How long does it take to process a critical illness claim?

How long does it take to receive a cheque from an insurance payout for critical illness? To the skeptics, do insurance companies actually pay out or will they screen through the contract wordings and make it hard to claim?

Those who have been following this blog will know that I had made a critical illness claim for Major Cancer on 31st May 2017. The definition for Major Cancer is as follow:-

A malignant tumour characterised by the uncontrolled growth and spread of malignant cells with invasion and destruction of normal tissue. This diagnosis must be supported by histological evidence of malignancy and confirmed by an oncologist or pathologist. The following are excluded:
• Tumours showing the malignant changes of carcinoma-in-situ and tumours which are histologically described as pre-malignant or
non-invasive, including, but not limited to: Carcinoma-in-Situ of the Breasts, Cervical Dysplasia CIN-1, CIN-2 and CIN-3;
• Hyperkeratoses, basal cell and squamous skin cancers, and melanomas of less than 1.5mm Breslow thickness, or less than Clark
Level 3, unless there is evidence of metastases;
• Prostate cancers histologically described as TNM Classification T1a or T1b or Prostate cancers of another equivalent or lesser
classification, T1N0M0 Papillary micro-carcinoma of the Thyroid less than 1 cm in diameter, Papillary micro-carcinoma of the
Bladder, and Chronic Lymphocytic Leukaemia less than RAI Stage 3; and
• All tumours in the presence of HIV infection.

A Major Cancer claim needs to be supported by the pathology or histology report. It states a few things such as the size, type of the cancerous cells and the diagnosis. The pathology report was received on the 20th Jun 2017 and submitted to the insurer on the 21st Jun 2017.

The payout was made on 20th Jul 2017. 20170731_171416

In most cancer claims that were rejected were due mainly to the first and third points of the exclusion list stated above which in layman terms means stage 1 or 2 cancer.  That is also the reason some financial advisers encourage taking up Early Stage Critical Illness policy instead or in additional to the usual Advance Stage Critical Illness policy.

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About Kim Heng
Independent Financial Adviser, Group Director kimheng@avallis.com

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