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Why tick-box cancer insurance does not work

Cancer sufferers are paying the price of the travel insurance industry's simplistic approach to risk assessment, argues Victoria Bischoff.


by Victoria Bischoff on Jul 31, 2012 at 14:31

Why tick-box cancer insurance does not work

It’s well-known that one in three people will be diagnosed with cancer during their lifetime.

Yet despite this, people who have or have had cancer are still struggling to find affordable travel insurance – even if they finished their treatment years ago.

Cancer is complex

There are more than 200 types of cancer, according to Cancer Research. But because everyone’s genes are different, no two cancers are the same, so you could say there are as many different types of cancer as there are people, the charity added.

As a result, assessing what risk a cancer sufferer poses is a complicated process. Or at least it should be.

Unfortunately, many insurance companies use a simplified tick-box system to calculate the risk. Doing this enables them to offer their services through price comparison websites, but it comes at a price.

Fiona Macrae, who set up specialist travel insurance company Insurancewith after being diagnosed with breast cancer, said she created her company to tackle this 'tick-box culture’.

‘When I went through my treatment for breast cancer, I became frustrated after being unable to find a travel insurance policy at an affordable premium,’ she explained. ‘The systems were far too rigid and one extra tick in a box can load your premium by 200-300%.’

Insurers are asking the wrong questions

Macrae explained that a typical question might be: how many times have you been to see a doctor this year? Using price comparison website Moneysupermarket you can see how your answer to this question could result in a £1,000 price difference.

Take 55-year-old ‘Joan’. Joan was diagnosed with breast cancer in 2006 and later had a relapse involving her liver. Her treatment is finished, and she has her oncologist’s consent to travel to Spain for a 17-day holiday.

According to Moneysupermarket, the cheapest premium available is £1,024. If Joan were to change the number of visits she made to the doctor from three to four or five, however, the cheapest quote increases to £1,363. Over five visits a year and the cheapest quote jumps to £2,124.

Macrae argues that the number of times you see your doctor has no relevance to how well you are. ‘I, for example, still see someone about my cancer three times a year, and I was diagnosed over seven years ago. That does not mean I am unwell, it’s just what my treatment programme is,’ she said.

Another question commonly asked by insurers is: are you on any strong pankillers? But what is the definition of 'strong'? ‘Such questions are loose, ill-devised and leave plenty of room for misinterpretation,’ said Krish Shastri, of specialist insurer Insurecancer.

The price does not reflect the risk

Alasdair Watt, of cancer support charity Macmillan, is also critical of the current screening process used by insurers. ‘It is a crude way of assessing people’s medical conditions,’ he said. ‘We need a more accurate and sophisticated pricing of risk.’

Watt pointed to the example of a 40-year-old woman diagnosed with Hodgkin’s Lymphoma at 17 who has not had a recurrence since. She was still being quoted premiums almost double the normal amount, and one insurer said she was such a high risk that she nearly had to refuse her insurance altogether.

‘We understand insurance is a risk-based industry, but we don’t agree that premiums quoted accurately reflect the risk of the medical condition,’ Watt said.

Earlier this summer travel insurance specialist All Clear said it had become the first to ‘drastically cut’ its premiums for people diagnosed with breast cancer.

Under its new pricing, a 55-year-old woman diagnosed with breast cancer two and a half years ago would pay from £100.36 for cover for a 17-day trip to the USA – widely regarded as one of the priciest places for cancer patients to visit.

However, Macrae pointed out that this is still a huge premium. It’s also a very carefully selected example, as if the patient’s cancer had spread she would have been quoted £1,461. That is just not affordable for most people – and as most companies use the same tick-box tool, they usually all arrive at a very similar price.

In contrast, Insurancewith would have quoted the same woman just £48.70, or £87.44 if the cancer had spread, she said. ‘This is because we ask more questions during our medical screening process so can assess the risk properly,’ Macrae said.

Denied cover

Some cancer patients, meanwhile, are unable to get cover at all. In instances where the cancer has spread most insurers – even specialist companies for people with medical conditions – will often refuse to give a quote.

Helena Oliver (pictured), who was first diagnosed with breast cancer three years ago and is now undergoing treatment for secondary cancer, described trying to find insurance for a family holiday to Florida with her husband and six children as a ‘horrific’ experience.

