to four cancers), Vitality will pay the following amounts:
- Stage one – 25 per cent of the sum assured
- Stage two – 50 per cent of the sum assured
- Stage three or four – 100 per cent of the sum assured
Vitality do, however, offer progressive claims. This means that if the cancer progresses to a later stage, Vitality will pay a second claim based on that level of severity.
Cancer in situ (CIS)
Advisers will be familiar with the term cancer (or carcinoma) in situ as most critical illness plans cover at least a couple of variations of these. As our doctors explain, a cancer in situ is essentially a pre-cancerous condition:
“Pre-cancerous conditions are not cancers, but the cells appear abnormal when they are looked at under a microscope and are more likely to progress into a cancer than normal cells would. This can be given different names, although they share very similar meanings. Many are listed as exclusions by insurers:
- Pre-malignant
- Borderline malignancy
- Low malignant potential
- Cancer in situ
“A cancer in situ, for example, is often referred to as stage zero, when the cells have not invaded surrounding tissue and are therefore only found in the place where they first formed.”
Most common cancer in situs in the UK
In comparison to stage one to four cancers, pre-cancerous conditions are less prevalent. Below, we highlight the number of cases of the top five cancer in situs for males and females.
Females
| Location of Carcinoma in Situ | Number of cases |
| Cervix | 20,978 |
| Breast | 7,014 |
| Melanoma (skin) | 3,164 |
| Bladder | 2,035 |
| Colon and rectum | 1,229 |
Males
| Location of Carcinoma in Situ | Number of cases |
| Bladder | 6,335 |
| Melanoma (skin) | 3,225 |
| Colon and rectum | 1,960 |
| Renal pelvis (part of the kidney) and ureters | 758 |
| Oesophagus | 295 |
How do critical illness plans cover cancer in situs?
These are relatively small numbers when considering that there were 156,444 and 149,239 diagnosis of invasive cancers in males and females respectively in the same year, but it is often where insurers vary in their overall coverage for cancer or potential cancer, as our doctors explain:
“The overall number of cases shown above only tell part of the story, as there are stipulations in the wordings of policies that often significantly restrict successful claims. For example, although cervical CIS has very high diagnosis rates, claims will only be approved if aggressive forms of treatments are used (for example, a hysterectomy), which is done rarely.
