New Critical Illness (CI) definition | Is it better to buy NOW?

If you have an existing critical illness policies, it will NOT be impacted by the new definitions.

Read till the end to see my analysis on differences and if you should buy your CI policy now from your adviser!

What are the key changes from the Previous 37 Critical Illness Conditions

Analysis of the key changes by understanding the TOP 5 CI claims

Do you know that 90 per cent of all severe stage claims received by life insurers are for five critical illnesses:

  1. major cancer
  2. heart attack of specified severity
  3. stroke with permanent neurological deficit
  4. coronary artery bypass surgery
  5. end-stage kidney failure.

This part is to examine how the new definitions reduce ambiguity.

1) Major Cancer:

It is now specified that: "Major Cancer diagnosed on the basis of finding tumour cells and/or tumour-associated molecules in blood, saliva, faeces, urine or any other bodily fluid in the absence of further definitive and clinically verifiable evidence does not meet the above definition".

There are cancer marker tests these days using body fluids but the conclusion is often with a scan. This is to specify that conclusive proof is needed not that it wasn't already previously.

In the exclusions list, MORE has been explicitly stated. I'd highlight two of them

A) Carcinoma-in-situ (Tis) or Ta;

Below is an image (on bladder cancer) to possibly help you understand more on Carcinoma in situ (Tis) or Ta since it is is common these days.

Carcinoma in situ (also called CIS or Tis) means very early, high grade cancer cells. It is a non invasive cancer of the flat urothelial or transitional cells. Source

Ta is now explicitly stated to be excluded moving forward.

cancer carcinoma

B) All grades of dysplasia, squamous intraepithelial lesions (HSIL and LSIL) and intra epithelial neoplasia.

This is to specifically state because dysplasia, squamous intraepithelial lesions (HSIL and LSIL) and intra epithelial neoplasia requires further testing.

Previously, the exclusion explicitly stated was only Cervical Dysplasia CIN-1, CIN-2 and CIN-3. NOT that HSIL and LSIL was previously payable.

2) Heart Attack of specified severity

The new definition is Death of heart muscle "due to ischaemia" vs "due to obstruction of blood flow". Medical professionals use Ischaemia and medically it is the same thing.

LIA specified that it replaced “obstruction of blood flow” with “ischaemia” to reflect the intent to cover Type 1 MI and Type 2 MI.

I did some further reading and there is Type 3 MI which is actually for deaths due to heart attack before conclusions can be made.  (source).

In any case, death to the patient happened before the CI survival period so it is not for discussion here.

3) Stroke with Permanent Neurological Deficit

From LIA: Deleted “with persisting clinical symptoms” as not necessary.

In my opinion, this simply is one less criteria which is good for claiming.

From LIA: Sometimes, after a cranial surgery, the pathological analysis of the resected tumour could show signs of “intra tumour” bleeding. Whilst there is intracranial or cerebrovascular bleeding, it is not a valid claim under the Stroke definition.

This is to remove ambiguity (by explicitly putting into exclusions) in my opinion for patients who exhibit stroke like symptoms due to cranial surgeries. 

4) Coronary Artery By-pass Surgery

No changes made.

5) End stage kidney failure

LIA changed header to reflect intent of end stage.

When will changes for the NEW Critical Illness (CI) definition take place?

From 26 August 2020, CI products using Version 2014 definitions may no longer be sold in Singapore.

New CI products introduced before 26 August 2020 may adopt either Version 2014 or Version 2019 definitions according to LIA.

The following is the NEW industry list of 37 critical illness conditions.

  • Major Cancer
  • Heart Attack of Specified Severity
  • Stroke with Permanent Neurological Deficit
  • Coronary Artery By-pass Surgery
  • End Stage Kidney Failure
  • Irreversible Aplastic Anaemia
  • End Stage Lung Disease
  • End Stage Liver Failure
  • Coma
  • Deafness (Irreversible Loss of Hearing)
  • Open Chest Heart Valve Surgery
  • Irreversible Loss of Speech
  • Major Burns
  • Major Organ / Bone Marrow Transplantation
  • Multiple Sclerosis
  • Muscular Dystrophy
  • Idiopathic Parkinson’s Disease
  • Open Chest Surgery to Aorta
  • Alzheimer’s Disease / Severe Dementia
  • Fulminant Hepatitis
  • Motor Neurone Disease
  • Primary Pulmonary Hypertension
  • HIV Due to Blood Transfusion and Occupationally Acquired HIV
  • Benign Brain Tumour
  • Severe Encephalitis
  • Severe Bacterial Meningitis
  • Angioplasty & Other Invasive Treatment for Coronary Artery
  • Blindness (Irreversible Loss of Sight)
  • Major Head Trauma
  • Paralysis (Irreversible Loss of Use of Limbs)
  • Terminal Illness
  • Progressive Scleroderma
  • Persistent Vegetative State (Apallic Syndrome)
  • Systemic Lupus Erythematosus with Lupus Nephritis
  • Other Serious Coronary Artery Disease
  • Poliomyelitis
  • Loss of Independent Existence

Why the changes to CI definitions?

I've a colleague whose client had CI policies with 2 insurers.

For a heart condition, one paid and one didn't. Despite successfully claiming from one, the policyholder was still severely dissatisfied that the other didn't pay.

These changes mentioned above is to further standardise definitions and avoid differences in definition applied for severe stage of the 37 common critical illnesses.

Hence, it gives you greater "fairness" in claims because what a patient/layman think is claimble and what a doctor and insurer interprets is often different.

Conclusion: IMO it is an exercise to remove ambiguity 

As medical science advances, new medical definitions come up all the time.

This means things that were clear cut last time are not so these days.

Another example of the CI definition change is to "10) Deafness (Irreversible Loss of Hearing)".

With scientific developments, some cases of deafness is possibly being able to be restored.

The most important message is that LIA is committed to reviewing CI definitions possibly to reflect medical changes and REDUCE ambiguity as they arise.

From that perspective, it is a plus for you and to all consumers!

Why should you buy critical illness NOW if you have a shortfall!

BUT new definitions or old being better is not the REAL QUESTION.

Moreover, there will likely be another "revised new definition" a few years later again.

If you have a shortfall in coverage, get insured NOW because critical illness (CI) can impact you from a sudden disease or a sudden trauma.

In addition, there is usually a further 90 day waiting period from your policy before you can claim for Critical illness (CI). Hope it helps.

Disclaimer: O&E omission. Please refer to LIA website for accurate information

Last updated on October 24th, 2019 at 03:04 pm

Josh Tan Jian Liang (CHFC) Principal Author

REVIEWS: https://theastuteparent.com/josh-tan Practising financial planner with Promiseland Independent Pte Ltd. EXPERIENCE: More than 13years. Josh Tan is a young parent, speaker, author and founder of TheAstuteParent.

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