After 15 or so calls to travel insurers she was on the verge of giving up. ‘They’d ask questions like ‘have you had a terminal diagnosis?’ ‘How many months have you got left to live?’ ‘I felt in despair,’ she said.

‘I understand that insurance companies are not charities, but there was no individualisation. It made me feel like I had been put in a box of no-hopers’.

Like many in this situation, Oliver and her family almost decided to travel without insurance. But if she had needed medical treatment she would be looking at a bill for thousands that could have bankrupted her family.

After writing to Richard Branson of Virgin for help, Branson's PA eventually put Helena in touch with InsureCancer, who after discussing her treatment in detail agreed to insure her.

Problems claiming

Watt also highlighted problems people have when claiming on their policy. ‘It seems that insurance companies’ default reaction is to not pay out – often for a spurious reason,’ he said.

Shastri, meanwhile, raised concerns about the lack of certainty ‘tick box’ screening offers those traveling with serious medical conditions such as active cancer.

It’s too easy for an insurer to void someone’s policy should they need to claim, Shastri explained. If a customer makes a mistake and ticks four visits to the doctor instead of five the insurer can refuse to pay out a claim on the basis of ‘non-disclosure’.

New legislation designed to put the onus back on the insurer to ask the right questions does not come into effect until next year.


‘Cancer is no longer always an end-of-life scenario,’ Alasdair said, which means there is a fairly large market that insurers are missing out on because most people are travelling uninsured or not travelling.

The insurance industry has an opportunity to make a contribution to the lives of cancer sufferers – to give someone a last hug with their grandchild. The only question is whether they'll take it.       

16 comments so far. Why not have your say?

White Stick follower

Jul 31, 2012 at 18:24

It's not merely cancer. Although my premium for a week in Tenerife, excluding personal property already covered under my House & Contents policy, were not too bad at £72 for a fit 71 years old, I had massive excesses loaded on to the policy, as because of rectal bleeding and a subsequent colonoscopy during which a tiny polyp was removed together with a dozen tissue samples, which were all cancer negative after histology, the fact that I have had colitis in the past and have diverticular disease which at my age is far from unusual a £1500 excess was applied to any GI problems. I asked if, for example I suffered food poisoning whilst away, would that be outside of the excess as it is a normal risk in no way connected to my GI problems and was told no- anything that affected the GI system carried that loading. I have BPH- again at my age probably 80% of the male population have it, no cancer at all- that created a £1K excess. Work related stress causing chest pains, over many years, which has been explored with several cardiac tests- all indicating no cardiac problems has a £5K excess. I have been retired for 11 years without any problems- no stress, no symptoms.

So if you follow up symptoms and get a clean bill of health & tell the truth you get 'clobbered' pretty much the same as if you omit medical problems and fall ill.

Remember the old Insurance industry advert' Get the strength of an Insurance policy round you'. What it really means is give us your money, but don't expect us to pay anything.

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Prof Eman

Jul 31, 2012 at 19:45

It is not just insurance Companies that are guilty.

I am a member of the Caravan and Camping Club, to pop abroad on occasion in Europe. Every year for some 20 years or so I took out a Multi-trip annual insurance, to facilitate popping across at a short notice. I have a mild asthma controlled by puffers for about as many years. Never made a claim, under any policy, nor attended hospital since the problem was diagnosed.

This year wanted to renew my policy.

The basic policy cost was the same as last year, but Europe Assistance, wanted to up my medical condition premium from £9.70 to £190, a multiple of over 19 times.

I refused to pay it and next was advised by letter that there would be an exclusion, for asthma, and further that the exclusion covered-ANY associated conditions, including but NOT limited to bronchitis, chest infection, pneumonia, chronic obstructive airways disease although I do not suffer from them.

I have written to the Caravan and Camping Club, complaining, and await their reply.

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derek farman

Aug 01, 2012 at 10:59

Agree totally with the article . But it goes further than that . Why do insurers load premiums if one takes low level precautianary pills to keep cholesterol and blood pressure at recommended levels. Why also load for us older folk who in many cases are much fitter than the many many overweight younger people.

