Health Insurance No Remedy For Some Breast Cancer Patients

Critical illness policies, as part of health insurance coverage, are held by an estimated two million women and are designed to pay out on the diagnosis of serious diseases, including cancer.

However, in the 3,000 and more cases where women are diagnosed with a form of breast cancer, the policy is of no consequence, offering no support when the woman in question is forced to undergo a mastectomy, endure chemotherapy and as a result of continuing ill health over 18 months or more, loses both her income and her home. Insurers defend this bizarre policy, or lack of, by asserting that the costs incurred due to the frequency with which the condition is diagnosed and the number of women it affects, would be too much.

This form of cancer arises more and more frequently as the screening process has been improved and the likelihood of needing major surgery, including breast removal, when a woman is treated for breast cancer is an expense for which most insurance companies are not prepared to take financial responsibility. Moreover, this particular form of breast cancer called ‘ductal carcinoma in situ’ (DCIS), which develops in the ducts of the breast, is a relatively early stage of the disease and can therefore be treated successfully in the majority of cases. Consequently, insurance companies do not term it as a critical condition regardless of the lengths to which a patient may have to go to have it treated, in addition to the significant physical loss which a woman must endure, and would feel the need for some form of compensation.

Moreover, the majority, if not all, the women who have been affected by this, and other forms, of breast cancer will undoubtedly perceive the illness as critical, with some patients possibly being forced to delay treatment as a result of their insurer’s standpoint, against the advice of their surgeon and GP, due to financial reasons. The delay would inevitably allow the cancer to spread, placing the patient in a worse and more life-threatening position and yet, ironically, qualifying them to make a claim on their health insurance.

Although exclusions in insurance policies may be clearly highlighted to make the policyholder aware upon purchasing the cover that some eventualities are not included, it is unfair that when faced with the fact that they have contracted the one, out of a small few diseases, they do not have any protection from their insurance companies from the costs they will have to pay for treatment. A spokeswoman from the charity Breast Cancer Care stated that the status of DCIS as cancer was actually questionable, Tara Beaumont ascertained that while the breast cells inside the ducts begin to change and are cancerous, because the cells in the tissue outside the ducts have not yet shown signs of being malignant, the condition cannot be authoritatively termed ‘cancer’. The ‘in situ’ status assigned to this condition is often labelled by doctors as ‘pre-cancer’, which they go on to describe as a non-invasive cancer, even though they will more often than not be expected to undergo major surgery.

One insurance provider, Skandia, will pay out around £10,000 to policyholders who are forced to undergo mastectomies as a result of contracting the condition.