In-Depth Guide on Cancer Insurance

Cancer is considered to be the deadliest disease in the entire world. As per World Health Organization (WHO), nearly 10 million people died of cancer. WHO also stated that around one-third of cancer deaths are due to tobacco consumption, high BMI, alcohol consumption, and lack of physical activity. Cancer patients can be cured if detected early and treated effectively. But the treatment cost of cancer has been rising potentially. Here, cancer insurance plays an important role by offering financial protection right from the date of diagnosis of cancer. Medical expenses like hospitalization, chemotherapy, radiation, surgery, etc., will be covered by the insurance.

What is Cancer Insurance?

Cancer insurance is a type of health insurance policy that is designed to offer financial help to the insured who are diagnosed with cancer after the waiting period mentioned in the policy document.

How Does Cancer Insurance Work?

Cancer insurance works as follows:

1. The customer purchases a cancer insurance policy for a specified period by paying the premium.
2. After the waiting period, if he is diagnosed with pre-cancer or early-stage of cancer, then a pre-determined lump-sum amount will be payable.
3. Usually, insurers waive off the future premium and the policy continues to exist.
4. If the disease enters the next stage, the balance sum insured will be paid to the insured.
5. In case, the cancer is diagnosed at the major stage, he will receive the entire amount of the sum insured.

Benefits of Cancer Insurance:

1. The insurance policy provides coverage at multiple cancer stages:
   • Pre-cancer stage (Carcinoma-in-Situ)
   • Early Stage of Cancer
   • Major Cancer Stage
2. A Lump-sum amount is payable at the time of diagnosis. It will be a pre-determined percentage of the sum insured.
3. If the disease enters the next stage, the balance sum assured will be payable.
4. Usually, the future premium of the policy cover will be waived off while the policy continues.
5. The sum insured increases by a pre-defined percentage in cases where the policyholder does not claim during the year.
6. Premium paid will be exempt from tax under Section 80D of the Income Tax Act.

Exclusions of Cancer Insurance

The following diseases will not be covered :

1. Cancer resulting from pre-existing conditions
2. Cancer diagnosed or found during the waiting period
3. Cancer caused by sexually transmitted diseases, HIV, AIDS
4. Skin cancer
5. All prostate tumours having Gleason score less than 6
6. Thyroid’s papillary micro-carcinoma less than 1 cm in diameter
7. Less than RAI stage 3 chronic lymphocytic leukaemia

There can be more exclusions to the insurance policy. Carefully read the terms and conditions of the policy.

When Should a Person Buy an Insurance for Cancer?

You must consider an insurance policy for cancer when:

1. There is a family history of cancer
2. You believe that there is a high risk of developing cancer (Due to environmental or other reasons).
3. Your regular health insurance plan does not cover cancer.
4. You are the breadwinner of the family.
5. You do not have savings or sufficient financial backup to pay medical bills.

What is the Claim Process of Claim?

Notify your Insurer: Inform your insurer about the diagnoses within a reasonable time (usually, 7 days). Intimation should not be delayed for more than 30 days.

Submit the claim form along with the necessary documents: Fill the claim form and submit it along with the following documents to the insurance company:

• Medical certificate
• Prescriptions
• Investigation reports
• Other procedure reports like radiology

After receiving the claim form, the insurance company will appoint a surveyor to investigate the case.

If the claim approves, the insurance company will transfer the claim amount to the bank account of the insured.

If the claim gets rejected, the company will send a claim rejection letter stating the reason for the claim rejection. Read the letter carefully. If the insured finds the claim to be genuine, then he can reapply for the claim. If you need help, you can approach Insurance Samadhan.*

Read how Insurance Samadhan Helped a Cancer Patient to Get His Claim Money

Shreya had a family history of cancer due to which she bought an insurance policy for cancer with a tenure of 20 years. After five years, she was diagnosed with breast cancer. Her family notified the insurance company about the diagnosis.

Her claim was rejected by the insurance company. The family has been stressed due to cancer and the rejection of the claim increased the stress level. They lost hope of getting the reimbursement amount.

Later, they came to know about Insurance Samadhan. They approached us with the case. After verifying the case, we concluded that it was a genuine case and the claim was rejected because of the non-submission of necessary documents. We guided the family with the case. The case was resolved within few months.

If you have taken an insurance product and are facing issues related to it, then you can approach Insurance Samadhan. We have resolved 14500+ insurance complaints like claim rejection, delay in the claim, mis-selling and fraud in insurance.

*Insurance Samadhan is a private organization and has no association with IRDA or any Government body.

Frequently Asked Questions

1. Can you get cancer insurance if you already have cancer?

No. If you already have cancer, you cannot get a cancer insurance policy.

2. Is cancer covered in life insurance?

Yes, if you buy a life insurance policy before your cancer diagnosis, passing away from cancer during the tenure of the policy may be covered. Read the terms and conditions of your policy document to know whether your life insurance policy covers cancer or not.

3. Is chemo covered by insurance?

Yes, all cancer insurance plans cover chemotherapy.

Click on the below links to read some cases resolved by Insurance Samadhan:

Dengue Claim Rejection

Mis-selling in a life insurance policy