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Prof Eman

Aug 01, 2012 at 12:20

Further to my earlier comment, I have now gone on line and found out that Europ Assistance after a management buyout has become Aria Assistance which is part of Aria Insurance Services Ltd.

Enough said.

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Prof Eman

Aug 02, 2012 at 16:58

Have now been contacted by Europ Assistance and have been advised that the reason for the increase from £9.70 to £190 is that last year I advised that the asthma started before I was 50, and this year they put me down as starting at over 50. I advised that it was such a long time ago that I did not know when it had started. Tomorrow I will see my doctor to find out.

Talk about tick boxing.

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Peter Jobling

Aug 03, 2012 at 10:08

It's all a con. Our son was diagnosed with bowel cancer last year. After 9 months of chemo and a major operation he has been given the 'all clear', thank God. He is back playing soccer and tennis, but wants to visit America.

What is the cancer risk in the fortnight he will be in America? What is likely to happen that would stop him flying home?

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derek farman

Aug 03, 2012 at 11:11

Peter Jobling ..... infuriating isn't it . However, should we be surprised. This is how our children are educated these days. Multiple choice, ticking boxes.

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Prof Eman

Aug 04, 2012 at 18:39

Been to the doctor's.

They could not tell me when my asthma started.

Their computerised records go back to year 2000. As it was before year 2000 they will have to check the manual records previous to that to advise the date.

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Aug 06, 2012 at 19:17

Hugely encouraged by the headline I got my friend to call Insurancewith. At the end of the call she tearfully said that they too are ticking boxes! We feel totally deceived! Fiona Macrae should be ashamed of herself, trying to deceive cancer patients in this way.

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Prof Eman

Aug 22, 2012 at 11:43

Managed to sort out my problem.

I was under 50 when my asthma symptoms started, so my extra premium is £9.70 for the declared medical condition.

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White Stick follower

Aug 22, 2012 at 12:01

Prof Eman, No doubt you understand the Insurers argument, but I don't. You have a mild condition which has never caused any problems over a significant number of years, but the insurers want an extra premium. I have had slight asthma for endless years,and that has never caused any problem, not even when I was an active athlete. My insurers have never loaded my premiums or applied excesses in respect of this.

As we all know asthma is on the increase due, most probably to increased air pollution, and indeed a great many children suffer it from a very early age, so it looks as though umpteen children will be charged extra premia if going on holiday abroad, and that 90+% will never need any medical attention whilst away. So its just another 'scam' from the insurance industry.

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Prof Eman

Aug 22, 2012 at 15:42

White Stick follower

The insurance I take out with the Caravan and Camping Club is a multi-trip insurance which lasts a whole year. As I have never claimed for an asthma condition in my life, the premium is in my opinion is unnecessary. But given that it is £ 9.70 for a year it is bearable.

The thing I do not understand is why it jumps from £9.70 below age 50 to £190 when over 50. I have asked the C&CC club to investigate.

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White Stick follower

Aug 22, 2012 at 16:01

Seems to me a typical insurance company 'rip off'. If you tell them you have, have had, or might have a defect they hike the premium or apply a loading. Some of my conditions have been investigated and found not to be a concern, but insurers promptly use the investigation to load the policy. As I mentioned before, any one might get food poisoning at home or abroad. In my case that is totally unconnected to my GI conditions, other than the infection would be initially within the GI system, but those conditions are loaded - including food poisoning. I checked and queried, but no change of position.

As for your colossal premium jump, I think I'd look elsewhere. There's nothing rare about asthma, and in your case it has never been a problem. The only thing that is fairly rare about asthma with someone who has the usual medication is asthma creating a life threatening attack.

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Prof Eman

Aug 22, 2012 at 16:26

White Stick follower

Fortunately for me, I got it before I was 50, so the premium is £9.70.

Just to explain why I got it, we got a dog at the time, and it was found that I was allergic to dogs.

If it was not for that, I might have never got it.

Fortunately it was so mild, that we continued with the dog a lovely collie cross from the PDSA.

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White Stick follower

Aug 22, 2012 at 16:40

Good for you. A dog is a good friend, listens intently and never answers back! As for insurers I think I've said it all. Good luck.

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Prof Eman

Aug 23, 2012 at 10:03

White stick follower

Good luck and good health to you always.

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